2658-6533Research Results in Biomedicine2658-653310.18413/2658-6533-2023-9-3-0-73167Medicine (miscellaneous)<strong>Features of intestinal microbiota diversity in elderly patients with metabolic disorders (literature review)</strong><strong>Features of intestinal microbiota diversity in elderly patients with metabolic disorders (literature review)</strong>ChizhkovPavel A.ChizhkovPavel A.qooleer@yandex.ruLagutinaSvetlana N.LagutinaSvetlana N.svlagutina97@mail.ruKotovaYuliya A.KotovaYuliya A.kotova_u@inbox.ruSyromyatnikovMikhail Y.SyromyatnikovMikhail Y.mihan.vrn@mail.ruPopovVasily N.PopovVasily N.pvn@bio.vsu.ruZuykovaAnna A.ZuykovaAnna A.zuikova@vrngmu.ru20239300

Background:&nbsp;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:&nbsp;To evaluate the biodiversity of the intestinal microbiota in elderly patients with metabolic disorders according to literature sources. Materials and methods:&nbsp;A review and analysis of literature sources in the Scopus, Web of Science, Pubmed databases over the past 5 years was carried out. Results:&nbsp;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:&nbsp;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.

Background:&nbsp;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:&nbsp;To evaluate the biodiversity of the intestinal microbiota in elderly patients with metabolic disorders according to literature sources. Materials and methods:&nbsp;A review and analysis of literature sources in the Scopus, Web of Science, Pubmed databases over the past 5 years was carried out. Results:&nbsp;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:&nbsp;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.

intestinal microbiotametabolic disordersgeriatric patientsdiabetes mellitusobesitydyslipidemiaintestinal microbiotametabolic disordersgeriatric patientsdiabetes mellitusobesitydyslipidemiaСписок литературыOzato N, Saito S, Yamaguchi T, et al. Blautia genus associated with visceral fat accumulation in adults 20-76 years of age. npj Biofilms and Microbiomes. 2019;5(1):28. DOI: https://doi.org/10.1038/s41522-019-0101-xHern&aacute;ndez-Luengo M, &Aacute;lvarez-Bueno C, Mart&iacute;nez-Hortelano JA, et al. The relationship between breastfeeding and motor development in children: a systematic review and meta-analysis. Nutrition Reviews. 2022;80(8):1827-1835. DOI: https://doi.org/10.1093/nutrit/nuac013Zheng Y, Ley S, Hu F. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology. 2018;14(2):88-98. DOI: https://doi.org/10.1038/nrendo.2017.151Zhang Y, Lin C, Chen R, et al. Association analysis of SOCS3, JAK2 and STAT3 gene polymorphisms and genetic susceptibility to type 2 diabetes mellitus in Chinese population. Diabetology and Metabolic Syndrome. 2022;14(1):4. DOI: https://doi.org/10.1186/s13098-021-00774-wHillman ET, Lu H, Yao T, et al. Microbial ecology along the gastrointestinal tract. Microbes and Environments. 2017;32(4):300-313. DOI: https://doi.org/10.1264/jsme2.ME17017Fan Y, Pedersen O. Gut microbiota in human metabolic health and disease. Nature Reviews Microbiology. 2021;19:55-71. DOI: https://doi.org/10.1038/s41579-020-0433-9Berg G, Rybakova D, Fischer D, et al. Microbiome definition re-visited: old concepts and new challenges. Microbiome. 2020;8(1):103. DOI: https://doi.org/10.1186/s40168-020-00875-0Amabebe E, Robert FO, Agbalalah T, et al. Microbial dysbiosis-induced obesity: role of gut microbiota in homoeostasis of energy metabolism. British Journal of Nutrition. 2020;123(10):1127-1137. DOI: https://doi.org/10.1017/S0007114520000380Cryan JF, O&#39;Riordan KJ, Cowan CSM, et al. The microbiota-gut-brain axis. Physiological Reviews. 2019;99(4):1877-2013. DOI: https://doi.org/10.1152/physrev.00018.2018Ni J, Wu GD, Albenberg L, et al. Gut microbiota and IBD: causation or correlation? Nature Reviews Gastroenterology and Hepatology. 