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To systematically analyze the current status and research trends and identify the key research hotspots in the field of gut microbiota and metabolic syndrome (MetS) from 2005 to 2024, thus providing references for future research and intervention strategies. Relevant literature on gut microbiota and MetS was retrieved and screened from the Web of Science Core Collection. Bibliometric tools such as VOSviewer, CiteSpace, and the R package bibliometrix were used to analyze the publication trends, countries and institutions, research themes, and emerging hotspots. A total of 4 210 relevant publications were included. The annual number of publications showed an increasing trend, which was particular rapid after 2010. China and the United States led in publication output, and major research findings were published in journals such as Nutrients, Gut, and Nature. Research hotspots primarily covered the fields of nutrition and diet, biochemistry and molecular biology, and microbiology. Keyword evolution analysis revealed a shift from early descriptive studies on gut microbiota composition to mechanism investigations focusing on dysbiosis-related pathways such as energy metabolism, inflammatory responses, and gut-organ axes. Co-occurrence analysis further indicated that key microbial metabolites (e.g., short-chain fatty acids and bile acids) and microbiota-targeted interventions (e.g., probiotics and fecal microbiota transplantation) had become focal points in recent studies. This bibliometric study comprehensively summarizes the research landscape of gut microbiota and MetS and highlights emerging trends and directions. Given the limitations of conventional therapies in terms of targeting specificity, patient adherence, and long-term safety, microbiota-based interventions offer a promising breakthrough for the prevention and treatment of MetS, providing valuable theoretical support for future precision medicine.

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系统分析2005-2024年间肠道微生物群与代谢综合征(metabolic syndrome, MetS)研究的现状和趋势,识别关键研究热点,为后续研究和干预措施提供参考。本文采用Web of Science核心合集数据库,检索并筛选涉及肠道微生物群与MetS的相关文献。利用VOSviewer、CiteSpace及R语言bibliometrix包等文献计量学工具,对文献的发表趋势、国家与机构分布、研究主题和热点等方面进行统计分析。共纳入4 210篇相关文献,年发文量持续增长,2010年后增速显著。中国和美国发文量位居前列,研究成果主要发表在NutrientsGutNature等期刊;研究热点主要覆盖营养与饮食、生物化学与分子生物学、微生物学等领域;关键词演化分析显示,研究主题已由早期的菌群结构描述转向机制探讨,聚焦于肠道微生物群失调相关的能量代谢、炎症反应及肠-远端器官互作等调控机制。高频关键词共现分析还表明,短链脂肪酸、胆汁酸等关键代谢产物,以及微生物制剂和粪菌移植等微生态干预策略,逐渐成为该领域关注焦点。本研究通过文献计量学系统梳理了肠道微生物群与MetS的研究现状,揭示了研究热点和未来趋势。鉴于传统治疗手段在靶向性、依从性及长期安全性方面仍存在一定局限,靶向肠道菌群的微生态干预有望成为MetS防治的潜在突破口,为未来精准治疗提供了重要理论支撑。

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作者贡献声明

张惠瑶:研究构思与设计、数据分析、结果可视化、论文撰写和修改;李浩:方法论、论文审阅与修改;周婷婷:数据收集、论文审阅与修订;武文玉:数据分析、论文审阅与修订、结果可视化及参与论文讨论;黄国栋:数据收集、结果可视化;黄鉦淇:方法论、结果可视化及参与论文讨论;胡好颖、饶显俊:数据收集、结果可视化及参与论文讨论;陈磊:数据收集、结果可视化;魏玮:项目管理、提供资源、监督管理、审阅。

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Scientific Reports, 2022, 12(1): 1152., articleTitle=Health improvements of type 2 diabetic patients through diet and diet plus fecal microbiota transplantation, refAbstract=null)], funds=[Fund(id=1226195564325417696, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, awardId=WJYY-ZZXT-2023-14, language=EN, fundingSource=the Independent Research Project of Wangjing Hospital, China Academy of Chinese Medical Sciences(WJYY-ZZXT-2023-14), fundOrder=null, country=null), Fund(id=1226195564455441130, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, awardId=WJYY-ZZXT-2023-14, language=CN, fundingSource=中国中医科学院望京医院自主选题专项课题(WJYY-ZZXT-2023-14), fundOrder=null, country=null), Fund(id=1226195564606436079, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, awardId=WJYY-ZZXT-2023-15, language=CN, fundingSource=中国中医科学院望京医院自主选题专项课题(WJYY-ZZXT-2023-15), fundOrder=null, 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language=CN, label=图1, caption=流程图展示了搜索和筛选的方法,详细说明了纳入和排除文章的标准, figureFileSmall=0Nqxhtpo6Wb4QbQCIWgknw==, figureFileBig=DNaFOUkf+ubcoHEMJFTrGQ==, tableContent=null), ArticleFig(id=1226195559615214119, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Figure 2, caption=Publications analysis of the relationship between gut microbiota and MetS from 2005 to 2024. A: Annual publication volume and cumulative publication volume obtained from WoSCC; B: Annual publication volume from 2005 to 2024 categorized by country; C: Top 10 countries ranked by total citations; D: Top 10 research fields based on publication quantity., figureFileSmall=ynT6jd70eMNgPbtYt+xW/A==, figureFileBig=yovaUw7Io1w2scleWNL/Hw==, tableContent=null), ArticleFig(id=1226195559745237548, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=图2, caption=2005-2024年肠道微生物群与MetS相关性的文献分析。A:从WoSCC获取的年度发文量和累计发文量;B:按国家划分的2005-2024年年度发文量;C:总被引次数排名前10的国家;D:基于发文数量的前10个研究领域。, figureFileSmall=ynT6jd70eMNgPbtYt+xW/A==, figureFileBig=yovaUw7Io1w2scleWNL/Hw==, tableContent=null), ArticleFig(id=1226195559824929328, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Figure 3, caption=Analysis of countries and institutional collaborations. A: Chord diagram of national collaborations; B: VOSviewer network visualization of the top 100 institutions by publication output in studies of gut microbiota and metabolic syndrome. Node size represents the number of publications; Edge thickness indicates the collaboration strength between institutions; Colors denote clusters., figureFileSmall=2+55icmt79mbZPjP9/3J5g==, figureFileBig=p2GGgmRfbvB4PuoKsPR9SA==, tableContent=null), ArticleFig(id=1226195559942369846, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=图3, caption=国家与机构合作分析。A:国家间合作的和弦图;B:肠道微生物群与代谢综合征的研究中发文量排名前100的机构合作网络(VOSviewer生成)。节点大小表示该机构的发文量,连线粗细表示机构间的合作强度,不同颜色表示所属聚类。, figureFileSmall=2+55icmt79mbZPjP9/3J5g==, figureFileBig=p2GGgmRfbvB4PuoKsPR9SA==, tableContent=null), ArticleFig(id=1226195560059810363, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Figure 4, caption=Author collaboration and co-citation networks. A: Author collaboration network; B: Author co-citation network (threshold: 100 co-citations)., figureFileSmall=CC+7Q3AESjwjFvvDZudS7A==, figureFileBig=1BnnOm8Op5XDDMfbHitrIA==, tableContent=null), ArticleFig(id=1226195560206611008, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=图4, caption=作者合作网络与共被引文网络图。A:作者的合作网络;B:作者的共被引网络图(共被引阈值为100次)。, figureFileSmall=CC+7Q3AESjwjFvvDZudS7A==, figureFileBig=1BnnOm8Op5XDDMfbHitrIA==, tableContent=null), ArticleFig(id=1226195560336634441, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Figure 5, caption=Visualization of journal networks. A: Clustered network of the top 100 most-cited journals; B: Journal co-citation network based on VOSviewer analysis (≥100 citations); C: Dual-map overlay of journals generated by CiteSpace., figureFileSmall=EERilikdqvaFZ6P40jaJ0A==, figureFileBig=KNnAvDwo5Vq/jQBKYpsXGA==, tableContent=null), ArticleFig(id=1226195560458269265, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=图5, caption=期刊网络的可视化分析。A:被引次数排名前100的期刊聚类网络;B:基于VOSviewer的高被引期刊共被引网络(≥100次);C:CiteSpace可视化生成的期刊双图叠加。, figureFileSmall=EERilikdqvaFZ6P40jaJ0A==, figureFileBig=KNnAvDwo5Vq/jQBKYpsXGA==, tableContent=null), ArticleFig(id=1226195560558932567, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Figure 6, caption=Visualization of references and keywords. A: Reference co-citation network; B: Keyword co-occurrence clustering analysis; C: Clustering of high-frequency keywords; D: Word cloud of the 100 most frequently used keywords in this field (Panels A and D generated by the R package bibliometrix, Panel B by CiteSpace, and Panel C by VOSviewer)., figureFileSmall=S+Kt4MYvu1F2D3W7sMY7ng==, figureFileBig=KYAoyircSx7QOa+zBJR6cQ==, tableContent=null), ArticleFig(id=1226195560697344610, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=图6, caption=文献与关键词的可视化分析。A:文献共被引网络;B:关键词共现聚类分析;C:高频关键词聚类分析;D:研究领域中使用频率最高的100个关键词词云(面板A和D由R语言bibliometrix包生成,面板B由CiteSpace生成,面板C由VOSviewer生成)。, figureFileSmall=S+Kt4MYvu1F2D3W7sMY7ng==, figureFileBig=KYAoyircSx7QOa+zBJR6cQ==, tableContent=null), ArticleFig(id=1226195560814785129, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Figure 7, caption=Citation bursts and keyword bursts. A: Top 25 references with the strongest burst intensity; B: Top 38 keywords with the strongest burst intensity., figureFileSmall=FCWLqj+u9DsZRzE/4e220A==, figureFileBig=4Zwm/JYL4xZRJ4zj8nN5iQ==, tableContent=null), ArticleFig(id=1226195560936419954, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=图7, caption=引文突现与关键词突现分析。A:突现强度排名前25的参考文献;B:突现强度排名前38的关键词。, figureFileSmall=FCWLqj+u9DsZRzE/4e220A==, figureFileBig=4Zwm/JYL4xZRJ4zj8nN5iQ==, tableContent=null), ArticleFig(id=1226195561053860475, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Figure 8, caption=Sankey diagram and keyword evolution. A: The Sankey diagram illustrates the main countries, keywords, and distinguished authors in the field; B: The theme evolution chart depicts the development of research in this field over three phases. It shows the shift in research focus through lines connecting different nodes. The thickness of these lines represents the frequency of shared keywords, with thicker lines indicating higher importance of the themes (This visualization was created using the R package bibliometrix)., figureFileSmall=IzhaYGrK2N0UNbNDfFdPdw==, figureFileBig=0YNRiXWncs/spS36SS3eeQ==, tableContent=null), ArticleFig(id=1226195561171300995, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=图8, caption=桑基图和关键词演变分析。A:桑基图展示了该领域的主要国家、高频关键词和代表性作者;B:主题演变图展示了研究在4个发展阶段中的主题流变,通过连接不同节点的线条反映研究重点的变化,线条的粗细表示关键词的共享频率,越粗的线条代表主题之间的关联性越强、重要性越高(该图由R语言bibliometrix包生成)。, figureFileSmall=IzhaYGrK2N0UNbNDfFdPdw==, figureFileBig=0YNRiXWncs/spS36SS3eeQ==, tableContent=null), ArticleFig(id=1226195561267769992, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Table 1, caption=

