diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13196diaendo-13196Research ArticleОбзорыReviewТерапевтический успех применения различных способов модуляции кишечной микробиоты в лечении ожирения, метаболического синдрома и сахарного диабета 2 типаThe therapeutic success of approaches to the gastrointestinal microbiome modulation in the treatment of obesity, metabolic syndrome and type 2 diabetes mellitushttps://orcid.org/0000-0001-5389-7833ЗаболотневаА. А.ZabolotnevaA. A.

Заболотнева Анастасия Александровна - к.б.н., доцент, cт.н.с.; Scopus Author ID: 36612706700.

117513, Москва, ул. Островитянова, д. 1

Anastasia A. Zabolotneva - PhD in Biology, Associate Professor, senior researcher; Scopus Author ID: 36612706700.

1 Ostrovityanova street, 117513 Moscow

a.zabolotneva@gmail.comhttps://orcid.org/0000-0003-4265-1293ШатоваО. П.ShatovaO. P.

Шатова Ольга Петровна - к.м.н., доцент.

Москва

Olga P. Shatova - PhD, Associate Professor.

Moscow

shatova.op@gmail.comhttps://orcid.org/0009-0000-1739-5545АгаповаЮ. А.AgapovaJ. A.

Агапова Юлия Андреевна - студент.

Москва

Julia A. Agapova - student.

Moscow

juagape@yandex.ruhttps://orcid.org/0009-0000-6349-6566РоманенкоА. С.RomanenkoA. S.

 

Романенко Александр Сергеевич - студент.

Москва

Alexander S. Romanenko - student.

Moscow

dev1ton@mail.ruhttps://orcid.org/0000-0002-7418-0222РумянцевС. А.RoumiantsevS. A.

Румянцев Сергей Александрович - д.м.н., профессор, член-корр. РАН.

Москва

Sergey A. Roumiantsev - PhD, Professor.

Moscow

umyantsev.sergey@endocrincentr.ruhttps://orcid.org/0000-0002-1428-7706ШестопаловА. В.ShestopalovA. V.

Шестопалов Александр Вячеславович - д.м.н., профессор; Scopus Author ID: 57195032259.

Москва

Aleksandr V. Shestopalov - MD, PhD, Professor; Scopus Author ID: 57195032259.

Moscow

al-shest@yandex.ruРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова; ГНЦ РФ ФГБУ «Национальный медицинский исследовательский центр эндокринологии»РоссияPirogov National Research Medical University; Endocrinology Research CentreRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov National Research Medical UniversityRussian Federation202418012025276598610Copyright © Заболотнева А.А., Шатова О.П., Агапова Ю.А., Романенко А.С., Румянцев С.А., Шестопалов А.В., 20252025Заболотнева А.А., Шатова О.П., Агапова Ю.А., Романенко А.С., Румянцев С.А., Шестопалов А.В.Zabolotneva A.A., Shatova O.P., Agapova J.A., Romanenko A.S., Roumiantsev S.A., Shestopalov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13196

Ожирение, сахарный диабет 2 типа (СД2) и сопутствующие метаболические нарушения занимают лидирующие позиции в списках заболеваемости во всем мире. Неудивительно, что усилия множества научных групп и клиницистов направлены на поиск эффективных терапевтических стратегий для лечения этих заболеваний. В последние десятилетия все более очевидной становится вовлеченность кишечной микробиоты в патогенез метаболических, иммунных и других нарушений у человека. В этой связи предпринимаются попытки по модуляции композиционного состава и функциональной активности микробиоты в качестве основного или дополнительного пути лечения различных нарушений. Целью настоящего обзора стало освещение и анализ результатов клинических исследований последних лет, посвященных изучению различных способов модуляции микробного сообщества кишечника с целью терапии ожирения, метаболического синдрома и СД2. Для реализации поставленной цели нами был проведен систематический поиск с использованием электронных баз данных, включая «Scopus», «Medline» и «PubMed», c ограничением срока публикации с 2019-го по 2024 гг. Проведенный анализ показал, что терапевтический успех различных методов модуляции кишечной микробиоты, с одной стороны, указывает на необходимость учитывать особенности микробного состава кишечника больных и направлять лечебные действия на коррекцию дисбиоза, с другой стороны — дает основание на широкое внедрение фармакологических или иных подходов коррекции микробиотического состава кишечника как эффективного способа лечения ожирения и ассоциированных с ним метаболических расстройств.

 

Obesity, type 2 diabetes mellitus (T2DM), and related metabolic disorders occupy the leading positions on the lists of diseases worldwide. It is not surprising that the efforts of many scientific groups and clinicians are aimed at finding effective therapeutic strategies to treat these diseases. In recent decades, the involvement of the intestinal microbiota in the pathogenesis of metabolic, immune, and other disorders in humans has become increasingly obvious. In this regard, attempts are made to modulate the composition and functional activity of the microbiota as a primary or adjuvant way of treating various disorders. The purpose of this review was to highlight and analyse the results of clinical studies in recent years devoted to the study of various methods of modulating the intestinal microbial community for the treatment of obesity, metabolic syndrome, and T2DM. To achieve this goal, we conducted a systematic search using electronic databases, including Scopus, Medline, and PubMed, limiting the publication period from 2019 to 2024. The conducted analysis showed that the therapeutic success of various methods of modulating intestinal microbiota, on the one hand, indicates the need to take into account the characteristics of the microbial composition of the intestines of patients and direct therapeutic actions to correct dysbiosis; on the other hand, it provides grounds for the widespread introduction of pharmacological or other approaches to correcting the microbiotic composition of the intestine as an effective method of treating obesity and associated metabolic disorders.

