从肠道微生物群代谢到微血管损伤：探索肠道微生物群在肥胖诱导的冠状动脉微循环功能障碍中的作用和机制
From gut microbiota metabolism to microvascular injury: Exploring the role and mechanisms of gut microbiota in obesity-induced coronary microcirculation dysfunction.
摘要(中文译文)
肥胖作为全球性流行病，通过肠道菌群失调驱动冠状动脉微血管功能障碍（CMD），后者是心血管疾病的前驱病变。临床证据显示，肥胖患者冠状动脉血流储备降低47.7%，凸显了肥胖在CMD发病机制中的关键作用。本综述阐明了肥胖诱导的菌群失调与CMD相关联的分子机制，重点关注微生物代谢产物：TMAO促进脂质沉积和炎症；短链脂肪酸（SCFAs）减少损害内皮功能；胆汁酸通过FXR/TGR5调节血管张力；LPS诱导代谢性内毒素血症；支链氨基酸（BCAAs）引发胰岛素抵抗；内源性乙醇促进氧化应激；吲哚类代谢产物对血管具有双重效应；ImP和PAGln加速动脉粥样硬化和血栓形成；硫化氢（HS）缺乏和琥珀酸升高加剧血管重构。肠-心轴放大了超越传统危险因素的CMD风险。未来的多组学研究应识别生物标志物并开发靶向治疗，如代谢产物抑制剂和精准营养，以减轻肥胖相关CMD并改善预后。图形摘要见图1。[图：见正文]。
Abstract
Obesity, a global epidemic, drives coronary microvascular dysfunction (CMD), a precursor to cardiovascular disease, via gut microbiota dysbiosis. Clinical evidence shows a 47.7% reduction in coronary flow reserve among obese patients, highlighting obesity's pivotal role in CMD pathogenesis. This review elucidates molecular mechanisms linking obesity-induced dysbiosis to CMD, focusing on microbial metabolites: TMAO promotes lipid deposition and inflammation; reduced SCFAs impair endothelial function; bile acids modulate vascular tone via FXR/TGR5; LPS induces metabolic endotoxemia; BCAAs trigger insulin resistance; endogenous ethanol fosters oxidative stress; indole metabolites exert dual vascular effects; ImP and PAGln accelerate atherosclerosis and thrombosis; and HS deficiency and elevated succinate exacerbate remodeling. The gut-heart axis amplifies CMD risk beyond traditional factors. Future multi-omics studies should identify biomarkers and develop targeted therapies, such as metabolite inhibitors and precision nutrition, to mitigate obesity-related CMD and improve outcomes. The Graphical Abstract is presented in Figure 1.[Figure: see text].
如何引用
AMA
Yuhang Liu, Yong Wang, Haodong Teng, Wenyang Nie, Xinyu Qiao, Yingying Shen, et al. From gut microbiota metabolism to microvascular injury: Exploring the role and mechanisms of gut microbiota in obesity-induced coronary microcirculation dysfunction.. Virulence. 2026; doi:10.1080/21505594.2026.2670787.
APA
Yuhang Liu, Yong Wang, Haodong Teng, Wenyang Nie, Xinyu Qiao, Yingying Shen, et al (2026). From gut microbiota metabolism to microvascular injury: Exploring the role and mechanisms of gut microbiota in obesity-induced coronary microcirculation dysfunction.. Virulence. https://doi.org/10.1080/21505594.2026.2670787
GB/T 7714
Yuhang Liu, Yong Wang, Haodong Teng, Wenyang Nie, Xinyu Qiao, Yingying Shen, et al. From gut microbiota metabolism to microvascular injury: Exploring the role and mechanisms of gut microbiota in obesity-induced coronary microcirculation dysfunction.[J]. Virulence, 2026 doi:10.1080/21505594.2026.2670787.
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