Top 10 countries/regions ranked by average citations per publication (minimum 100 publications)

, figureFileSmall=null, figureFileBig=null, tableContent=
CountryDocumentsCitationsAverage number of citationsTotal link strength
Netherlands17521 542123.102 984
United Kingdom29230 027102.833 246
France18317 62796.322 402
Germany17413 47277.431 699
United States97672 01473.787 725
Italy37824 26264.193 131
Spain26415 35558.162 296
Canada21512 50258.151 978
Australia1769 67654.981 383
Brazil1125 50849.18930
), ArticleFig(id=1226195561368433296, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=表1, caption=

篇均被引次数最高的10个国家/地区(发文量≥100)

, figureFileSmall=null, figureFileBig=null, tableContent=
CountryDocumentsCitationsAverage number of citationsTotal link strength
Netherlands17521 542123.102 984
United Kingdom29230 027102.833 246
France18317 62796.322 402
Germany17413 47277.431 699
United States97672 01473.787 725
Italy37824 26264.193 131
Spain26415 35558.162 296
Canada21512 50258.151 978
Australia1769 67654.981 383
Brazil1125 50849.18930
), ArticleFig(id=1226195561498456728, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Table 2, caption=

Top 10 authors ranked by publication volume in gut microbiota and metabolic syndrome research

, figureFileSmall=null, figureFileBig=null, tableContent=
AuthorsDocumentsCitationsTotal link strengthAuthorsDocumentsCitationsTotal link strength
Nieuwdorp M526 060159Delzenne NM213 64576
Chassaing B364 06378Gasbarrini A213 05328
De vos WM297 510117Zhao L203 04668
Cani PD275 84492Vijay-Kumar M192 83959
Gewirtz AT275 47279Herrema H1885735
), ArticleFig(id=1226195561594925723, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=表2, caption=

在肠道微生物群与代谢综合征的研究中根据发表量排名的前10的作者

, figureFileSmall=null, figureFileBig=null, tableContent=
AuthorsDocumentsCitationsTotal link strengthAuthorsDocumentsCitationsTotal link strength
Nieuwdorp M526 060159Delzenne NM213 64576
Chassaing B364 06378Gasbarrini A213 05328
De vos WM297 510117Zhao L203 04668
Cani PD275 84492Vijay-Kumar M192 83959
Gewirtz AT275 47279Herrema H1885735
), ArticleFig(id=1226195561657840288, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Table 3, caption=

Top 10 authors ranked by co-citation frequency in the field of gut microbiota and metabolic syndrome research

, figureFileSmall=null, figureFileBig=null, tableContent=
AuthorsCo-citation countsTotal link strengthAuthorsCo-citation countsTotal link strength
Cani PD2 369263 862Gin IJ67775 863
Turnbaugh PJ1 786181 873Tilg H45858 653
Ley RE1 210122 767Vrieze A45347 598
Bäckhed F1 024114 193Chassaing B40036 570
Everard A70772 126Caporaso JG39026 307
), ArticleFig(id=1226195561758503587, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=表3, caption=

肠道微生物群与代谢综合征研究领域共被引次数排名前10位的作者

, figureFileSmall=null, figureFileBig=null, tableContent=
AuthorsCo-citation countsTotal link strengthAuthorsCo-citation countsTotal link strength
Cani PD2 369263 862Gin IJ67775 863
Turnbaugh PJ1 786181 873Tilg H45858 653
Ley RE1 210122 767Vrieze A45347 598
Bäckhed F1 024114 193Chassaing B40036 570
Everard A70772 126Caporaso JG39026 307
), ArticleFig(id=1226195561884332717, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Table 4, caption=

Top 10 most-cited journals related to gut microbiota and MetS research

, figureFileSmall=null, figureFileBig=null, tableContent=
JournalDocumentsCitationsAverage citationsCountryIFJIF quartile
Nutrients26810 74140.1Switzerland4.8Q1
Gut288 949319.6United Kingdom23.0Q1
Nature77 6551 093.6United States50.5Q1
Cell95 372596.9United States45.5Q1
PLoS One664 84873.5United States2.9Q1
Gastroenterology154 349289.9United States25.7Q1
International Journal of Molecular Sciences1194 15234.9Switzerland4.9Q1
Scientific Reports813 89248.0United Kingdom3.8Q1
British Journal of Nutrition223 414155.2United Kingdom3.0Q2
World Journal of Gastroenterology433 24875.5China4.3Q1
), ArticleFig(id=1226195562031133360, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=表4, caption=

肠道微生物群与代谢综合征研究中被引次数排名前10的期刊

, figureFileSmall=null, figureFileBig=null, tableContent=
JournalDocumentsCitationsAverage citationsCountryIFJIF quartile
Nutrients26810 74140.1Switzerland4.8Q1
Gut288 949319.6United Kingdom23.0Q1
Nature77 6551 093.6United States50.5Q1
Cell95 372596.9United States45.5Q1
PLoS One664 84873.5United States2.9Q1
Gastroenterology154 349289.9United States25.7Q1
International Journal of Molecular Sciences1194 15234.9Switzerland4.9Q1
Scientific Reports813 89248.0United Kingdom3.8Q1
British Journal of Nutrition223 414155.2United Kingdom3.0Q2
World Journal of Gastroenterology433 24875.5China4.3Q1
), ArticleFig(id=1226195562144379574, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Table 5, caption=

Co-citation analysis of journals in the field of gut microbiota and MetS

, figureFileSmall=null, figureFileBig=null, tableContent=
JournalCitationsTotal link strengthCountryIFJIF quartile
Nature10 4761 267 003United States50.5Q1
PLoS One8 7081 151 077United States2.9Q1
Nutrients6 811957 109Switzerland4.8Q1
PNAS6 376825 421United States9.4Q1
Gastroenterology6 157832 617United States25.7Q1
Gut6 148812 447United Kingdom23.0Q1
Science5 197682 143United States44.7Q1
Scientific Reports4 668667 014United Kingdom3.8Q1
Hepatology4 667661 139United States12.9Q1
Diabetes4 267539 096United States6.2Q1
), ArticleFig(id=1226195562274403003, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=表5, caption=

肠道微生物群与代谢综合征研究中的共被引期刊分析

, figureFileSmall=null, figureFileBig=null, tableContent=
JournalCitationsTotal link strengthCountryIFJIF quartile
Nature10 4761 267 003United States50.5Q1
PLoS One8 7081 151 077United States2.9Q1
Nutrients6 811957 109Switzerland4.8Q1
PNAS6 376825 421United States9.4Q1
Gastroenterology6 157832 617United States25.7Q1
Gut6 148812 447United Kingdom23.0Q1
Science5 197682 143United States44.7Q1
Scientific Reports4 668667 014United Kingdom3.8Q1
Hepatology4 667661 139United States12.9Q1
Diabetes4 267539 096United States6.2Q1
), ArticleFig(id=1226195563675300544, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Table 6, caption=

The 10 most frequently cited publications from a dataset of 4 210 publications concerning gut microbiota and MetS research

, figureFileSmall=null, figureFileBig=null, tableContent=
RankTitleFirst authorJournalYearCitationsDOI
1Functional interactions between the gut microbiota and host metabolism[13]Tremaroli VNature20123 14110.1038/nature11552
2Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome[14]Vrieze AGastroenterology20122 02110.1053/j.gastro.2012.06.031
3The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD)[15]Buzzetti EMetabolism20161 91510.1016/j.metabol.2015.12.012
4Inflammasome-mediated dysbiosis regulates progression of NAFLD and obesity[16]Henao-Mejia JNature20121 80810.1038/nature10809
5What is the healthy gut microbiota composition? A changing ecosystem across age, environment, diet, and diseases[17]Rinninella EMicroorganisms20191 72010.3390/microorganisms7010014
6Personalized nutrition by prediction of glycemic responses[18]Zeevi DCell20151 56110.1016/j.cell.2015.11.001
7Metabolic syndrome and altered gut microbiota in mice lacking Toll-like receptor 5[7]Vijay-Kumar MScience20101 55610.1126/science.1179721
8The gut microbiota and host health: a new clinical frontier[19]Marchesi JRGut20161 51310.1136/gutjnl-2015-309990
9Influence of diet on the gut microbiome and implications for human health[20]