кишечная микробиотаожирениеметаболический синдромсахарный диабет 2 типатрансплантация фекальной микробиотыпробиотикипребиотикибариатрическая хирургияглюкагоноподобный пептид-1метформинgastrointestinal microbiomeobesitymetabolic syndrometype 2 diabetes mellitusfecal microbiota transplantationprobioticsprebioticsbariatric surgeryglucagon-like peptide 1metforminРабота выполнена в рамках гранта НЦМУ №075-15-2022-310 от 20.04.2022ReferencesUrsell LK, Haiser HJ, Van Treuren W, et al. The Intestinal Metabolome: An Intersection Between Microbiota and Host. Gastroenterology. 2014;146(6):1470-1476. https://doi.org/10.1053/j.gastro.2014.03.001Ursell LK, Haiser HJ, Van Treuren W, Garg N, Reddivari L, Vanamala J, et al. The Intestinal Metabolome: An Intersection Between Microbiota and Host. Gastroenterology. 2014 May;146(6):1470–6.Morais LH, Schreiber HL, Mazmanian SK. The gut microbiota–brain axis in behaviour and brain disorders. Nat Rev Microbiol. 2021. https://doi.org/10.1038/s41579-020-00460-0Morais LH, Schreiber HL, Mazmanian SK. The gut microbiota–brain axis in behaviour and brain disorders. Nat Rev Microbiol. 2021 Apr 22;19(4):241–55.Wang J, Zhu N, Su X, et al. Gut-Microbiota-Derived Metabolites Maintain Gut and Systemic Immune Homeostasis. Cells. 2023;12(5):793. https://doi.org/10.3390/cells12050793Wang J, Zhu N, Su X, Gao Y, Yang R. Gut-Microbiota-Derived Metabolites Maintain Gut and Systemic Immune Homeostasis. Cells. 2023 Mar 2;12(5):793.Rooks MG, Garrett WS. Gut microbiota, metabolites and host immunity. Nat Rev Immunol. 2016. https://doi.org/10.1038/nri.2016.42Rooks MG, Garrett WS. Gut microbiota, metabolites and host immunity. Nat Rev Immunol. 2016 Jun 27;16(6):341–52.Cani PD, Van Hul M. Gut microbiota in overweight and obesity: crosstalk with adipose tissue. Nat Rev Gastroenterol Hepatol. 2024. https://doi.org/10.1038/s41575-023-00867-zCani PD, Van Hul M. Gut microbiota in overweight and obesity: crosstalk with adipose tissue. Nat Rev Gastroenterol Hepatol. 2024 Mar 8;21(3):164–83.Mancin L, Wu GD, Paoli A. Gut microbiota–bile acid–skeletal muscle axis. Trends Microbiol. 2023;31(3):254-269. https://doi.org/10.1016/j.tim.2022.10.003Mancin L, Wu GD, Paoli A. Gut microbiota–bile acid–skeletal muscle axis. Trends Microbiol. 2023 Mar;31(3):254–69.Qiu P, Ishimoto T, Fu L, Zhang J, Zhang Z, Liu Y. The Gut Microbiota in Inflammatory Bowel Disease. Front Cell Infect Microbiol. 2022;12. https://doi.org/10.3389/fcimb.2022.733992Qiu P, Ishimoto T, Fu L, Zhang J, Zhang Z, Liu Y. The Gut Microbiota in Inflammatory Bowel Disease. Front Cell Infect Microbiol. 2022 Feb 22;12.Albhaisi SAM, Bajaj JS, Sanyal AJ. Role of gut microbiota in liver disease. Am J Physiol - Gastrointest Liver Physiol. 2020. https://doi.org/10.1152/AJPGI.00118.2019Albhaisi SAM, Bajaj JS, Sanyal AJ. Role of gut microbiota in liver disease. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2020 Jan 1;318(1):G84–98.Arumugam M, Raes J, Pelletier E, et al. Enterotypes of the human gut microbiome. Nature. 2011;473(7346):174-180. https://doi.org/10.1038/nature09944Arumugam M, Raes J, Pelletier E, Le Paslier D, Yamada T, Mende DR, et al. Enterotypes of the human gut microbiome. Nature. 2011 May 12;473(7346):174–80.Takeuchi T, Kameyama K, Miyauchi E, et al. Fatty acid overproduction by gut commensal microbiota exacerbates obesity. Cell Metab. 2023;35(2):361-375.e9. https://doi.org/10.1016/j.cmet.2022.12.013Takeuchi T, Kameyama K, Miyauchi E, Nakanishi Y, Kanaya T, Fujii T, et al. Fatty acid overproduction by gut commensal microbiota exacerbates obesity. Cell Metab. 2023 Feb;35(2):361-375.e9.Scheithauer TPM, Rampanelli E, Nieuwdorp M, et al. Gut Microbiota as a Trigger for Metabolic Inflammation in Obesity and Type 2 Diabetes. Front Immunol. 2020;11. https://doi.org/10.3389/fimmu.2020.571731Scheithauer TPM, Rampanelli E, Nieuwdorp M, Vallance BA, Verchere CB, van Raalte DH, et al. Gut Microbiota as a Trigger for Metabolic Inflammation in Obesity and Type 2 Diabetes. Front Immunol. 2020 Oct 16;11.Amabebe E, Robert FO, Agbalalah T, Orubu ESF. Microbial dysbiosis-induced obesity: role of gut microbiota in homoeostasis of energy metabolism. Br J Nutr. 2020;123(10):1127-1137. https://doi.org/10.1017/S0007114520000380Amabebe E, Robert FO, Agbalalah T, Orubu ESF. Microbial dysbiosis-induced obesity: role of gut microbiota in homoeostasis of energy metabolism. British Journal of Nutrition. 2020 May 28;123(10):1127–37.Wang P-X, Deng X-R, Zhang C-H, Yuan H-J. Gut microbiota and metabolic syndrome. Chin Med J (Engl). 2020;133(7):808-816. https://doi.org/10.1097/CM9.0000000000000696Wang PX, Deng XR, Zhang CH, Yuan HJ. Gut microbiota and metabolic syndrome. Chin Med J (Engl). 2020 Apr 5;133(7):808–16.Zhou Z, Sun B, Yu D, Zhu C. Gut Microbiota: An Important Player in Type 2 Diabetes Mellitus. Front Cell Infect Microbiol. 2022;12. https://doi.org/10.3389/fcimb.2022.834485Zhou Z, Sun B, Yu D, Zhu C. Gut Microbiota: An Important Player in Type 2 Diabetes Mellitus. Front Cell Infect Microbiol. 2022 Feb 15;12.Gomes AC, Hoffmann C, Mota JF. The human gut microbiota: Metabolism and perspective in obesity. Gut Microbes. April 2018:1-18. https://doi.org/10.1080/19490976.2018.1465157Gomes AC, Hoffmann C, Mota JF. The human gut microbiota: Metabolism and perspective in obesity. Gut Microbes. 