摘　要：2型糖尿病（T2DM）是一种代谢性疾病，其特征是患者的代谢过程严重紊乱。这种紊乱状态不仅影响了机体的糖代谢，还改变了肠道菌群的原生组成。当前的研究表明，T2DM患者的肠道微生物组成具有其独特性，这种肠道菌群的失衡与胰岛素抵抗、胰腺炎症紧密相关，并且与糖尿病相关的微血管和大血管并发症的发展有着不可忽视的联系。本综述深入探讨了肠道菌群及其代谢产物对T2DM发生和发展的影响，重点分析了肠道菌群失调对T2DM进展的影响，揭示了有益细菌和潜在有害细菌在疾病发展中的作用；同时还详细讨论了短链脂肪酸（SCFAs）、氧化三甲胺（TMAO）、次级胆汁酸和硫化氢（H2S）等关键代谢产物通过不同的信号通路影响肠道屏障功能、全身性炎症反应和维持葡萄糖稳态的机制。通过这些分析，本文旨在为糖尿病的预防和治疗提供全新的视角和策略，以期通过调节肠道菌群平衡和干预代谢产物来延缓糖尿病的进展，并减少并发症的发生，为临床治疗提供可能的新靶点。
关键词：肠道微生物；微生物代谢物；2型糖尿病；糖代谢；分子机制
中图分类号：R73-36+2　　　　         文献标志码：A　　　　　DOI：10.3969/j.issn.1007-7146.2025.02.003

Abstract: Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by severe metabolic disarray in patients. This disruption not only affects glucose metabolism but also alters the composition of the native gut microbiota. Current research indicates that the gut microbiome of T2DM patients is distinctive, with dysbiosis being closely associated with insulin resistance, pancreatic inflammation, and the development of microvascular and macrovascular complications related to diabetes. This review aims to delve into the molecular mechanisms by which the gut microbiota and their metabolites influence the onset and progression of T2DM. It emphasizes the role of beneficial and potentially harmful bacteria in disease development and provides a detailed discussion on the impact of key metabolites such as short-chain fatty acids (SCFAs), trimethylamine N-oxide (TMAO), secondary bile acids, and hydrogen sulfide (H2S). These metabolites affect intestinal barrier function, systemic inflammation, and the maintenance of glucose homeostasis through various signaling pathways. Through these analyses, the review seeks to offer new perspectives and strategies for the prevention and treatment of diabetes. It hopes to contribute to the clinical management of the disease by modulating gut microbiota balance and intervening in metabolite production, thereby delaying the progression of diabetes and reducing the incidence of complications, potentially providing new targets for clinical therapy.
Key words: gut microbiota; microbial metabolites; T2DM; sugar metabolism; molecular mechanisms
（Acta Laser Biology Sinica, 2025, 34(2): 113-120）