Singh RK

Journal of Translational Medicine20171 49410.1186/s12967-017-1175-y
10Prebiotic effects: metabolic and health benefits[21]Roberfroid MBritish Journal of Nutrition20101 43910.1017/S0007114510003363
), ArticleFig(id=1226195563834684106, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=表6, caption=

在涉及肠道微生物群与代谢综合征研究的4 210篇文献数据集中被引次数最多的10篇文献

, figureFileSmall=null, figureFileBig=null, tableContent=
RankTitleFirst authorJournalYearCitationsDOI
1Functional interactions between the gut microbiota and host metabolism[13]Tremaroli VNature20123 14110.1038/nature11552
2Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome[14]Vrieze AGastroenterology20122 02110.1053/j.gastro.2012.06.031
3The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD)[15]Buzzetti EMetabolism20161 91510.1016/j.metabol.2015.12.012
4Inflammasome-mediated dysbiosis regulates progression of NAFLD and obesity[16]Henao-Mejia JNature20121 80810.1038/nature10809
5What is the healthy gut microbiota composition? A changing ecosystem across age, environment, diet, and diseases[17]Rinninella EMicroorganisms20191 72010.3390/microorganisms7010014
6Personalized nutrition by prediction of glycemic responses[18]Zeevi DCell20151 56110.1016/j.cell.2015.11.001
7Metabolic syndrome and altered gut microbiota in mice lacking Toll-like receptor 5[7]Vijay-Kumar MScience20101 55610.1126/science.1179721
8The gut microbiota and host health: a new clinical frontier[19]Marchesi JRGut20161 51310.1136/gutjnl-2015-309990
9Influence of diet on the gut microbiome and implications for human health[20]

Singh RK

Journal of Translational Medicine20171 49410.1186/s12967-017-1175-y
10Prebiotic effects: metabolic and health benefits[21]Roberfroid MBritish Journal of Nutrition20101 43910.1017/S0007114510003363
), ArticleFig(id=1226195563973096144, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=EN, label=Table 7, caption=

Top 10 references ranked by co-citation frequency from 4 210 articles on gut microbiota and MetS

, figureFileSmall=null, figureFileBig=null, tableContent=
RankTitleFirst authorJournalYearCitationsDOI
1Diet rapidly and reproducibly alters the human gut microbiome[22]David LANature201317010.1038/nature12820
2Supplementation with Akkermansia muciniphila in overweight and obese human volunteers: a proof-of-concept exploratory study[23]Depommier CNature Medicine201914610.1038/s41591-019-0495-2
3Improvement of insulin sensitivity after lean donor feces in metabolic syndrome is driven by baseline intestinal microbiota composition[24]Kootte RSCell Metabolism201714310.1016/j.cmet.2017.09.008
4Cross-talk between Akkermansia muciniphila and intestinal epithelium controls diet-induced obesity[25]Everard APNAS201313010.1073/pnas.1219451110
5Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome[14]Vrieze AGastroenterology201212510.1053/j.gastro.2012.06.031
6Gut microbiota in human metabolic health and disease[9]Fan YNature Reviews Microbiology202112410.1038/s41579-020-0433-9
7Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology[26]Dao MCGut201611910.1136/gutjnl-2014-308778
8Richness of human gut microbiome correlates with metabolic markers[27]Le Chatelier ENature201311310.1038/nature12506
9Reproducible, interactive, scalable and extensible microbiome data science using QIIME 2[28]Bolyen ENature Biotechnology201911310.1038/s41587-019-0209-9
10Gut microbiota from twins discordant for obesity modulate metabolism in mice[29]Ridaura VKScience201311210.1126/science.1241214
), ArticleFig(id=1226195564086342358, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136786737475921, language=CN, label=表7, caption=

在分析的4 210篇肠道微生物群和代谢综合征研究文献中共被引次数排名前10的参考文献

, figureFileSmall=null, figureFileBig=null, tableContent=
RankTitleFirst authorJournalYearCitationsDOI
1Diet rapidly and reproducibly alters the human gut microbiome[22]David LANature201317010.1038/nature12820
2Supplementation with Akkermansia muciniphila in overweight and obese human volunteers: a proof-of-concept exploratory study[23]Depommier CNature Medicine201914610.1038/s41591-019-0495-2
3Improvement of insulin sensitivity after lean donor feces in metabolic syndrome is driven by baseline intestinal microbiota composition[24]Kootte RSCell Metabolism201714310.1016/j.cmet.2017.09.008
4Cross-talk between Akkermansia muciniphila and intestinal epithelium controls diet-induced obesity[25]Everard APNAS201313010.1073/pnas.1219451110
5Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome[14]Vrieze AGastroenterology201212510.1053/j.gastro.2012.06.031
6Gut microbiota in human metabolic health and disease[9]Fan YNature Reviews Microbiology202112410.1038/s41579-020-0433-9
7Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology[26]Dao MCGut201611910.1136/gutjnl-2014-308778
8Richness of human gut microbiome correlates with metabolic markers[27]Le Chatelier ENature201311310.1038/nature12506
9Reproducible, interactive, scalable and extensible microbiome data science using QIIME 2[28]Bolyen ENature Biotechnology201911310.1038/s41587-019-0209-9
10Gut microbiota from twins discordant for obesity modulate metabolism in mice[29]Ridaura VKScience201311210.1126/science.1241214
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基于Web of Science的肠道微生物群与代谢综合征全球研究热点与趋势(2005-2024)
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张惠瑶 1, 2 , 李浩 1, 2 , 周婷婷 2 , 武文玉 2 , 黄国栋 2 , 黄鉦淇 1, 2 , 胡好颖 3 , 饶显俊 2 , 陈磊 2 , 魏玮 1, 2
微生物学报 | 专论 2026,66(2): 926-955
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微生物学报 | 专论 2026, 66(2): 926-955
基于Web of Science的肠道微生物群与代谢综合征全球研究热点与趋势(2005-2024)
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张惠瑶1, 2, 李浩1, 2, 周婷婷2, 武文玉2, 黄国栋2, 黄鉦淇1, 2, 胡好颖3, 饶显俊2, 陈磊2, 魏玮1, 2
作者信息
  • 1.广州中医药大学,科技创新中心,广东 广州
  • 2.中国中医科学院望京医院,北京
  • 3.成都中医药大学,四川 成都
Global hotspots and trends in gut microbiota and metabolic syndrome research based on Web of Science (2005-2024)
Huiyao ZHANG1, 2, Hao LI1, 2, Tingting ZHOU2, Wenyu WU2, Guodong HUANG2, Zhengqi HUANG1, 2, Haoying HU3, Xianjun RAO2, Lei CHEN2, Wei WEI1, 2
Affiliations
  • 1.Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
  • 2.Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
  • 3.Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
出版时间: 2026-02-04 doi: 10.13343/j.cnki.wsxb.20250521
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系统分析2005-2024年间肠道微生物群与代谢综合征(metabolic syndrome, MetS)研究的现状和趋势,识别关键研究热点,为后续研究和干预措施提供参考。本文采用Web of Science核心合集数据库,检索并筛选涉及肠道微生物群与MetS的相关文献。利用VOSviewer、CiteSpace及R语言bibliometrix包等文献计量学工具,对文献的发表趋势、国家与机构分布、研究主题和热点等方面进行统计分析。共纳入4 210篇相关文献,年发文量持续增长,2010年后增速显著。中国和美国发文量位居前列,研究成果主要发表在NutrientsGutNature等期刊;研究热点主要覆盖营养与饮食、生物化学与分子生物学、微生物学等领域;关键词演化分析显示,研究主题已由早期的菌群结构描述转向机制探讨,聚焦于肠道微生物群失调相关的能量代谢、炎症反应及肠-远端器官互作等调控机制。高频关键词共现分析还表明,短链脂肪酸、胆汁酸等关键代谢产物,以及微生物制剂和粪菌移植等微生态干预策略,逐渐成为该领域关注焦点。本研究通过文献计量学系统梳理了肠道微生物群与MetS的研究现状,揭示了研究热点和未来趋势。鉴于传统治疗手段在靶向性、依从性及长期安全性方面仍存在一定局限,靶向肠道菌群的微生态干预有望成为MetS防治的潜在突破口,为未来精准治疗提供了重要理论支撑。

肠道微生物群  /  代谢综合征  /  文献计量学  /  可视化分析

To systematically analyze the current status and research trends and identify the key research hotspots in the field of gut microbiota and metabolic syndrome (MetS) from 2005 to 2024, thus providing references for future research and intervention strategies. Relevant literature on gut microbiota and MetS was retrieved and screened from the Web of Science Core Collection. Bibliometric tools such as VOSviewer, CiteSpace, and the R package bibliometrix were used to analyze the publication trends, countries and institutions, research themes, and emerging hotspots. A total of 4 210 relevant publications were included. The annual number of publications showed an increasing trend, which was particular rapid after 2010. China and the United States led in publication output, and major research findings were published in journals such as Nutrients, Gut, and Nature. Research hotspots primarily covered the fields of nutrition and diet, biochemistry and molecular biology, and microbiology. Keyword evolution analysis revealed a shift from early descriptive studies on gut microbiota composition to mechanism investigations focusing on dysbiosis-related pathways such as energy metabolism, inflammatory responses, and gut-organ axes. Co-occurrence analysis further indicated that key microbial metabolites (e.g., short-chain fatty acids and bile acids) and microbiota-targeted interventions (e.g., probiotics and fecal microbiota transplantation) had become focal points in recent studies. This bibliometric study comprehensively summarizes the research landscape of gut microbiota and MetS and highlights emerging trends and directions. Given the limitations of conventional therapies in terms of targeting specificity, patient adherence, and long-term safety, microbiota-based interventions offer a promising breakthrough for the prevention and treatment of MetS, providing valuable theoretical support for future precision medicine.