2018 Apr 18;1–18.Yadav MK, Kumari I, Singh B, Sharma KK, Tiwari SK. Probiotics, prebiotics and synbiotics: Safe options for next-generation therapeutics. Appl Microbiol Biotechnol. 2022. https://doi.org/10.1007/s00253-021-11646-8Yadav MK, Kumari I, Singh B, Sharma KK, Tiwari SK. Probiotics, prebiotics and synbiotics: Safe options for next-generation therapeutics. Appl MicrobiolBiotechnol. 2022 Jan 11;106(2):505–21.Yoo J, Kim S. Probiotics and Prebiotics: Present Status and Future Perspectives on Metabolic Disorders. Nutrients. 2016;8(3):173. https://doi.org/10.3390/nu8030173Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Author Correction: Probiotics and prebiotics in intestinal health and disease: from biology to the clinic. Nat Rev Gastroenterol Hepatol. 2019 Oct 9;16(10):642–642.Sanders ME, Merenstein DJ, Reid G, et al. Author Correction: Probiotics and prebiotics in intestinal health and disease: from biology to the clinic. Nat Rev Gastroenterol Hepatol. 2019;16(10):642-642. https://doi.org/10.1038/s41575-019-0199-6Yoo J, Kim S. Probiotics and Prebiotics: Present Status and Future Perspectives on Metabolic Disorders. Nutrients. 2016 Mar 18;8(3):173.Markowiak-Kopeć P, Śliżewska K. The Effect of Probiotics on the Production of Short-Chain Fatty Acids by Human Intestinal Microbiome. Nutrients. 2020;12(4):1107. https://doi.org/10.3390/nu12041107Markowiak-Kopeć P, Śliżewska K. The Effect of Probiotics on the Production of Short-Chain Fatty Acids by Human Intestinal Microbiome. Nutrients. 2020 Apr 16;12(4):1107.Drucker DJ. GLP-1 physiology informs the pharmacotherapy of obesity. Mol Metab. 2022;57:101351. https://doi.org/10.1016/j.molmet.2021.101351Drucker DJ. GLP-1 physiology informs the pharmacotherapy of obesity. Mol Metab. 2022 Mar;57:101351.Everard A, Cani PD. Gut microbiota and GLP-1. Rev Endocr Metab Disord. 2014. https://doi.org/10.1007/s11154-014-9288-6Everard A, Cani PD. Gut microbiota and GLP-1. Rev EndocrMetabDisord. 2014 Sep 1;15(3):189–96.Duan FF, Liu JH, March JC. Engineered commensal bacteria reprogram intestinal cells into glucose-responsive insulin-secreting cells for the treatment of diabetes. Diabetes. 2015. https://doi.org/10.2337/db14-0635Duan FF, Liu JH, March JC. Engineered Commensal Bacteria Reprogram Intestinal Cells Into Glucose-Responsive Insulin-Secreting Cells for the Treatment of Diabetes. Diabetes. 2015 May 1;64(5):1794–803.Sergeev IN, Aljutaily T, Walton G, Huarte E. Effects of Synbiotic Supplement on Human Gut Microbiota, Body Composition and Weight Loss in Obesity. Nutrients. 2020;12(1):222. https://doi.org/10.3390/nu12010222Sergeev IN, Aljutaily T, Walton G, Huarte E. Effects of Synbiotic Supplement on Human Gut Microbiota, Body Composition and Weight Loss in Obesity. Nutrients. 2020 Jan 15;12(1):222.Razmpoosh E, Javadi A, Ejtahed HS, et al. The effect of probiotic supplementation on glycemic control and lipid profile in patients with type 2 diabetes: A randomized placebo controlled trial. Diabetes Metab Syndr Clin Res Rev. 2019;13(1):175-182. https://doi.org/10.1016/j.dsx.2018.08.008Razmpoosh E, Javadi A, Ejtahed HS, Mirmiran P, Javadi M, Yousefinejad A. The effect of probiotic supplementation on glycemic control and lipid profile in patients with type 2 diabetes: A randomized placebo controlled trial. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019 Jan;13(1):175–82.Pedret A, Valls RM, Calderón-Pérez L, et al. Effects of daily consumption of the probiotic Bifidobacterium animalis subsp. lactis CECT 8145 on anthropometric adiposity biomarkers in abdominally obese subjects: a randomized controlled trial. Int J Obes. 2019;43(9):1863-1868. https://doi.org/10.1038/s41366-018-0220-0Pedret A, Valls RM, Calderón-Pérez L, Llauradó E, Companys J, Pla-Pagà L, et al. Effects of daily consumption of the probiotic Bifidobacterium animalis subsp. lactis CECT 8145 on anthropometric adiposity biomarkers in abdominally obese subjects: a randomized controlled trial. Int J Obes. 2019 Sep 27;43(9):1863–8.Ziegler MC, Garbim Junior EE, Jahnke VS, et al. Impact of probiotic supplementation in a patient with type 2 diabetes on glycemic and lipid profile. Clin Nutr ESPEN. 2022. https://doi.org/10.1016/j.clnesp.2022.04.002Ziegler MC, Garbim Junior EE, Jahnke VS, Lisbôa Moura JG, Brasil CS, Schimitt da Cunha PH, et al. Impact of probiotic supplementation in a patient with type 2 diabetes on glycemic and lipid profile. Clin Nutr ESPEN. 2022 Jun;49:264–9.Solito A, Bozzi Cionci N, Calgaro M, et al. Supplementation with Bifidobacterium breve BR03 and B632 strains improved insulin sensitivity in children and adolescents with obesity in a cross-over, randomized double-blind placebo-controlled trial. Clin Nutr. 2021;40(7):4585-4594. https://doi.org/10.1016/j.clnu.2021.06.002Solito A, BozziCionci N, Calgaro M, Caputo M, Vannini L, Hasballa I, et al. Supplementation with Bifidobacterium breve BR03 and B632 strains improved insulin sensitivity in children and adolescents with obesity in a cross-over, randomized double-blind placebo-controlled trial. Clinical Nutrition. 