2017;14(10):573-584. DOI: https://doi.org/10.1038/nrgastro.2017.88Kitamoto S, Nagao-Kitamoto H, Jiao Y, et al. The intermucosal connection between the mouth and gut in commensal pathobiont-driven colitis. Cell. 2020;182(2):447-462. DOI: https://doi.org/10.1016/j.cell.2020.05.048Desai MS, Seekatz AM, Koropatkin NM, et al. A dietary fiber-deprived gut microbiota degrades the colonic mucus barrier and enhances pathogen susceptibility. Cell. 2016;167(5):1339-1353. DOI: https://doi.org/10.1016/j.cell.2016.10.043Gallo A, Passaro G, Gasbarrini A, et al. Modulation of microbiota as treatment for intestinal inflammatory disorders: an uptodate. World Journal of Gastroenterology. 2016;22(32):7186-7202. DOI: https://doi.org/10.3748/wjg.v22.i32.7186Zhang Z, Mocanu V, Cai C, et al. Impact of fecal microbiota transplantation on obesity and metabolic syndrome &ndash; a systematic review. Nutrients. 2019;11(10):2291. DOI: https://doi.org/10.3390/nu11102291Wu H, Esteve E, Tremaroli V, et al. Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug. Nature Medicine. 2017;23(7):850-858. DOI: https://doi.org/10.1038/nm.4345Mohajeri MH, Brummer RJM, Rastall RA, et al. The role of the microbiome for human health: From basic science to clinical applications. European Journal of Nutrition. 2018;57:1-14. DOI: https://doi.org/10.1007/s00394-018-1703-4Stremmel W, Schmidt KV, Schuhmann V, et al. Blood trimethylamine-N-oxide originates from microbiota mediated breakdown of phosphatidylcholine and absorption from small intestine. PLoS ONE. 2017;12(1):e0170742. DOI: https://doi.org/10.1371/journal.pone.0170742Dumas ME, Rothwell AR, Hoyles L, et al. Microbial-host co-metabolites are prodromal markers predicting phenotypic heterogeneity in behavior, obesity, and impaired glucose tolerance. Cell Reports. 2017;20(1):136-148. DOI: https://doi.org/10.1016/j.celrep.2017.06.039Wahlstr&ouml;m A, Sayin SI, Marschall HU, et al. Intestinal crosstalk between bile acids and microbiota and its impact on host metabolism. Cell Metabolism. 2016;24(1):41-50. DOI: https://doi.org/10.1016/j.cmet.2016.05.005Allin KH, Tremaroli W, Caesar R, et al. Aberrant intestinal microbiota in individuals with prediabetes. Diabetologia. 2018;61(4):810-820. DOI: https://doi.org/10.1007/s00125-018-4550-1Ottosson P, Brankvoll L, Erickson U, et al. Relationship between BMI-associated plasma metabolite profile and gut microbiota. Journal of Clinical Endocrinology and Metabolism. 2018;103(4):1491-1501. DOI: https://doi.org/10.1210/jc.2017-02114Thomas C, Gioiello A, Noriega L, et al. TGR5-Mediated Bile Acid Sensing Controls Glucose Homeostasis. Cell Metabolism. 2009;10(3):167-177. DOI: https://doi.org/10.1016/j.cmet.2009.08.001Pokrovskaya EV, Shamkhalova MS, Shestakova MV. The new views on the state of the gut microbiota in obesity and type 2 diabetes mellitus. Diabetes mellitus. 2019;22(3):253-262. Russian. DOI: https://doi.org/10.14341/DM10194&nbsp;Koeth R, Wang Z, Levison BS, et al. Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis. Nature Medicine. 2013;19(5):576-585. DOI: https://doi.org/10.1038/nm.3145Caparros E, Wist R, Charles M, et al. Dysbiotic microbiota interactions in Crohn&#39;s disease. Gut Microbes. 2021;13(1):1949096. DOI: https://doi.org/10.1080/19490976.2021.1949096Anand S, Kaur H, Mande SS. Comparative In Silico Analysis of Butyrate Production Pathways in Gut Commensals and Pathogens. Frontiers in Microbiology. 2016;7:1945. DOI: https://doi.org/10.3389/fmicb.2016.01945Deng K, Shuai M, Zhang Z, et al. Temporal Relationship among Adiposity, GutMicrobiota, and Insulin Resistance in a Longitudinal Human Cohort. BMC Medicine. 2022;20:171. DOI: https://doi.org/10.1186/s12916-022-02376-3Kaplan RC, Wang Z, Usyk M, et al. Gut Microbiome Composition in the Hispanic Community Health Study/Study of Latinos Is Shaped by Geographic Relocation, Environmental Factors, and Obesity. Genome Biology. 2019;20:219. DOI: https://doi.org/10.1186/s13059-019-1831-zPedrogo DAM, Jensen MD, Van Dyke CT, et al. Gut Microbial Carbohydrate Metabolism Hinders Weight Loss in Overweight Adults Undergoing Lifestyle Intervention with a Volumetric Diet. Mayo Clinic Proceedings. 