gut microbiota  /  metabolic syndrome  /  bibliometrics  /  visualization analysis
张惠瑶, 李浩, 周婷婷, 武文玉, 黄国栋, 黄鉦淇, 胡好颖, 饶显俊, 陈磊, 魏玮. 基于Web of Science的肠道微生物群与代谢综合征全球研究热点与趋势(2005-2024). 微生物学报, 2026 , 66 (2) : 926 -955 . DOI: 10.13343/j.cnki.wsxb.20250521
Huiyao ZHANG, Hao LI, Tingting ZHOU, Wenyu WU, Guodong HUANG, Zhengqi HUANG, Haoying HU, Xianjun RAO, Lei CHEN, Wei WEI. Global hotspots and trends in gut microbiota and metabolic syndrome research based on Web of Science (2005-2024)[J]. Acta Microbiologica Sinica, 2026 , 66 (2) : 926 -955 . DOI: 10.13343/j.cnki.wsxb.20250521
代谢综合征(metabolic syndrome, MetS)是一组常见且严重影响健康的代谢紊乱综合征,其主要特征包括腹型肥胖、胰岛素抵抗、高血糖、高血脂和高血压等一系列相互关联的危险因素[1-2]。这些因素会增加动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease, ASCVD)、2型糖尿病(type 2 diabetes mellitus, T2DM)、中风及其他相关疾病的发病风险[3]。尽管MetS的通用定义仍存在部分争议,但目前主要有5项指标被用于评估和诊断该综合征,分别为中心性肥胖、血压、血糖、甘油三酯和高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C)[4]。根据1999-2018年美国国家健康与营养调查(National Health and Nutrition Examination Survey, NHANES)数据,美国成年人中MetS的患病率从28.23%上升至37.09%[3]。随着全球老龄化进程加速以及生活方式西化,MetS患病率逐年攀升,已成为严重威胁全球公共健康的慢性病之一,给患者和社会造成了巨大的经济负担[5-6]。尽管当前的干预策略主要依赖药物治疗、膳食控制及生活方式管理,但其疗效受限于个体依从性差、靶向性不足以及存在副作用等问题,因此亟需探索更具针对性与可持续性的治疗新途径。
人类的皮肤、呼吸道、消化道以及生殖道栖息着大量微生物,它们构成了各式各样复杂的微生物群落。数万亿微生物寄居于人体肠道,参与吸收、代谢、免疫和内分泌等多种生理功能,对健康起着至关重要的调节作用。Vijay-Kumar等和Kawano等的研究表明,肠道微生物可能影响MetS的发生、发展和预后转归[7-8]。肠道微生物群失调可导致肠道屏障功能障碍和全身性炎症。相关研究显示,肠道微生物群通过各种活性成分介导MetS的发生,其中短链脂肪酸(short-chain fatty acids, SCFAs)等代谢产物对宿主的代谢调节发挥着重要作用[9]。此外,文献计量分析和数据可视化最近在生物医学领域受到广泛关注,越来越多的免费文献计量工具被应用于相关研究[10-11]。本研究利用CiteSpace、VOSviewer和R语言bibliometrix包等进行可视化分析,构建知识图谱,以评估近20年来肠道微生物群与代谢综合征的研究现状、研究热点和发展趋势,旨在为相关领域研究提供理论支撑和选题策略参考。
文献摘自Web of Science核心合集数据库(Web of Science Core Collection, WoSCC),并于2024年10月8日下载。为避免数据库更新带来的偏差,本研究在同一天完成了所有数据的提取和下载[检索策略存储于国家微生物科学数据中心(http://nmdc.cn),编号为NMDCX0002166]。这些检索策略综合运用了PubMed MeSH数据库中肠道微生物群和MetS的主题词及其同义词。在初步数据搜索完成后,2名研究人员分别对所有文献进行审查,并根据纳入与排除标准独立筛选数据。若意见存在分歧,则由第3位作者进行确认筛选,以确保纳入文献的报告内容与本研究主题相关。最终,经过图1所示的筛选流程,共纳入4 210篇文献。
共检索获得4 210篇相关文献,以“全记录及其引用参考文献”的形式从WoSCC数据库导出,保存为纯文本或制表符分隔格式,以便用于后续文献计量学分析。随后,采用Microsoft Excel 2021对核心数据进行统计汇总,涵盖年度发文量与被引次数、国家/地区、机构、作者、期刊及关键词等内容。期刊影响因子(journal impact factor, JIF)及学科四分位分类信息来自《2024年度期刊引证报告》(journal citation reports, JCR),其中JCR依据JIF将同一学科的期刊划分为4个等级:前25%为Q1,25%-50%为Q2,以此类推。其他文献计量指标,如总被引次数、篇均被引次数及研究领域等,则通过WoSCC的引文报告功能获取。
本研究将所有符合标准的WoSCC数据转换为TXT格式,并导入CiteSpace 6.2.R4、VOSviewer 1.6.18、R语言bibliometrix包、Pajek和Charticulator等专业软件平台进行文献计量学与可视化分析[10-12]。利用VOSviewer并结合Pajek进行网络优化,构建国家/地区、机构和作者的合作网络,以及期刊、作者和文献的被引与共被引网络。采用CiteSpace进行参考文献共被引聚类、关键词与参考文献突现分析,并绘制期刊双图叠加。此外,使用R语言bibliometrix包生成关键词词云、桑基图与主题演变图等分析结果。国家/地区发文量、年度累计发文量及年度发文趋势由Microsoft Excel 2021进行基础统计与绘图,研究结果进一步在Charticulator中制作可视化图表。
从文献类型来看,共纳入2 569篇研究论文和1 641篇综述文章。利用R语言bibliometrix包评估了过去20年间不同国家/地区在肠道微生物群与代谢综合征领域的论文发表量,以识别主要贡献者及其研究趋势。如图2A所示,代谢综合征与肠道微生物群的研究经历了多个发展阶段。2005-2010年为初始阶段,研究文章数量逐年上升,从2005年的6篇跃升至2010年的48篇,这表明该领域的早期探索逐渐展开。随后,2011-2022年期间,文献数量显著增加,从2011年的54篇激增至2021年的632篇,这一增长趋势反映了该领域的活跃性和研究深化的倾向。然而,2022-2023年间进入了调整和波动阶段,发表论文数量降至2022年的555篇,2023年上半年则降至360篇。图2B展示了近20年发文量前10的国家/地区。2005-2021年间,美国在肠道微生物群与MetS研究中的文献数量持续增长并保持领先地位。然而,自2022年起,中国成为该领域文献发文数量最多的国家。表明中国在肠道微生物群与代谢综合征研究中的影响力日益增强。
2005-2024年间,共有104个国家/地区发表了4 210篇关于肠道微生物群与MetS研究的文章,其中,中国(1 206篇)和美国(976篇)是主要研究力量(图2C)。图2C显示了各国的总被引次数,其中美国以72 014次居首,意大利为24 262次。表1列出了篇均被引次数最高的10个国家/地区(发文量≥100篇),其中荷兰(123.10次)、英国(102.83次)和法国(96.32次)位居前3;美国以73.78次排名第5,而中国虽发文量较大,但篇均被引仅为32.26次,未进入前10名,这可能因发表年份较晚导致累积引用不足。图3A展示了不同国家之间合作的和弦图,其中弧段的长度与出版量相关,弧段之间用曲线连接,曲线的宽度表示合作频率。该和弦图反映了亚洲、欧洲和美洲等国家之间广泛的国际合作及跨区域互动趋势。中国和美国在国际合作中处于中心地位,并与多个国家保持紧密联系。
本研究通过将总被引次数除以发文量,计算出各国的篇均被引次数,并根据Web of Science学科类别对所有出版物进行了分类。图2D显示,在肠道微生物群与MetS研究中,5 017个机构发表的论文涉及前10个主要研究领域。图3B展示了发文量不少于15篇的前100个机构的合作网络图,结果表明这些机构之间形成了紧密的合作关系。其中,上海交通大学发文量最高(71篇),其次是卡洛斯三世健康研究所(54篇)、哥本哈根大学(53篇)、中国科学院(52篇)、浙江大学(50篇)、赫尔辛基大学(48篇)和加州大学圣地亚哥分校(48篇)。
在过去20年间,共有23 818名作者参与了肠道微生物群与MetS的研究。在发文量排名前10的作者中,有6位的发文量超过25篇(表2)。为了揭示作者间的合作关系,构建了一个包含至少5篇已发表文献的作者合作网络(图4A)。结果显示,Nieuwdorp M、Chassaing B、De Vos WM、Cani PD、Gewirtz AT、Delzenne NM、Gasbarrini A、Zhao L、Vijay-Kumar M和Herrema H的节点规模最大,表明其在该领域具有重要影响力。值得注意的是,大多数高产作者倾向于形成稳定的合作网络。此外,在119 400名共被引作者中,有10位的被引次数超过390次(表3),其中Cani PD (2 369次)位居首位,其次为Turnbaugh PJ (1 786次)、Ley RE (1 210次)、Bäckhed F (1 024次)和Everard A (707次)。通过设定共被引次数≥100的阈值,进一步绘制了共被引网络图(图4B),展示了合著者之间的合作动态,反映出该领域复杂的学术互动网络与知识贡献格局。