2021 Jul;40(7):4585–94.Kassaian N, Feizi A, Rostami S, et al. The effects of 6 mo of supplementation with probiotics and synbiotics on gut microbiota in the adults with prediabetes: A double blind randomized clinical trial. Nutrition. 2020. https://doi.org/10.1016/j.nut.2020.110854Kassaian N, Feizi A, Rostami S, Aminorroaya A, Yaran M, Amini M. The effects of 6 mo of supplementation with probiotics and synbiotics on gut microbiota in the adults with prediabetes: A double blind randomized clinical trial. Nutrition. 2020 Nov;79–80:110854.Mo SJ, Lee K, Hong HJ, et al. Effects of Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032 on Overweight and the Gut Microbiota in Humans: Randomized, Double‐Blinded, Placebo‐Controlled Clinical Trial. Nutrients. 2022. https://doi.org/10.3390/nu14122484Mo SJ, Lee K, Hong HJ, Hong DK, Jung SH, Park SD, et al. Effects of Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032 on Overweight and the Gut Microbiota in Humans: Randomized, Double-Blinded, Placebo-Controlled Clinical Trial. Nutrients. 2022 Jun 15;14(12):2484.Sohn M, Na GY, Chu J, et al. Efficacy and Safety of Lactobacillus plantarum K50 on Lipids in Koreans With Obesity: A Randomized, Double-Blind Controlled Clinical Trial. Front Endocrinol (Lausanne). 2022;12. https://doi.org/10.3389/fendo.2021.790046Sohn M, Na GY, Chu J, Joung H, Kim BK, Lim S. Efficacy and Safety of Lactobacillus plantarum K50 on Lipids in Koreans With Obesity: A Randomized, Double-Blind Controlled Clinical Trial. Front Endocrinol (Lausanne). 2022 Jan 19;12.Parastouei K, Saeidipoor S, Sepandi M, et al. Effects of synbiotic supplementation on the components of metabolic syndrome in military personnel: a double-blind randomised controlled trial. BMJ Mil Heal. 2022;168(5):362-367. https://doi.org/10.1136/bmjmilitary-2020-001459Parastouei K, Saeidipoor S, Sepandi M, Abbaszadeh S, Taghdir M. Effects of synbiotic supplementation on the components of metabolic syndrome in military personnel: a double-blind randomised controlled trial. BMJ Mil Health. 2022 Oct;168(5):362–7.Hadi A, Sepandi M, Marx W, et al. Clinical and psychological responses to synbiotic supplementation in obese or overweight adults: A randomized clinical trial. Complement Ther Med. 2019;47:102216. https://doi.org/10.1016/j.ctim.2019.102216Hadi A, Sepandi M, Marx W, Moradi S, Parastouei K. Clinical and psychological responses to synbiotic supplementation in obese or overweight adults: A randomized clinical trial. Complement Ther Med. 2019 Dec;47:102216.Barthow C, Hood F, Crane J, et al. A randomised controlled trial of a probiotic and a prebiotic examining metabolic and mental health outcomes in adults with pre-diabetes. BMJ Open. 2022;12(3):e055214. https://doi.org/10.1136/bmjopen-2021-055214Barthow C, Hood F, Crane J, Huthwaite M, Weatherall M, Parry-Strong A, et al. A randomised controlled trial of a probiotic and a prebiotic examining metabolic and mental health outcomes in adults with pre-diabetes. BMJ Open. 2022 Mar 24;12(3):e055214.Narmaki E, Borazjani M, Ataie-Jafari A, et al. The combined effects of probiotics and restricted calorie diet on the anthropometric indices, eating behavior, and hormone levels of obese women with food addiction: a randomized clinical trial. Nutr Neurosci. 2022;25(5):963-975. https://doi.org/10.1080/1028415X.2020.1826763Narmaki E, Borazjani M, Ataie-Jafari A, Hariri N, Doost AH, Qorbani M, et al. The combined effects of probiotics and restricted calorie diet on the anthropometric indices, eating behavior, and hormone levels of obese women with food addiction : a randomized clinical trial. NutrNeurosci. 2022 May 4;25(5):963–75.Cho YG, Yang YJ, Yoon YS, et al. Effect of MED-02 Containing Two Probiotic Strains, Limosilactobacillus fermentum MG4231 and MG4244, on Body Fat Reduction in Overweight or Obese Subjects: A Randomized, Multicenter, Double-Blind, Placebo-Controlled Study. Nutrients. 2022;14(17):3583. https://doi.org/10.3390/nu14173583Cho YG, Yang YJ, Yoon YS, Lee ES, Lee JH, Jeong Y, et al. Effect of MED-02 Containing Two Probiotic Strains, Limosilactobacillus fermentum MG4231 and MG4244, on Body Fat Reduction in Overweight or Obese Subjects: A Randomized, Multicenter, Double-Blind, Placebo-Controlled Study. Nutrients. 2022 Aug 30;14(17):3583.Rezazadeh L, Gargari BP, Jafarabadi MA, Alipour B. Effects of probiotic yogurt on glycemic indexes and endothelial dysfunction markers in patients with metabolic syndrome. Nutrition. 2019. https://doi.org/10.1016/j.nut.2018.12.011Rezazadeh L, Gargari BP, Jafarabadi MA, Alipour B. Effects of probiotic yogurt on glycemic indexes and endothelial dysfunction markers in patients with metabolic syndrome. Nutrition. 2019 Jun;62:162–8.Ratna Sudha M, Ahire JJ, Jayanthi N, et al. Effect of multi-strain probiotic (UB0316) in weight management in overweight/obese adults: A 12-week double blind, randomised, placebo-controlled study. Benef Microbes. 2019. https://doi.org/10.3920/BM2019.0052Sudha MR, Ahire JJ, Jayanthi N, Tripathi A, Nanal S. Effect of multi-strain probiotic (UB0316) in weight management in overweight/obese adults: a 12-week double blind, randomised, placebo-controlled study. Benef Microbes. 