2018;93(8):1104-1110. DOI: https://doi.org/10.1016/j.mayocp.2018.02.019Liu F, Li P, Chen M, et al. Fructooligosaccharide (FOS) and Galactooligosaccharide (GOS) Increase Bifidobacterium but Reduce Butyrate Producing Bacteria with Adverse Glycemic Metabolism in Healthy Young Population. Scientific Reports. 2017;7:11789. DOI: https://doi.org/10.1038/s41598-017-10722-2Wang TY, Zhang XQ, Chen AL, et al. A Comparative Study of Microbial Community and Functions of Type 2 Diabetes Mellitus Patients with Obesity and Healthy People. Applied Microbiology and Biotechnology. 2020;104:7143-7153. DOI: https://doi.org/10.1007/s00253-020-10689-7Shenderov BA, Yudin SM, Zagaynova AV, et al. The role of commensal gut bacteria in the aetiopathogenesis of inflammatory bowel disease: Akkermansia muciniphila. Experimental and Clinical Gastroenterology. 2018;11:4-13. Russian.Sitkin SI, Vakhitov TY, Tkachenko EI, et al. Gut microbiota in ulcerative colitis and celiac disease. Experimental and Clinical Gastroenterology. 2017;1:8-30. Russian.Sitkin SI, Vakhitov TYa, Demyanova EV. Microbiome, gut dysbiosis and inflammatory bowel disease: That moment when the function is more important than taxonomy. Almanac of Clinical Medicine. 2018;46(5):396-425. Russian. DOI: https://doi.org/10.18786/2072-0505-2018-46-5-396-425Kim AD, Lepekhova SA, Chashkova EY, et al. Results of the microbiota assessment in experimental ulcerative colitis. Bulletin of Siberian Medicine. 2021;20(1):59-66. Russian. DOI: https://doi.org/10.20538/1682-0363-2021-1-59-66Kovaleva AL, Ulyanin AI, Kiselyova OYu, et al. Treatment of autonomous intestinal neuropathy in critical care by prucalopride and multistrain probiotic. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2018;28(3):88-100. Russian. DOI: https://doi.org/10.22416/1382-4376-2018-28-3-88-100Lagutina SN, Zuykova AA, Dobrynina IS, et al. Features of the intestinal microbiome in patients with coronary heart disease and metabolic disorders. Scientific and Medical Bulletin of the Central Chernozem Region. 2022;87:20-24. Russian.Melikhova SP, Zuykova AA, Shevtsova VI. Calculation of comorbidity indices in type 2 diabetes mellitus as a complication of the metabolic syndrome. Molodezhnyy innovatsionnyy vestnik. 2018;7(S1):68-69. Russian.Khavkin AI, Volynets GV, Nikitin AV. The relationship of the gut microbiome and metabolism of bile acids. Clinical Practice in Pediatrics. 2020;15(1):53-60. Russian. DOI: https://doi.org/10.20953/1817-7646-2020-1-53-60Plotnikova EY, Krasnov OA. Gut microbial landscape and metabolic syndrome &ndash; what do they have in common? Vestnik kluba pankreatologov. 2016;12(112):64-73. Russian.Fadieienko GD, Nikiforova YaV. Human microbiome: general information and clinical significance of digestive canal eubiosis. Sovremennaya gastroenterologiya. 2019;5(109):65-74. Russian. DOI: https://doi.org/10.30978/MG-2019-5-65Hurt RT, Wilson T. Geriatric obesity: evaluating the evidence for the use of flavonoids to promote weight loss. Journal of Nutrition in Gerontology and Geriatrics. 2012;31(3):269-289. DOI: https://doi.org/10.1080/21551197.2012.698222Etxeberria U, Arias N, Boqu&eacute; N, et al. Reshaping faecal gut microbiota composition by the intake of trans-resveratrol and quercetin in high-fat sucrose diet-fed rats. Journal of Nutritional Biochemistry. 2017;26(6):651-660. DOI: https://doi.org/10.1016/j.jnutbio.2015.01.002Zhao M, Cai H, Jiang Z, et al. Glycerol-Monolaurate-Mediated Attenuation of Metabolic Syndrome is Associated with the Modulation of Gut Microbiota in High-Fat-Diet-Fed Mice. Molecular Nutrition and Food Research. 2019;63(18):e1801417. DOI: https://doi.org/10.1002/mnfr.201801417Kelly JR, Clarke G, Cryan JF, et al. Brain&ndash;gut&ndash;microbiota axis: challenges for translation in psychiatry. Annals of Epidemiology. 2016;26(5):366-372. DOI: https://doi.org/10.1016/j.annepidem.2016.02.008