期刊是展示科学研究成果、传播知识的重要平台,研究人员常面临选择合适期刊的难题。在过去的20年间,共有988种期刊发表了4 210篇与肠道微生物群和MetS相关的论文。通过VOSviewer对引文网络进行分析,并将阈值设定为至少发表8篇文献,生成了100种期刊的共现网络图(图5A)。表4列出了与肠道微生物群和MetS研究关联度最高、被引次数排名前10的期刊。其中,Nutrients的总被引次数最高(10 741次),其次是Gut (8 949次)和Nature (7 655次)。值得注意的是,发表在Nature的论文篇均被引次数最高(1 093.6次),且排名前10的高被引期刊多数由美国出版。为进一步识别该领域的核心期刊,本研究总结了共被引分析结果并构建了高影响力期刊的共被引网络图。根据表5的数据,在共同被引次数上排名前10的期刊中,有6本期刊的被引次数超过6 000次。其中,Nature的共被引次数最高,达10 476次;其次是PLoS One (8 708次)和Nutrients (6 811次)。此外,Nature的影响因子最高(impact factor, IF=50.5)。在构建共被引网络时设置了最少共被引次数为1 000的阈值。如图5B所示,NaturePLoS One呈正向共引关系。这些核心期刊发表的相关研究在肠道微生物群与MetS领域具有较高的引用价值和学术影响力。
CiteSpace双图叠加分析清晰地揭示了肠道微生物群与MetS研究的跨学科知识流动情况。图中左侧代表引用文献所在的学科区域(citing region),右侧代表被引文献所属的学科区域(cited region) (图5C)。中间的曲线表示不同学科之间的引用关系,线条颜色代表不同的时间阶段或演化趋势,线条越粗表示引用强度越高。可见有5条黄色或绿色的引用路径,显示环境科学/毒理学/营养学、分子生物学/生物学/遗传学以及健康科学/护理学/医学期刊的研究成果,常被分子生物学/生物学/免疫学及医学/临床医学期刊文献引用。同时,叠加图边缘路径显示,数学/系统科学/数理科学、生态学/地球科学/海洋科学、物理学/材料科学/化学、心理学/教育学/健康科学、兽医学/动物科学/生命科学、神经病学/运动科学/眼科学和牙科学/皮肤病学/外科学等学科也参与了肠道微生物群与MetS的研究。双图叠加结果表明这些学科领域之间的知识交流日益频繁,研究主题逐渐交叉与融合,反映出跨学科合作和研究主题融合在该领域研究中的重要性。
被引次数通常被视为衡量科研成果学术影响力的重要指标。本文对这4 210篇相关文献的被引用情况进行了统计和排序,结果显示被引次数排名前10的文献列于表6中。Tremaroli等[13]Nature上发表的文章被引次数最高(3 141次),该文探讨了肠道微生物群对能量代谢的影响及其在肥胖中的作用。第2篇文章由Vrieze等[14]于2012年发表在Gastroenterology,被引次数达2 021次,研究发现来自瘦供体的粪菌移植(fecal microbiota transplantation, FMT)能够改善受体的胰岛素敏感性。第3篇文章由Buzzetti等[15]于2016年发表在Metabolism,被引次数达1 915次,研究提出了非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)的“多重打击”假说,强调肠道微生物群在胰岛素抵抗中的重要性。排名第5的文章由Rinninella等[17]于2019年发表在Microorganisms,被引次数达1 720次,研究强调早期生活因素在塑造核心原生菌群中的关键作用。
在检索的4 210篇文献中,共引用了200 378篇参考文献。在文献计量学中,经常被共同引用的文献被视为研究领域的核心基础。通过对这些共被引文献的分析,可以揭示肠道微生物群与MetS研究的知识背景和学术体系。图6A展示了肠道微生物群与MetS研究的共被引网络,节点大小与被引频率相关,连线粗细表示共被引强度。彩条中红色节点表示近年来高频被引文献,反映其在该领域的持续影响力。表7列出了共被引频率最高的前10篇参考文献。如图6B所示,本研究利用CiteSpace对这些共被引的参考文献进行了聚类分析。分析结果表明,整体网络的模块度(Q值)为0.717,每个集群的平均轮廓值均大于0.775 9,提示聚类结构显著且可靠。集群编号显示对研究主题的关注强度,集群分数越低,关注度越高。集群#0、#1、#4、#10、#13和#20探讨了肠道微生物群与MetS的初始联系及潜在触发因素;集群#10、#14、#16、#18和#19研究了肠道微生物群与MetS的发病机制;集群#2、#3、#5、#7、#9和#17探讨了肠道微生物群与MetS相关疾病的联系;集群#6、#8、#11、#12和#15则关注肠道微生物群的治疗策略。
被引文献的突现检测有助于揭示阶段性研究热点及未来潜在研究方向。在CiteSpace中设置最小持续时间为2年、g值为1,最终筛选出25篇突现强度最高的被引文献。这些文献在肠道微生物群与MetS研究领域具有重要的学术价值(图7A)。蓝线表示2005-2024年期间的时间轴,红线代表突发文献的持续时间。这些参考文献中,Vijay-Kumar等[7]发现缺乏Toll样受体5 (Toll-like receptor 5, TLR5)的小鼠表现出肥胖、胰岛素抵抗和高脂血症等MetS特征,且伴随肠道微生物群结构显著改变;将其菌群移植至无菌小鼠后也可诱导类似代谢表型,提示肠道微生物群在代谢疾病发生中的关键作用(突现强度49.47)。Vrieze等[14]发现,来自健康瘦型供体肠道微生物群可能通过调节丁酸盐生成来改善胰岛素敏感性,为MetS治疗提供新思路(突现强度为49.85)。Qin等[30]基于高通量宏基因组测序首次构建了人类肠道微生物基因目录,为未来的研究奠定了基础(突现强度为40.43)。David等[22]研究显示,短期饮食模式的改变可显著影响肠道微生物的结构与基因表达,从而影响其多样性和代谢活性,为MetS的饮食干预提供理论依据(突现强度为49.26)。Everard等[25]发现,补充嗜黏蛋白阿克曼氏菌(Akkermansia muciniphila)能够逆转肥胖和2型糖尿病相关的代谢异常,并改善炎症与肠道屏障功能(突现强度为45.64)。Fan等[9]探讨了肠道微生物群通过宿主-微生物相互作用影响代谢和免疫,并提出调节肠道微生物群以改善代谢健康的潜在策略(突现强度为39.1)。
关键词共现网络有助于识别研究热点和趋势。本研究使用VOSviewer软件,设定关键词最小出现次数为10,提取出613个关键词并进行聚类分析。图6C显示了关键词共现网络,每个节点表示一个关键词,节点大小与词频成正比,连线表示关键词之间的共现关系,颜色则区分不同的聚类类别。结果显示关键词可划分为8个聚类,每个聚类代表一个独立的研究方向。聚类1主要探讨肠道微生物群与代谢综合征相关疾病之间复杂的相互关系,特别关注饮食因素和微生物组成如何影响宿主代谢健康与疾病发生;聚类2、4和7聚焦于MetS的发病机制及其病理生理特征,强调肠道微生物群在代谢异常中的潜在治疗作用;聚类3和5则聚焦于MetS的危险因素,如肥胖、胰岛素抵抗、慢性炎症、高脂饮食及肠道菌群失调,讨论这些因素如何通过影响微生态环境进而推动代谢综合征的发生发展;聚类6和8则突出强调干预策略,包括“地中海饮食” “营养干预” “多酚”“益生菌”与“益生元”等手段在改善肠道菌群失衡、缓解代谢紊乱方面的研究进展。
关键词突现分析可用于识别在特定时期内研究热度迅速上升的术语,从而揭示潜在的研究热点及发展趋势。图7B展示了2005-2024年间与肠道微生物群和MetS相关的突现强度排名前38的关键词,以及对应的高峰年份、突现强度和持续时间等信息。2005-2016年,“细菌过度生长”关键词呈现6.44的突现强度,提示其与肠道微生物群失衡、肠道屏障功能受损及MetS发展密切相关。与此同时,2006-2016年间,“C反应蛋白”关键词的突现强度为5.67,反映其作为代谢综合征低度炎症标志物的研究关注度显著提升,并逐渐被用于疾病评估与管理。2010-2018年,“内毒素血症”关键词的突现强度为9.68,提示源自肠道微生物的细菌内毒素可能刺激宿主免疫反应,导致微生物群失调并引发慢性低度炎症(chronic low-grade inflammation, CLGI),这一过程被认为是MetS发生和发展过程中的关键因素。自2012年起,“饮食诱导肥胖”关键词的突现强度达18.16,并持续5年,与全球肥胖率上升趋势吻合,凸显饮食因素在肥胖及相关代谢紊乱中的重要性。2021-2022年,“肠道微生物群失调”关键词的突现强度为5.06,强调了其在MetS中的潜在作用及作为治疗靶点的研究价值。2021-2024年,“西方饮食”关键词的突现强度为4.99,表明在全球化背景下高脂高糖饮食模式对肠道微生物及宿主代谢稳态影响机制的研究受到持续关注。2022-2024年,“病理生理学”关键词的突现强度为5.33,表明研究热点正进一步聚焦于肠道微生物在MetS病理生理机制中的作用探索。此外,词云图(图6D)展示了肠道微生物群与MetS相关领域的100个高频关键词,词频反映了其在研究中的重要性。总体而言,肠道微生物群与MetS的相关研究已经从初期对肠道微生物群落结构的描述性分析,经历了技术革新的推动,尤其是分子生物学和高通量测序技术的飞跃,进而转向对疾病发生病理生理机制的深入探究。同时,特定饮食模式(如西方饮食)引发的研究热潮,也反映了在全球化背景下,人们对生活方式与公共健康之间关系的持续关注。这些研究进展不仅拓宽了对肠道微生物群在代谢性疾病中作用的理解,也为开发新的预防和治疗策略提供了坚实的科学基础。
