The paper deals with small bowel (SB) functional disorders in metabolic syndrome (MS). The main components of a cascade of metabolic abnormalities in MS are closely due to SB functional changes. This is associated to some extent with the presence of common neurohormonal mechanisms in the development of enteropathy and MS. The paper gives the physical, laboratory and instrumental methods for identifying SB dysfunctions in patients with MS. Therapy for the latter is of particular interest in the context of SB functional recovery. The authors discuss the possibilities of enteropathy therapy in patients with MS; thus there is not only SB functional recovery, but also improved overall metabolic processes.
Purpose. To summarize the estimates of the effect of the use of potassium-competitive proton pump inhibitors in pharmacotherapy algorithms for patients with peptic ulcer disease, GERD on treatment outcomes. Material and methods. The most large-scale (as a rule) publications of the last five years devoted to the problem under consideration are analyzed. The search was carried out by keywords in the Pubmed information database (ncbi.nlm.nih.gov). Findings. Potassium-competitive acid blockers (P-CABs), in comparison with «traditional» drugs of this class (proton pump inhibitors), have advantages from a clinical and pharmacoeconomic point of view both in peptic ulcer disease (in particular, as part of eradication therapy) and in gastro-esophageal reflux disease. Confirmation of these data in the conditions of use of K-CCB in patients of the Russian Federation seems appropriate.
Aim. To characterize of the features of changes in the cavity and parietal microbiota of the small intestine in patients with non-alcoholic fatty liver disease (NAFLD).
Materials and methods. Fifty four patients with NAFLD at the stage of steatosis and steatohepatitis at the age of 1860 years were examined. The diagnosis was verified by ultrasound of the hepatobiliary system using a SONIX OP analyzer (Canada), FibroMax test data and liver elastography using an AIXPLORER apparatus (France). The degree of steatohepatitis activity was determined by biochemical blood tests for alanine aminotransferase and aspartate aminotransferase on a Huma Star 600 analyzer (Germany). The cavity microbiota of the small intestine was evaluated using a Lactofan2 analyzer of the Association of Medicine and Analytics company (Russia) using hydrogen breath tests with lactulose. The parietal microbiota of the small intestine was examined using an Agilent 7890 gas chromatograph with mass-selective and plasma-ionization detectors (Agilent Technologies, USA).
Results. In the study of cavity enteric microbiota in patients with NAFLD, the syndrome of excessive bacterial growth was detected in 68.5% of cases, while it was caused in 48.6% of patients by a violation of the function of the ileocecal valve, in 21.7% by a deficiency of cleavage of lactulose microorganisms and/or slowing down the motility of the digestive tract. When studying the parietal enteral microbiota, the total bacterial load in patients with NAFLD was significantly lower compared with the control group due to a decrease in useful microbiota. At the same time, a decrease in all normal bacterial representatives Bifidobacterium, Lactobacillus and Lactococcus, Eubacterium and Propionibacterium was noted. The content of opportunistic microbiota in patients with NAFLD did not reveal significant changes.
Conclusion. The syndrome of excessive bacterial growth in patients with NAFLD is associated with a decrease in useful parietal enteral microbiota.
Aim. To evaluate the qualitative and quantitative composition of the parietal microbiota of the small intestine (SI) and its significance in the disturbance of the digestive and absorption functions of the small intestine in metabolic syndrome (MS). Materials and methods. 67 patients with metabolic syndrome were examined. In addition to clinical data, a comprehensive study of the digestive and absorption function of SI was carried out using exercise tests with carbohydrates. The compositional characteristics of mucosal SI microbiota in MS patients were determined by gas chromatography mass spectrometry. The relationship of enteric disorders with changes in small intestinal microbiocenosis was assessed by correlation analysis. Results. The majority (82.9%) of patients with metabolic syndrome showed clinical local and general signs of small intestinal lesions. Violations of all stages of the hydrolysis - resorption process were revealed against the background of changes in the quantitative and qualitative composition of the parietal microbiota of the small intestine. In patients with MS, excessive bacterial growth is observed in the small intestine mainly due to conditionally pathogenic microbiota strains, and, in comparison with the control group, there is a significant increase in the growth of aerobes, microscopic fungi and viruses. The relationship between the severity of excess bacterial growth and impaired digestion and absorption in the small intestine in MS. Conclusion. The results of our research suggest that the identified changes in the functional state of SI in combination with a violation of mucosal enteral microbiocenosis are an important link in the complex pathogenesis of the MS.
The combined use of pancreatic enzymes and actovegin is pathogenetically sound in correcting SB dysfunctions and may be one of the most effective directions for the treatment of patients with MS.
Aims. Characterization of the composition of the enteric parietal microbiota and its role in impaired functional state of the small intestine (SI) in individuals with metabolic syndrome (MS).Materials and methods. 68 patients with MS were examined. The quantitative and qualitative composition of the near-wall microbiota of SI and the level of endotoxinemia were determined using an Agilent gas chromatograph with mass-selective and flame-ionization detectors. In evaluating the absorption function, substances that were not subjected to enzymatic processing, glucose and D-xylose, were used. The state of parietal digestion in the SI was evaluated by the results of the assimilation of sucrose disaccharide, and cavity digestion by the assimilation of soluble starch. Blood levels of total cholesterol, cholesterol of high density lipoproteins, triglycerides were determined. Carbohydrate metabolism was evaluated using an oral glucose tolerance test.Results. According to GC–MS data of microbial blood markers in patients with MS, parietal bacterial growth in SI increases due to opportunistic microbiota (bacteria such as Firmicutes, fungi of the genus Candida, Herpes Simplex viruses). In patients with increased absorption of monosaccharides in the postprandial period, inhibition of abdominal and parietal digestion is observed. In MS, an increase in the level of endotoxin in the blood by more than six times was established in comparison with the control group. A correlation study revealed a strong positive relationship between the degree of endotoxinemia increase and the level of atherogenicity coefficient.Conclusion. The results of the study suggest that the interconnected violation of hydrolysis, resorption and parietal ecosystems in SI is an important link in the complex pathogenetic circle of MS.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.