2019 Dec 9;10(8):855–66.Horvath A, Leber B, Feldbacher N, et al. Effects of a multispecies synbiotic on glucose metabolism, lipid marker, gut microbiome composition, gut permeability, and quality of life in diabesity: a randomized, double-blind, placebo-controlled pilot study. Eur J Nutr. 2020;59(7):2969-2983. https://doi.org/10.1007/s00394-019-02135-wHorvath A, Leber B, Feldbacher N, Tripolt N, Rainer F, Blesl A, et al. Effects of a multispecies synbiotic on glucose metabolism, lipid marker, gut microbiome composition, gut permeability, and quality of life in diabesity: a randomized, double-blind, placebo-controlled pilot study. Eur J Nutr. 2020 Oct 15;59(7):2969–83.Choi BSY, Brunelle L, Pilon G, et al. Lacticaseibacillus rhamnosus HA-114 improves eating behaviors and mood-related factors in adults with overweight during weight loss: a randomized controlled trial. Nutr Neurosci. 2023;26(7):667-679. https://doi.org/10.1080/1028415X.2022.2081288Choi BSY, Brunelle L, Pilon G, Cautela BG, Tompkins TA, Drapeau V, et al. Lacticaseibacillusrhamnosus HA-114 improves eating behaviors and mood-related factors in adults with overweight during weight loss: a randomized controlled trial. NutrNeurosci. 2023 Jul 3;26(7):667–79.Sohn M, Jung H, Lee WS, et al. Effect of Lactobacillus plantarum LMT1-48 on Body Fat in Overweight Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial. Diabetes Metab J. 2023;47(1):92-103. https://doi.org/10.4093/dmj.2021.0370Sohn M, Jung H, Lee WS, Kim TH, Lim S. Effect of Lactobacillus plantarum LMT1-48 on Body Fat in Overweight Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial. Diabetes Metab J. 2023 Jan 31;47(1):92–103.Rahimi F, Pasdar Y, Kaviani M, et al. Efficacy of the Synbiotic Supplementation on the Metabolic Factors in Patients with Metabolic Syndrome: A Randomized, Triple-Blind, Placebo-Controlled Trial. Int J Clin Pract. 2022. https://doi.org/10.1155/2022/2967977Rahimi F, Pasdar Y, Kaviani M, Abbasi S, Fry H, Hekmatdoost A, et al. Efficacy of the Synbiotic Supplementation on the Metabolic Factors in Patients with Metabolic Syndrome: A Randomized, Triple-Blind, Placebo-Controlled Trial. Int J Clin Pract. 2022 Apr 16;2022:1–11.Laue C, Papazova E, Pannenbeckers A, Schrezenmeir J. Effect of a Probiotic and a Synbiotic on Body Fat Mass, Body Weight and Traits of Metabolic Syndrome in Individuals with Abdominal Overweight: A Human, Double-Blind, Randomised, Controlled Clinical Study. Nutrients. 2023;15(13):3039. https://doi.org/10.3390/nu15133039Laue C, Papazova E, Pannenbeckers A, Schrezenmeir J. Effect of a Probiotic and a Synbiotic on Body Fat Mass, Body Weight and Traits of Metabolic Syndrome in Individuals with Abdominal Overweight: A Human, Double-Blind, Randomised, Controlled Clinical Study. Nutrients. 2023 Jul 5;15(13):3039.Nasiri G, Bastani A, Haji-Aghamohammadi AA, et al. Effects of probiotic and alpha-lipoic acid supplements, separately or in combination on the anthropometric indicators and maintenance of weight in overweight individuals. Clin Nutr ESPEN. 2021;41:242-248. https://doi.org/10.1016/j.clnesp.2020.12.007Nasiri G, Bastani A, Haji-Aghamohammadi AA, Nooshabadi MR, Shahmirzalou P, Haghighian HK. Effects of probiotic and alpha-lipoic acid supplements, separately or in combination on the anthropometric indicators and maintenance of weight in overweight individuals. Clin Nutr ESPEN. 2021 Feb;41:242–8.Hasain Z, Raja Ali RA, Ahmad HF, et al. The Roles of Probiotics in the Gut Microbiota Composition and Metabolic Outcomes in Asymptomatic Post-Gestational Diabetes Women: A Randomized Controlled Trial. Nutrients. 2022;14(18):3878. https://doi.org/10.3390/nu14183878Hasain Z, Raja Ali RA, Ahmad HF, Abdul Rauf UF, Oon SF, Mokhtar NM. The Roles of Probiotics in the Gut Microbiota Composition and Metabolic Outcomes in Asymptomatic Post-Gestational Diabetes Women: A Randomized Controlled Trial. Nutrients. 2022 Sep 19;14(18):3878.Kong X-J, Liu K, Zhuang P, et al. The Effects of Limosilactobacillus reuteri LR-99 Supplementation on Body Mass Index, Social Communication, Fine Motor Function, and Gut Microbiome Composition in Individuals with Prader–Willi Syndrome: a Randomized Double-Blinded Placebo-Controlled Trial. Probiotics Antimicrob Proteins. 2021;13(6):1508-1520. https://doi.org/10.1007/s12602-021-09800-9Kong XJ, Liu K, Zhuang P, Tian R, Liu S, Clairmont C, et al. The Effects of Limosilactobacillusreuteri LR-99 Supplementation on Body Mass Index, Social Communication, Fine Motor Function, and Gut Microbiome Composition in Individuals with Prader–Willi Syndrome: a Randomized Double-Blinded Placebo-Controlled Trial. ProbioticsAntimicrobProteins. 2021 Dec 11;13(6):1508–20.Carlos L, Ramos M, Wagner N, et al. Probiotic supplementation attenuates binge eating and food addiction 1 year after roux-en-y gastric bypass: a randomized, double-blind, placebo-controlled trial. ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo). 2022;35. https://doi.org/10.1590/0102-672020210002e1659CARLOS L de O, RAMOS MRZ, WAGNER NRF, FREITAS LAC de, FELICIDADE I, CAMPOS ACL. PROBIOTIC SUPPLEMENTATION ATTENUATES BINGE EATING AND FOOD ADDICTION 1 YEAR AFTER ROUX-EN-Y GASTRIC BYPASS: A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL. ABCD ArquivosBrasileiros de CirurgiaDigestiva (São Paulo). 