Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya70239810.26442/00403660.2026.02.203596Editorial articleПередовая статьяResearch ArticleThe gut microbiome in obesity: new horizons in personalized medicineМикробиом кишечника при ожирении: новые горизонты персонализированной медициныhttps://orcid.org/0000-0001-9262-9233StarodubovaAntonina V.СтародубоваАнтонина Владимировна
Russian Federation

д-р мед. наук, доц., зам. дир. по научной и лечебной работе; зав. каф. факультетской терапии Института клинической медицины

lechebnoedelo@yandex.ruhttps://orcid.org/0000-0002-2028-8748KislyakOxana A.КислякОксана Андреевна
Russian Federation

д-р мед. наук, проф., почетный зав. каф. факультетской терапии Института клинической медицины

lechebnoedelo@yandex.ruhttps://orcid.org/0000-0001-6385-540XDemidovaTatyana Y.ДемидоваТатьяна Юльевна
Russian Federation

д-р мед. наук, проф., зав. каф. эндокринологии Института клинической медицины

lechebnoedelo@yandex.ruhttps://orcid.org/0000-0003-1699-0881NikitinIgor G.НикитинИгорь Геннадиевич
Russian Federation

д-р мед. наук, проф., зав. каф. госпитальной терапии им. акад. Г.И. Сторожакова Института клинической медицины

lechebnoedelo@yandex.ruhttps://orcid.org/0000-0002-5632-7040LeonovGeorgy E.ЛеоновГеоргий Евгеньевич
Russian Federation

науч. сотр.

lechebnoedelo@yandex.ruFederal Research Centre of Nutrition, Biotechnology and Food SafetyФГБУН «Федеральный исследовательский центр питания и биотехнологии»Pirogov Russian National Research Medical University (Pirogov University)ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России (Пироговский Университет)07032026982Issues of gastroenterologyВопросы гастроэнтерологии92981002202613022026Copyright ©; 2026, Consilium MedicumCopyright ©; 2026, ООО "Консилиум Медикум"2026Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/702398

Currently, disturbances in the composition and metabolic activity of the intestinal microbiota are considered a key modifiable factor in obesity and associated metabolic disorders. This review summarizes data on the characteristics and variability of the microbiota composition in individuals with obesity. The main mechanisms linking dysbiosis to metabolic disorders are discussed: changes in the production of short-chain fatty acids and other microbial metabolites, as well as the contribution of lipopolysaccharide-induced chronic inflammation. The influence of the microbiota on the regulation of appetite and eating behavior through the microbiota-gut-brain axis and intestinal hormones is discussed separately. Current approaches to the diagnosis of dysbiosis and potential strategies for correcting microbiome-associated disorders in obesity in the context of personalized medicine are presented.

В последнее время нарушения состава и метаболической активности кишечной микробиоты стали рассматривать как ключевой модифицируемый фактор ожирения и связанных с ним метаболических нарушений. В обзоре обобщены данные об особенностях и вариабельности состава микробиоты у лиц с ожирением. Рассмотрены основные механизмы, связывающие дисбиоз с метаболическими нарушениями: изменения продукции короткоцепочечных жирных кислот и других микробных метаболитов, а также вклад липополисахарид-индуцированного хронического воспаления. Отдельно исследовано влияние микробиоты на регуляцию аппетита и пищевого поведения через ось «кишечник – мозг» и гастроинтестинальные гормоны. Представлены современные подходы к диагностике дисбиоза и потенциальные стратегии коррекции микробиом-ассоциированных нарушений при ожирении в контексте персонализированной медицины.

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