图8A所示,桑基图从国家、高频关键词与主要研究主题3个维度展示了肠道微生物群与MetS的全球学术网络。左侧柱状条表示参与国家,柱高代表作者数量,颜色深浅反映研究贡献强度,其中中国和美国在该领域的贡献度最为突出,其次为意大利等国。中间列为主要关键词,包括“肠道微生物群” “代谢综合征” “肥胖” “炎症”等。矩形大小反映关键词在文献中的出现频率,映射主要研究方向。右侧为主要作者,通过连接线展示作者、国家与关键词之间的关联,描绘该领域的复杂网络。图8B展示了肠道微生物群与MetS相关研究主题的时间演变,追踪多个主题的流动,提供其进展和相互关系的定量洞察。彩色矩形的高度表示该主题在相应时间段内的研究热度,流线的粗细则反映主题之间的关联强度与概念重叠程度。不同颜色代表不同研究领域,节点的时序邻近性展示主题的连续性。主题演变映射到4个时期:2005-2009年,研究集中在“肠道微生物群” “胰岛素抵抗” “动脉粥样硬化”;2010-2014年,“肠道微生物群”与“代谢综合征”成为研究重点;2015-2019年,主题扩展至“肥胖” “肠道微生物群”和“肠易激综合征”;2020-2024年,“肠道微生物群”和“肥胖”的重要性持续突出。主题演变也进一步显示该领域的动态性与复杂性。
过去20年,肠道微生物群的研究逐渐受到重视,其在MetS治疗中的潜在价值日益凸显。因此针对肠道微生物群的干预措施在MetS的诊断、预防和治疗中展现出广阔的应用前景。本研究通过对WoSCC数据库中相关文献进行计量分析,借助可视化图谱系统梳理该领域的发展脉络与研究重点,旨在为未来肠道微生物群与MetS的研究提供有价值的参考。
对2005-2024年肠道微生物群与MetS相关文献的分析显示,过去20年该领域年发文量持续增长。图2B展示了不同国家在肠道微生物群与代谢综合征研究领域内论文数量的变化情况。其中,中国近年来增长尤为显著,论文数量已超过美国,成为该领域最活跃的研究国家之一。总体趋势显示,国际合作不断深化,有助于提升研究效率与成果质量。美国在国家合作中处于核心位置,中国紧随其后(图3A)。前10所高产机构多为综合实力较强的高校与研究机构,具备丰富的科研资源与人才基础,能够在该领域中发挥引领作用。其中,中国共有3所机构(上海交通大学、中国科学院、浙江大学),美国则有2所机构(加州大学圣地亚哥分校和哈佛医学院),反映出中美在高等教育和资源配置方面的优势。尤其是上海交通大学,在该领域的发文量排名第1,体现了其在该研究方向中的学术影响力(图3B)。从过去20年中为肠道微生物群和MetS的研究作出重大贡献的前10位作者来看,如Nieuwdorp M、Chassaing B、De vos WM、Cani PD和Gewirtz A在该领域发表的文献最多。Nieuwdorp M及其团队通过研究发现,健康瘦型供体的粪便微生物移植能在短期内有效改善代谢综合征患者的胰岛素敏感性,干预效果与患者的基础肠道微生物组组成显著相关[24]。Chassaing B及其团队则通过小鼠模型研究西方饮食引起的脂肪组织炎症,发现复杂的肠道微生物群是诱发脂肪炎症和代谢综合征的重要因素,为开发针对微生物的疗法提供了证据[31]。此外,De vos WM等[32]系统阐述了肠道微生物代谢产物,如短链脂肪酸、胆汁酸(bile acids, BAs)及内源性大麻素等,在宿主代谢调节中的作用,为靶向微生态干预提供了理论基础。
研究领域方面,Nutrients (IF=4.8)的总被引次数达10 741次,成为最活跃的期刊,而消化病学权威期刊Gut (IF=23.0)则以发表创新性研究著称。值得注意的是,Nature (IF=50.5)篇均被引次数为1 093.6次,位居首位,显示出其在该领域内较强的学术影响力。这些期刊中,美国占4种,英国3种,瑞士和中国各1种,反映出美国在推动肠道微生物群与MetS研究方面的重要作用。在共被引期刊中,大部分为高影响力的Q1期刊,体现了它们对肠道微生物与MetS研究的认可。此外,目前关于肠道微生物群与MetS的研究主要发表在NutrientsInternational Journal of Molecular SciencesScientific Reports等期刊。这些期刊大多属于基础研究类,覆盖生命科学、分子生物学、微生物学及营养学等领域,表明当前研究主要集中于基础研究层面,临床研究仍然相对有限,未来基础研究转化应用方面仍将面临挑战。根据总被引次数,在肠道微生物群与MetS研究中美国和中国是过去20年最具影响力的国家,主要因其发表数量分别位列全球第1和第2。在发文量≥100篇的国家/地区中,荷兰、英国和法国的篇均被引次数最高,分别为123.10、102.83和96.32次,显示出其在该领域具有较高的研究质量与国际影响力。被引频次最高的前10篇文献主要聚焦于基础研究,强调了肠道微生物群在代谢调节、炎症及个性化营养中的关键作用机制[7,13-21]。共同引用的参考文献是众多学术文献的重要来源,被认为是某一领域研究的基础。在本次文献计量分析中,前10篇共被引参考文献揭示了肠道微生物在代谢健康调控中的关键作用,涵盖了肠道微生物对代谢综合征的影响机制、风险因素以及干预策略等不同研究方向。Everard等[25]发现A. muciniphila在肥胖和2型糖尿病小鼠中丰度降低,通过补充益生元可恢复其丰度,从而改善肥胖小鼠的代谢综合征,并提升内源性大麻素水平。进一步研究显示,Dao等[26]发现超重和肥胖成年人中A. muciniphila的丰度与更健康的代谢状态相关,特别是在饮食限制后提高了胰岛素敏感性并降低血糖水平。在一项随机、双盲、安慰剂对照的临床试验中,Depommier等[23]发现在超重和肥胖的胰岛素抵抗个体中,连续3个月每天补充A. muciniphila可以改善胰岛素敏感性和代谢健康。此外,Bolyen等[28]介绍了QIIME 2这一先进的微生物组数据分析平台,有助于推进微生物组研究的可重复性与模块化。总体而言,这些研究为进一步理解肠道微生物群在代谢性疾病中的作用机制奠定了重要基础,并为基于微生物的干预策略提供了理论支持,具有重要的临床转化意义。
肠道微生物群失调被认为是MetS发展的重要上游驱动因素。其核心特征表现为菌群的丰富度和多样性下降以及微生态失衡,即有益菌减少和致病菌增加,可能扰乱宿主的能量代谢与免疫稳态[33]。这种微生态失衡通常与高脂饮食、抗生素使用以及生活方式等环境因素密切相关[34]。多项宏基因组学研究为菌群改变与代谢异常之间的联系提供了证据。例如,一项针对2型糖尿病患者的宏基因组学研究发现,肠道中以罗斯拜瑞氏菌属(Roseburia)为代表的丁酸产生菌显著减少,同时条件致病菌相对增多[35]。另一项欧洲肥胖人群的大规模定量宏基因组学进一步指出,菌群基因丰富度的降低与胰岛素抵抗、血脂异常及系统性炎症密切相关,并表现出栖粪杆菌属(Faecalibacterium)和双歧杆菌属(Bifidobacterium)等有益菌减少的特征[27]。此外,挪威HUNT大规模队列数据显示,活泼瘤胃球菌(Ruminococcus gnavus)丰度升高与身体质量指数、腰围及血清甘油三酯水平等MetS临床表型呈正相关[36]。在机制层面,肠道微生物群失调可通过多条通路扰乱宿主代谢稳态。首先,能量代谢异常是最早提出的机制之一。Turnbaugh等[37]发现,“肥胖型菌群”可显著增强能量获取效率,并通过粪菌移植在无菌小鼠中复制肥胖动物模型。Fei等[38]进一步证明从肥胖个体分离的阴沟肠杆菌(Enterobacter cloacae) B29菌株在高脂饮食条件下可引发无菌小鼠肥胖和胰岛素抵抗,提示某些致病菌株或具有直接致病潜能。其次,肠道屏障功能障碍及系统性低度炎症被认为是MetS发展的关键环节。Cani等[39]首次提出“代谢性内毒素血症”概念,指出高脂饮食导致血浆脂多糖(lipopolysaccharide, LPS)持续升高,可通过分化簇14 (cluster of differentiation 14, CD14)-Toll样受体4 (Toll-like receptor 4, TLR4)-核因子κB (nuclear factor κB, NF-κB)通路触发全身性炎症反应并促进胰岛素抵抗。Vijay-Kumar等[7]的研究显示,TLR5基因缺失小鼠可自发形成MetS样表型,且该表型可通过粪菌移植传递给无菌小鼠,为菌群-免疫-代谢异常之间的联系提供了实验证据。此外,肠道微生物群失调可通过调控脂肪组织微环境,加剧炎症级联反应,促进MetS进展。在肥胖状态下,肠道微生物群失调可促进巨噬细胞M1极化及α肿瘤坏死因子(tumor necrosis factor-α, TNF-α)、白细胞介素(interleukin, IL)-6等因子的释放,干扰胰岛素受体底物(insulin receptor substrate, IRS)磷酸化,从而削弱胰岛素信号传导[40]。肠源LPS则可通过激活TLR4-NOD样受体热蛋白结构域相关蛋白3 (NOD-likereceptorthermalprotein domain associated protein3, NLRP3)通路,加重脂肪组织胰岛素抵抗[41]。随着研究深入,肠-远端器官互作机制已成为MetS研究的重要方向。菌群失调产生的代谢产物及炎症介质可通过血液循环跨器官传递信号,协同调控肝脏与中枢神经系统的代谢功能,进一步放大全身代谢紊乱。在肠-肝轴中,肠屏障破坏使LPS经门静脉激活肝内Kupffer细胞TLR4-NF-κB/NLRP3通路,抑制胰岛素受体底物-1 (insulin receptor substrate-1, IRS-1)/蛋白激酶B (protein kinase B, Akt)并上调固醇调节元件结合蛋白-1c (sterol regulatory element-binding protein-1c, SREBP-1c),导致胰岛素抵抗与肝脂质沉积[42];此外,肠道微生物群还可通过调节胆汁酸代谢,影响法尼醇X受体(farnesoid X receptor, FXR)与武田G蛋白偶联受体5 (Takeda G protein-coupled receptor 5, TGR5)等受体信号,从而参与调控宿主糖脂代谢与胰岛素敏感性[43]。值得注意的是,肠-脑轴近年来也受到广泛关注。研究表明菌群来源的SCFAs可通过迷走神经作用于下丘脑神经肽Y (neuropeptide Y, NPY)/刺鼠相关蛋白(agouti-related protein, AgRP)神经元,调节食欲与能量摄入[44];而菌群调控的色氨酸代谢物如吲哚-3-丙酸(indole-3-propionic acid)可进入循环并到达下丘脑弓状核等区域,直接靶向信号转导和转录激活因子3 (signal transducer and activator of transcription 3, STAT3),参与能量代谢调控[45]