2022;35.Wang H, Ma C, Li Y, et al. Probio-X Relieves Symptoms of Hyperlipidemia by Regulating Patients’ Gut Microbiome, Blood Lipid Metabolism, and Lifestyle Habits. Hung YP, ed. Microbiol Spectr. 2023;11(3). https://doi.org/10.1128/spectrum.04440-22Wang H, Ma C, Li Y, Zhang L, A lima, Yang C, et al. Probio-X Relieves Symptoms of Hyperlipidemia by Regulating Patients’ Gut Microbiome, Blood Lipid Metabolism, and Lifestyle Habits. MicrobiolSpectr. 2023 Jun 15;11(3).Chen Y, Shen X, Ma T, et al. Adjunctive Probio-X Treatment Enhances the Therapeutic Effect of a Conventional Drug in Managing Type 2 Diabetes Mellitus by Promoting Short-Chain Fatty Acid-Producing Bacteria and Bile Acid Pathways. Gilbert JA, ed. mSystems. 2023;8(1). https://doi.org/10.1128/msystems.01300-22Chen Y, Shen X, Ma T, Yu X, Kwok LY, Li Y, et al. Adjunctive Probio-X Treatment Enhances the Therapeutic Effect of a Conventional Drug in Managing Type 2 Diabetes Mellitus by Promoting Short-Chain Fatty Acid-Producing Bacteria and Bile Acid Pathways. mSystems. 2023 Feb 23;8(1).Khalili L, Alipour B, Asghari Jafar-Abadi M, et al. The Effects of Lactobacillus casei on Glycemic Response, Serum Sirtuin1 and Fetuin-A Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Iran Biomed J. 2019;23(1):68-77. https://doi.org/10.29252/ibj.23.1.68Khalili L, Alipour B, Asghari Jafar-Abadi M, Faraji I, Hassanalilou T, Mesgari Abbasi M, et al. The Effects of Lactobacillus casei on Glycemic Response, Serum Sirtuin1 and Fetuin-A Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Iran Biomed J. 2019 Jan;23(1):68–77.Amat-Bou M, Garcia-Ribera S, Climent E, et al. Effects of Bifidobacterium animalis Subsp. lactis (BPL1) Supplementation in Children and Adolescents with Prader–Willi Syndrome: A Randomized Crossover Trial. Nutrients. 2020;12(10):3123. https://doi.org/10.3390/nu12103123Amat-Bou M, Garcia-Ribera S, Climent E, Piquer-Garcia I, Corripio R, Sanchez-Infantes D, et al. Effects of Bifidobacterium animalis Subsp. lactis (BPL1) Supplementation in Children and Adolescents with Prader–Willi Syndrome: A Randomized Crossover Trial. Nutrients. 2020 Oct 13;12(10):3123.Sabico S, Al-Mashharawi A, Al-Daghri NM, et al. Effects of a 6-month multi-strain probiotics supplementation in endotoxemic, inflammatory and cardiometabolic status of T2DM patients: A randomized, double-blind, placebo-controlled trial. Clin Nutr. 2019;38(4):1561-1569. https://doi.org/10.1016/j.clnu.2018.08.009Sabico S, Al-Mashharawi A, Al-Daghri NM, Wani K, Amer OE, Hussain DS, et al. Effects of a 6-month multi-strain probiotics supplementation in endotoxemic, inflammatory and cardiometabolic status of T2DM patients: A randomized, double-blind, placebo-controlled trial. Clinical Nutrition. 2019 Aug;38(4):1561–9.Cani PD, Depommier C, Derrien M, et al. Author Correction: Akkermansia muciniphila: paradigm for next-generation beneficial microorganisms. Nat Rev Gastroenterol Hepatol. 2022;19(10):682-682. https://doi.org/10.1038/s41575-022-00650-6Cani PD, Depommier C, Derrien M, Everard A, de Vos WM. Author Correction: Akkermansiamuciniphila: paradigm for next-generation beneficial microorganisms. Nat Rev Gastroenterol Hepatol. 2022 Oct 23;19(10):682–682.Gul L, Modos D, Fonseca S, et al. Extracellular vesicles produced by the human commensal gut bacterium Bacteroides thetaiotaomicron affect host immune pathways in a cell‐type specific manner that are altered in inflammatory bowel disease. J Extracell Vesicles. 2022;11(1). https://doi.org/10.1002/jev2.12189Gul L, Modos D, Fonseca S, Madgwick M, Thomas JP, Sudhakar P, et al. Extracellular vesicles produced by the human commensal gut bacterium Bacteroides thetaiotaomicron affect host immune pathways in a cell‐type specific manner that are altered in inflammatory bowel disease. J Extracell Vesicles. 2022 Jan 22;11(1).Yao S, Zhao Z, Wang W, Liu X. Bifidobacterium Longum: Protection against Inflammatory Bowel Disease. J Immunol Res. 2021. https://doi.org/10.1155/2021/8030297Yao S, Zhao Z, Wang W, Liu X. Bifidobacterium Longum: Protection against Inflammatory Bowel Disease. J Immunol Res. 2021 Jul 23;2021:1–11.Song Q, Zhang X, Liu W, et al. Bifidobacterium pseudolongum-generated acetate suppresses non-alcoholic fatty liver disease-associated hepatocellular carcinoma. J Hepatol. 2023. https://doi.org/10.1016/j.jhep.2023.07.005Song Q, Zhang X, Liu W, Wei H, Liang W, Zhou Y, et al. Bifidobacterium pseudolongum-generated acetate suppresses non-alcoholic fatty liver disease-associated hepatocellular carcinoma. J Hepatol. 2023 Dec;79(6):1352–65.Ang W-S, Law JW-F, Letchumanan V, et al. A Keystone Gut Bacterium Christensenella minuta—A Potential Biotherapeutic Agent for Obesity and Associated Metabolic Diseases. Foods. 2023;12(13):2485. https://doi.org/10.3390/foods12132485Ang WS, Law JWF, Letchumanan V, Hong KW, Wong SH, Ab Mutalib NS, et al. A Keystone Gut Bacterium Christensenellaminuta—A Potential Biotherapeutic Agent for Obesity and Associated Metabolic Diseases. Foods. 