DOI: 10.18413/2658-6533-2023-9-3-0-7

Features of intestinal microbiota diversity in elderly patients with metabolic disorders (literature review)

Background: Currently, the proportion of elderly patients is increasing all over the world (more than 20% of patients over the age of 60 in the Russian Federation), most of whom suffer from chronic non-communicable diseases, including metabolic disorders (type 2 diabetes mellitus, obesity, dyslipidemia). Laboratory diagnostic methods (glucose tolerance test, determination of glucose, glycated hemoglobin, total cholesterol, low- and high-density lipoproteins, atherogenic coefficient), widely used by specialists in various fields, are able to make a diagnosis in a timely manner. There are many theories explaining the development of the pathological process in metabolic disorders. In atherosclerotic vascular lesions, endothelial dysfunction and oxidative stress can play an important role. In addition, one of the new mechanisms for the development of pathological inflammation may be the formation of the intestinal microbiota with a predominance of a cluster of bacteria that produce active metabolites (short-chain fatty acids (SCFA) in excess, which are a substrate for gluconeogenesis and lipogenesis, which contributes to a change in glucose metabolism and a decrease in tissue sensitivity to insulin. Also known is the effect of SCFA on the regulation of the synthesis of incretins (GLP-1, DPP-4), the inhibition of which is carried out by modern hypoglycemic drugs. The study of genus-species biodiversity can be a new diagnostic feature that affects the timely correction of therapeutic measures. The aim of the study: To evaluate the biodiversity of the intestinal microbiota in elderly patients with metabolic disorders according to literature sources. Materials and methods: A review and analysis of literature sources in the Scopus, Web of Science, Pubmed databases over the past 5 years was carried out. Results: Data on the influence of the vital activity of the intestinal microbiota confirm its impact on the development of metabolic disorders in elderly patients, including identifying new possible mechanisms for the development of type 2 diabetes mellitus. In connection with the violation of the metabolism of fatty acids in adipocytes and hepatocytes, there is a change in gluconeogenesis. The main cause of metabolic disorders is the active production of SCFA. As a result, there is a modulation of the expression of intestinal cannabinoids that regulate the permeability of the mucous membrane, which leads to a violation of the secretion of incretins. Conclusion: The results obtained indicate the need for an in-depth study of the intestinal microbiota in geriatric patients with this pathology, which may contribute to the identification of new approaches in diagnosis and treatment.

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