SCFAs主要包括乙酸、丙酸和丁酸,是肠道微生物群分解膳食纤维和碳水化合物产生的重要代谢产物[46-48],被认为是连接肠道微生物群与宿主代谢的关键中介,与MetS的发生、进展和改善密切相关。在代谢功能方面,SCFAs不仅为肠道上皮细胞提供能量,还通过多种机制调节宿主代谢功能与免疫功能,包括改善葡萄糖稳态、胰岛素敏感性和脂质代谢,并缓解低度慢性炎症[49-52]。SCFAs在体内分布存在差异。乙酸在血液循环中含量最高,可作为脂肪酸和胆固醇合成的底物;丙酸主要在肝脏中代谢并作为糖异生底物;而丁酸则主要在结肠局部代谢,是肠上皮细胞的主要能量来源[53-55]。在分子机制层面,SCFAs可通过激活肠道L细胞上的游离脂肪酸受体2 (free fatty acid receptor 2, FFAR2)和游离脂肪酸受体3 (free fatty acid receptor 3, FFAR3)发挥作用。其中FFAR2主要偶联Gq蛋白/磷脂酶C-钙离子信号通路(Gq protein/phospholipase C-calcium ion signaling pathway,Gq/PLC-Ca2+信号通路),促进胰高血糖素样肽-1 (glucagon-like peptide-1, GLP-1)与肽YY (peptide YY, PYY)的分泌;而FFAR3主要依赖Gi/o信号通路,作用相对较弱[53,56]。上述激素的分泌可协同抑制食欲、改善胰岛素敏感性并促进脂质代谢。此外,丁酸盐还可通过抑制组蛋白去乙酰化酶(histone deacetylase, HDAC)或激活G蛋白偶联受体(G protein-coupled receptor, GPCR),增强肠道屏障功能并调节黏膜免疫,发挥抗炎效应[57]。最新研究也显示丁酸可能通过肠-脑轴调控中枢代谢信号,为探讨微生物群-宿主互作机制开辟新方向[58]。值得注意的是,在人群研究中,来自不同地区和人群的证据一致表明SCFAs与代谢健康密切相关。一项河南农村人群横断面研究显示,粪便中总SCFAs、乙酸和丁酸水平与2型糖尿病的患病率呈显著负相关,且呈近似倒“S”型剂量-反应关系,提示其在糖尿病易感性中的保护作用[59]。另一项研究发现,肥胖女性粪便中SCFAs水平下降,与腰围、胰岛素抵抗及低HDL-C水平正相关[60]。然而,大规模非洲裔成人队列的流行病学转型建模研究(modeling the epidemiologic transition study, METS)提示不同社会经济发展阶段国家的人群SCFAs水平存在显著差异,经济欠发达国家居民的SCFAs水平普遍高于发达国家,且与肥胖状态呈负相关[61]
胆汁酸的合成和代谢是胆固醇和脂质分解代谢的主要途径,与多种代谢性疾病密切相关,包括肥胖、胰岛素抵抗和NAFLD[62]。肠道微生物群通过胆盐水解酶(bile salt hydrolase, BSH)介导的解偶联反应和7α-脱羟基化反应,将肝脏合成的初级胆汁酸转化为次级胆汁酸。具体而言,胆酸(cholic acid, CA)被转化为脱氧胆酸(deoxycholic acid, DCA),鹅脱氧胆酸(chenodeoxycholic acid, CDCA)被转化为石胆酸(lithocholic acid, LCA)[63]。这一由菌群主导的生物转化极大地丰富了胆汁酸池的化学构成并生成了功能各异的新型信号分子,构成了“肠道菌群-胆汁酸”轴调控宿主代谢的基础。这些功能各异的胆汁酸通过激活FXR和TGR5等关键受体,参与多种代谢通路调节葡萄糖和脂质代谢[64-67]。其中,CDCA作为最强效的天然FXR配体,其激活效力远高于CA、DCA和LCA[68]。FXR的激活会上调小异二聚体伴侣(small heterodimer partner, SHP)的表达,进而抑制甾醇调节SREBP-1c及其下游脂质合成相关基因的转录,减少肝脏甘油三酯沉积[69]。相较而言,肠道微生物群代谢产物的次级胆汁酸(如LCA和DCA)是TGR5最有效的激动剂[68]。TGR5的激活可以增加细胞内环磷酸腺苷(cyclic adenosine monophosphate, cAMP)水平,促进小肠L细胞分泌GLP-1等肠促胰素,从而增强胰岛素分泌,改善胰岛素敏感性[70]。然而,次级胆汁酸具有浓度依赖效应,当因菌群失调或高脂饮食导致其在肠道内异常积累时会表现出细胞毒性,可能损伤肠道上皮,破坏肠道屏障,并引发低度慢性炎症,凸显其在代谢调节中的复杂双重角色[71-72]。此外,胆汁酸还作用于下丘脑,通过结合AgRP/NPY神经元上的TGR5受体,抑制食欲相关神经肽释放,减少摄食行为,维持能量代谢稳态[69]。最新研究也发现,复合益生菌制剂可显著增强BSH和7α-脱羟基化活性,促进CA和CDCA向次级胆汁酸转化,将胆汁酸浓度恢复至有益范围,激活FXR与TGR5等受体信号通路,参与调节葡萄糖稳态、脂质合成与炎症反应,改善宿主代谢环境[64,73]。该机制提示“肠道菌群-胆汁酸”代谢轴在代谢综合征治疗中具有重要干预价值,为后续开发靶向微生态疗法提供了理论依据与转化方向。
随着肠道微生物群在代谢调控中的关键作用日益明确,基于微生态干预的治疗策略已成为MetS研究的重要方向。益生菌作为一种相对安全、耐受性良好的活性微生物制剂,能够显著改善宿主的代谢功能[74]。研究表明特定益生菌的补充可抑制致病菌生长、减少内毒素产生,并显著增强肠道屏障的完整性,有效调节免疫系统、血糖代谢及血脂谱,从而缓解高脂饮食引起的代谢紊乱[75]。动物实验和临床研究均证实,益生菌可以有效缓解MetS及其相关并发症。例如,补充鼠李糖乳杆菌(Lactobacillus rhamnosus) FJSYC4-1和罗伊特氏黏液乳杆菌(Limosilactobacillus reuteri) FGSZY33L6可以调节肠道微生物群,促进短链脂肪酸的产生,诱导饱腹激素的分泌,从而降低能量摄入、改善胰岛素敏感性并缓解炎症水平[76]Lactobacillus reuteri能够降低MetS小鼠模型的体重、减少脂肪堆积、改善胰岛素抵抗,并调节有害菌群[77]。另一项随机双盲临床研究显示,索氏厌氧丁酸杆菌(Anaerobutyricum soehngenii)可刺激GLP-1的产生,有效改善血糖控制[78]。益生元作为益生菌的替代品或辅助剂,主要由难以消化的食物成分构成,能够通过选择性促进有益菌增殖而改善代谢健康;低聚果糖可显著提升双歧杆菌丰度,重构肠道微生物群,降低内毒素水平,并改善胰岛素敏感性[79]。此外,菊粉类益生元则可促进PYY和GLP-1分泌,调控血清中的饥饿素水平,改善能量代谢[80]。相较于单一干预,合生元作为益生菌与益生元的协同组合,可更有效地改善肠道微生态并发挥代谢调控效应[81]。已有研究证实,基于薏苡种子挤压熟化产物(adlay seed extrusion cooked, ASEC)开发的合生元[含类干酪乳杆菌(Lactobacillus paracasei)和凝结魏茨曼氏菌(Weizmannia coagulans)]能显著改善高脂饮食诱导的肥胖小鼠代谢紊乱[82]。另有研究显示,含植物乳植杆菌(Lactiplantibacillus plantarum) PBS067、嗜酸乳杆菌(Lactobacillus acidophilus) PBS066和罗伊特氏黏液乳杆菌(Limosilactobacillus reuteri) PBS072的合生元配方也被证实可改善老年MetS患者的代谢指标和生活质量[83]