2023 Jun 26;12(13):2485.Lopez-Siles M, Duncan SH, Garcia-Gil LJ, Martinez-Medina M. Faecalibacterium prausnitzii: From microbiology to diagnostics and prognostics. ISME J. 2017. https://doi.org/10.1038/ismej.2016.176Lopez-Siles M, Duncan SH, Garcia-Gil LJ, Martinez-Medina M. Faecalibacteriumprausnitzii : from microbiology to diagnostics and prognostics. ISME J. 2017 Apr 1;11(4):841–52.Ghavami SB, Rostami E, Sephay AA, et al. Alterations of the human gut Methanobrevibacter smithii as a biomarker for inflammatory bowel diseases. Microb Pathog. 2018. https://doi.org/10.1016/j.micpath.2018.01.029Ghavami SB, Rostami E, Sephay AA, Shahrokh S, Balaii H, Aghdaei HA, et al. Alterations of the human gut Methanobrevibactersmithii as a biomarker for inflammatory bowel diseases. MicrobPathog. 2018 Apr;117:285–9.Beghini F, McIver LJ, Blanco-Míguez A, et al. Integrating taxonomic, functional, and strain-level profiling of diverse microbial communities with bioBakery 3. Elife. 2021;10. https://doi.org/10.7554/eLife.65088Beghini F, McIver LJ, Blanco-Míguez A, Dubois L, Asnicar F, Maharjan S, et al. Integrating taxonomic, functional, and strain-level profiling of diverse microbial communities with bioBakery 3. Elife. 2021 May 4;10.Antushevich H. Fecal microbiota transplantation in disease therapy. Clin Chim Acta. 2020;503:90-98. https://doi.org/10.1016/j.cca.2019.12.010Antushevich H. Fecal microbiota transplantation in disease therapy. ClinicaChimica Acta. 2020 Apr;503:90–8.Vrieze A, Van Nood E, Holleman F, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology. 2012. https://doi.org/10.1053/j.gastro.2012.06.031Vrieze A, Van Nood E, Holleman F, Salojärvi J, Kootte RS, Bartelsman JFWM, et al. Transfer of Intestinal Microbiota From Lean Donors Increases Insulin Sensitivity in Individuals With Metabolic Syndrome. Gastroenterology. 2012 Oct;143(4):913-916.e7.Allegretti JR, Kassam Z, Mullish BH, et al. Effects of Fecal Microbiota Transplantation With Oral Capsules in Obese Patients. Clin Gastroenterol Hepatol. 2020. https://doi.org/10.1016/j.cgh.2019.07.006Allegretti JR, Kassam Z, Mullish BH, Chiang A, Carrellas M, Hurtado J, et al. Effects of Fecal Microbiota Transplantation With Oral Capsules in Obese Patients. ClinicalGastroenterologyandHepatology. 2020 Apr;18(4):855-863.e2.Ng SC, Xu Z, Mak JWY, et al. Microbiota engraftment after faecal microbiota transplantation in obese subjects with type 2 diabetes: A 24-week, double-blind, randomised controlled trial. Gut. 2022. https://doi.org/10.1136/gutjnl-2020-323617Ng SC, Xu Z, Mak JWY, Yang K, Liu Q, Zuo T, et al. Microbiota engraftment after faecal microbiota transplantation in obese subjects with type 2 diabetes: a 24-week, double-blind, randomised controlled trial. Gut. 2022 Apr;71(4):716–23.Wu Z, Zhang B, Chen F, et al. Fecal microbiota transplantation reverses insulin resistance in type 2 diabetes: A randomized, controlled, prospective study. Front Cell Infect Microbiol. 2023;12. https://doi.org/10.3389/fcimb.2022.1089991Wu Z, Zhang B, Chen F, Xia R, Zhu D, Chen B, et al. Fecal microbiota transplantation reverses insulin resistance in type 2 diabetes: A randomized, controlled, prospective study. Front Cell Infect Microbiol. 2023 Jan 4;12.Ooijevaar RE, Terveer EM, Verspaget HW, et al. Clinical Application and Potential of Fecal Microbiota Transplantation. Annu Rev Med. 2019;70(1):335-351. https://doi.org/10.1146/annurev-med-111717-122956Ooijevaar RE, Terveer EM, Verspaget HW, Kuijper EJ, Keller JJ. Clinical Application and Potential of Fecal Microbiota Transplantation. Annu Rev Med. 2019 Jan 27;70(1):335–51.Chang S-H, Stoll CRT, Song J, et al. The Effectiveness and Risks of Bariatric Surgery. JAMA Surg. 2014;149(3):275. https://doi.org/10.1001/jamasurg.2013.3654Chang SH, Stoll CRT, Song J, Varela JE, Eagon CJ, Colditz GA. The Effectiveness and Risks of Bariatric Surgery. JAMA Surg. 2014 Mar 1;149(3):275.Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and Risks of Bariatric Surgery in Adults. JAMA. 2020;324(9):879. https://doi.org/10.1001/jama.2020.12567Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and Risks of Bariatric Surgery in Adults. JAMA. 2020 Sep 1;324(9):879.Dang JT, Mocanu V, Park H, et al. Roux-en-Y gastric bypass and sleeve gastrectomy induce substantial and persistent changes in microbial communities and metabolic pathways. Gut Microbes. 2022. https://doi.org/10.1080/19490976.2022.2050636Dang JT, Mocanu V, Park H, Laffin M, Hotte N, Karmali S, et al. Roux-en-Y gastric bypass and sleeve gastrectomy induce substantial and persistent changes in microbial communities and metabolic pathways. Gut Microbes. 2022 Dec 31;14(1).Lee CJ, Florea L, Sears CL, et al. Changes in Gut Microbiome after Bariatric Surgery Versus Medical Weight Loss in a Pilot Randomized Trial. Obes Surg. 2019;29(10):3239-3245. https://doi.org/10.1007/s11695-019-03976-4Lee CJ, Florea L, Sears CL, Maruthur N, Potter JJ, Schweitzer M, et al. Changes in Gut Microbiome after Bariatric Surgery Versus Medical Weight Loss in a Pilot Randomized Trial. Obes Surg. 2019 Oct 29;29(10):3239–45.Hernández-Montoliu L, Rodríguez-Peña M-M, Puig R, et al. A specific gut microbiota signature is associated with an enhanced GLP-1 and GLP-2 secretion and improved metabolic control in patients with type 2 diabetes after metabolic Roux-en-Y gastric bypass. Front Endocrinol (Lausanne). 2023;14. https://doi.org/10.3389/fendo.2023.1181744Hernández-Montoliu L, Rodríguez-Peña MM, Puig R, Astiarraga B, Guerrero-Pérez F, Virgili N, et al. A specific gut microbiota signature is associated with an enhanced GLP-1 and GLP-2 secretion and improved metabolic control in patients with type 2 diabetes after metabolic Roux-en-Y gastric bypass. Front Endocrinol (Lausanne). 2023 Oct 17;14.Debédat J, Le Roy T, Voland L, et al. The human gut microbiota contributes to type-2 diabetes non-resolution 5-years after Roux-en-Y gastric bypass. Gut Microbes. 2022 Dec 31;14(1). https://doi.org/10.1080/19490976.2022.2050635Debédat J, Le Roy T, Voland L, Belda E, Alili R, Adriouch S, et al. The human gut microbiota contributes to type-2 diabetes non-resolution 5-years after Roux-en-Y gastric bypass. Gut Microbes. 2022 Dec 31;14(1).Díaz-Perdigones CM, Muñoz-Garach A, Álvarez-Bermúdez MD, et al. Gut microbiota of patients with type 2 diabetes and gastrointestinal intolerance to metformin differs in composition and functionality from tolerant patients. Biomed Pharmacother. 2022. https://doi.org/10.1016/j.biopha.2021.112448Díaz-Perdigones CM, Muñoz-Garach A, Álvarez-Bermúdez MD, Moreno-Indias I, Tinahones FJ. Gut microbiota of patients with type 2 diabetes and gastrointestinal intolerance to metformin differs in composition and functionality from tolerant patients. Biomedicine & Pharmacotherapy. 2022 Jan;145:112448.Nakajima H, Takewaki F, Hashimoto Y, et al. The Effects of Metformin on the Gut Microbiota of Patients with Type 2 Diabetes: A Two-Center, Quasi-Experimental Study. Life. 2020;10(9):195. https://doi.org/10.3390/life10090195Nakajima H, Takewaki F, Hashimoto Y, Kajiyama S, Majima S, Okada H, et al. The Effects of Metformin on the Gut Microbiota of Patients with Type 2 Diabetes: A Two-Center, Quasi-Experimental Study. Life. 2020 Sep 11;10(9):195.Niu X, Lu P, Huang L, et al. The effect of metformin combined with liraglutide on gut microbiota of Chinese patients with type 2 diabetes. Int Microbiol. 2023;27(1):265-276. https://doi.org/10.1007/s10123-023-00380-yNiu X, Lu P, Huang L, Sun Y, Jin M, Liu J, et al. The effect of metformin combined with liraglutide on gut microbiota of Chinese patients with type 2 diabetes. International Microbiology. 2023 Jun 14;27(1):265–76.Ying X, Rongjiong Z, Kahaer M, et al. Therapeutic efficacy of liraglutide versus metformin in modulating the gut microbiota for treating type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease. Front Microbiol. 2023;14. https://doi.org/10.3389/fmicb.2023.1088187Ying X, Rongjiong Z, Kahaer M, Chunhui J, Wulasihan M. Therapeutic efficacy of liraglutide versus metformin in modulating the gut microbiota for treating type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease. Front Microbiol. 2023 Jan 26;14.Zhang F, Wang M, Yang J, et al. Response of gut microbiota in type 2 diabetes to hypoglycemic agents. Endocrine. 2019;66(3):485-493. https://doi.org/10.1007/s12020-019-02041-5Zhang F, Wang M, Yang J, Xu Q, Liang C, Chen B, et al. Response of gut microbiota in type 2 diabetes to hypoglycemic agents. Endocrine. 2019 Dec 13;66(3):485–93.Smits MM, Fluitman KS, Herrema H, et al. Liraglutide and sitagliptin have no effect on intestinal microbiota composition: A 12-week randomized placebo-controlled trial in adults with type 2 diabetes. Diabetes Metab. 2021;47(5):101223. https://doi.org/10.1016/j.diabet.2021.101223Estrella MLY, Daniel NR, Armando EHD, Cristian PM, Aarón VJ, Paul SCJ, et al. Effect of metformin and metformin/linagliptin on gut microbiota in patients with prediabetes. Sci Rep. 2024 Apr 27;14(1):9678.Zhang X, Ren H, Zhao C, et al. Metagenomic analysis reveals crosstalk between gut microbiota and glucose-lowering drugs targeting the gastrointestinal tract in Chinese patients with type 2 diabetes: a 6 month, two-arm randomised trial. Diabetologia. 2022;65(10):1613-1626. https://doi.org/10.1007/s00125-022-05768-5Smits MM, Fluitman KS, Herrema H, Davids M, Kramer MHH, Groen AK, et al. Liraglutide and sitagliptin have no effect on intestinal microbiota composition: A 12-week randomized placebo-controlled trial in adults with type 2 diabetes. DiabetesMetab. 2021 Sep;47(5):101223.van Bommel EJM, Herrema H, Davids M, et al. Effects of 12-week treatment with dapagliflozin and gliclazide on faecal microbiome: Results of a double-blind randomized trial in patients with type 2 diabetes. Diabetes Metab. 2020. https://doi.org/10.1016/j.diabet.2019.11.005van Bommel EJM, Herrema H, Davids M, et al. Effects of 12-week treatment with dapagliflozin and gliclazide on faecal microbiome: Results of a double-blind randomized trial in patients with type 2 diabetes. Diabetes Metab. 2020. https://doi.org/10.1016/j.diabet.2019.11.005Estrella MLY, Daniel NR, Armando EHD, et al. Effect of metformin and metformin/linagliptin on gut microbiota in patients with prediabetes. Sci Rep. 2024;14(1):9678. https://doi.org/10.1038/s41598-024-60081-yEstrella MLY, Daniel NR, Armando EHD, et al. Effect of metformin and metformin/linagliptin on gut microbiota in patients with prediabetes. Sci Rep. 2024;14(1):9678. https://doi.org/10.1038/s41598-024-60081-y

The authors declare that there are no conflicts of interest present.