然而,传统微生态干预仍面临诸多挑战,如干预效应具有菌株特异性、个体间定植效率存在差异,以及活菌制剂在免疫功能低下宿主中的潜在安全性风险。这些问题限制了传统益生菌干预的广泛推广。为此,“后生元(postbiotics)”概念应运而生。根据国际益生菌和益生元科学协会(International Scientific Association for Probiotics and Prebiotics, ISAPP)的定义,后生元指对宿主健康有益的无生命微生物和/或其成分的制剂[84]。相比传统益生菌,后生元具备成分明确、机制清晰、质量可控及安全性高等优势,标志着微生态干预从整体菌群调节向分子机制导向的转型。近年来,多项研究开始揭示后生元在代谢综合征干预中的潜在价值。例如,临床试验证实,巴氏杀菌后的灭活A. muciniphila的外膜蛋白Amuc_1100可通过激活宿主肠道上皮细胞的Toll样受体2 (Toll-like receptor 2, TLR2),调控磷脂酰肌醇3-激酶-蛋白激酶B (phosphatidylinositol 3-kinase-protein kinase B, PI3K-AKT)信号通路,进而促进5-羟色胺合成、增强肠道屏障功能并维持代谢稳态[85]Lactiplantibacillus plantarum ZJ316来源的脂磷壁酸(lipoteichoic acid, LTA)也可靶向TLR2,抑制细胞外信号调节激酶(extracellular signal-regulated kinase, ERK)/p38丝裂原活化蛋白激酶(p38mitogen-activated protein kinase, p38MAPK)通路以调控炎症因子表达、强化上皮紧密连接,从而缓解代谢性内毒素血症相关的肠屏障障碍[86]。除了结构分子,功能性代谢产物也是后生元研究的重要组成。例如,共轭亚油酸(conjugated linoleic acid, CLA)由特定益生菌合成,已被证实在高脂饮食诱导的代谢综合征模型中可通过激活过氧化物酶体增殖物激活受体γ (peroxisome proliferator-activated receptor γ, PPARγ)、PI3K-Akt及腺苷酸活化蛋白激酶(adenosine monophosphate-activated protein kinase, AMPK)等信号通路,调节脂质代谢、改善胰岛素抵抗及抑制脂肪堆积,发挥代谢调节潜力[87]。尽管后生元策略在安全性与可控性方面具优势,但由于缺乏活菌的持续定植能力及生态调节功能,仍难以完全替代传统活菌干预。
基于此,“下一代益生菌(next-generation probiotics, NGPs)”逐渐成为微生态干预的新兴方向,为代谢综合征的精准治疗提供新策略[88]。NGPs多为宿主健康状态密切相关的核心共生菌,具有更明确的宿主互作通路和代谢调控能力[89-90]。其中,A. muciniphila的临床研究显示在肥胖人群中补充该菌可显著降低炎症水平并改善胰岛素抵抗与脂质代谢[23]。此外,粪便普雷沃氏菌(Prevotella copri)和小克里斯滕森氏菌(Christensenella minuta)也被发现与改善胰岛素抵抗相关,而古氏副拟杆菌(Parabacteroides goldsteinii)、A. muciniphila和多形拟杆菌(Bacteroides thetaiotaomicron)则显示出逆转肥胖和胰岛素抵抗的潜力[89]。NGPs的理念进一步催生了工程化益生菌(engineered probiotics, EPs),即利用合成生物学技术改造菌株,使其能感应疾病信号并递送特定治疗分子,构建“活体药物(living therapeutics)”。例如,通过基因工程修饰GLP-1并将其整合至Lactiplantibacillus plantarum WCFS1,实现了可口服递送的GLP-1激动剂系统,在db/db小鼠模型中明显缓解2型糖尿病相关代谢紊乱[91]。为推动益生菌、后生元及NGPs等微生物制剂的精准化干预,整合多组学技术已成为关键研究方向。通过宏基因组、代谢组和转录组等多组学手段,研究者能够系统地解析肠道微生物与宿主之间的代谢互作机制,从而为功能性菌株的筛选及其定向设计提供理论支持与潜在靶点依据。未来研究应加强NGPs的安全性评估、生产工艺标准化及个体化干预方案开发,推动其从基础研究向临床应用的有效转化[92]。此外,构建科学完善的监管体系也是保障NGPs安全、规范应用的关键环节[88]
粪菌移植通过将健康供体的粪便微生物移植至受体,以重塑肠道微生态,在代谢综合征的治疗中展现出巨大潜力。临床研究证实,FMT可改善受体的胰岛素敏感性、血糖控制和脂质代谢。Vrieze等[14]和Kootte等[24]发现,接受来自瘦型供体的FMT后,代谢综合征患者在随访6周时外周胰岛素敏感性显著提高。更重要的是,FMT的代谢改善效应可由受体的基线肠道菌群特征预测[24]。此外,FMT联合特定饮食方案也显示出协同效应,例如一项Ⅱ期双盲随机对照试验显示,FMT结合低发酵性膳食纤维补充能显著改善重度肥胖合并MetS患者的胰岛素抵抗指数(homeostatic model assessment of insulin resistance, HOMA2-IR)指标[93]。然而,FMT的长期疗效仍存争议。Kootte等[24]在随访中观察到,FMT干预18周后其对胰岛素敏感性的改善作用不再显著,受体肠道微生物群结构逐步回归基线状态,提示其代谢效应可能是短暂的。此外,FMT的疗效可能受到供体菌群特征的影响。De Groot等[94]发现,来自代谢综合征供体的FMT不仅未改善受体代谢状态,甚至显著降低了其胰岛素敏感性,而胃旁路术后供体的FMT则表现出积极效果,该差异或与供体菌群组成、胆汁酸代谢能力及肠道转运时间等因素有关。近期多项荟萃分析也证实FMT能有效降低空腹血糖、糖化血红蛋白和胰岛素水平,但对体重、身体质量指数等肥胖相关指标的影响相对有限[95-96]。此外,研究还发现FMT的临床效果在不同个体间存在显著差异,可能与基线微生物多样性、供体菌株组成及干预时机等因素有关[97]。为进一步提升FMT在MetS治疗中的临床应用价值,当前研究正朝着策略优化方向推进,包括基于功能表型的供体筛选、标准化递送方式,以及与饮食、益生菌等干预手段的联合应用。未来研究可进一步结合多组学数据,关注特定代谢产物的功能验证与区域人群菌群特征差异,通过大样本、多中心、长期随访的随机对照研究,系统评估FMT的长期疗效与安全性,推动其在代谢相关疾病中的标准化与精准化应用。
在本项文献计量学研究中,对过去20年间肠道微生物群与MetS的相互作用及研究动态进行了系统性回顾,并梳理了该领域的重要发展趋势。目前,肠道微生态失调已被认为是驱动MetS发展的关键上游因素之一。其作用机制主要涉及能量代谢重编程、肠道屏障功能受损所致的LPS转移、短链脂肪酸与胆汁酸等代谢信号异常,以及肠-肝、肠-脑、肠-脂肪组织等远端器官间的互作,共同诱发系统性低度炎症与胰岛素抵抗,从而破坏宿主代谢稳态。针对上述机制,多种微生态干预策略应运而生。传统的益生菌、益生元及FMT显示出一定的应用潜力,但其疗效的个体差异性与不稳定性限制了其临床推广。因此近年来的研究焦点逐步转向机制更明确、靶点更清晰的新型干预手段,如后生元、NGPs及EPs等。这些被称为“活体药物”的新策略为实现精准可控的个体化干预提供了新的方向。然而,将这些新兴策略转化为成熟的临床应用仍面临诸多挑战。未来的研究应致力于更严格地验证特定微生物的因果作用,而非仅停留在相关性层面。同时,解决因个体特征导致的疗效差异问题是提升临床应用价值的核心。此外,对于NGPs等新型疗法,其长期有效性与安全性亟待通过大规模、长周期的随机对照试验加以确认,并需配套建立相应的临床应用和监管规范。本研究的局限性在于文献检索主要基于WoSCC数据库,文献覆盖范围可能存在局限。此外,文献计量学方法自身也存在固有局限,如无法对研究质量进行评价或校正外部研究资源等因素。未来的相关分析可整合更多文献数据来源,以获得更为全面的视角。
  • 中国中医科学院望京医院自主选题专项课题(WJYY-ZZXT-2023-14)
  • 中国中医科学院望京医院自主选题专项课题(WJYY-ZZXT-2023-15)
  • 国家重点研发计划(2023YFC3503601)
  • 国家自然科学基金(82204865)
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2026年第66卷第2期
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doi: 10.13343/j.cnki.wsxb.20250521
  • 接收时间:2025-07-08
  • 首发时间:2026-02-05
  • 出版时间:2026-02-04
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  • 收稿日期:2025-07-08
  • 录用日期:2025-09-17
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the Independent Research Project of Wangjing Hospital, China Academy of Chinese Medical Sciences(WJYY-ZZXT-2023-14)
中国中医科学院望京医院自主选题专项课题(WJYY-ZZXT-2023-14)
中国中医科学院望京医院自主选题专项课题(WJYY-ZZXT-2023-15)
the National Key Research and Development Program of China(2023YFC3503601)
国家重点研发计划(2023YFC3503601)
the National Natural Science Foundation of China(82204865)
国家自然科学基金(82204865)
作者信息
    1.广州中医药大学,科技创新中心,广东 广州
    2.中国中医科学院望京医院,北京
    3.成都中医药大学,四川 成都
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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