Metabolism and Metabolic Disorders and the Microbiome: The Intestinal Microbiota Associated With Obesity, Lipid Metabolism, and Metabolic Health-Pathophysiology and Therapeutic Strategies

Gastroenterology. 2021 Jan;160(2):573-599. doi: 10.1053/j.gastro.2020.10.057. Epub 2020 Nov 27.


Changes in the intestinal microbiome have been associated with obesity and type 2 diabetes, in epidemiological studies and studies of the effects of fecal transfer in germ-free mice. We review the mechanisms by which alterations in the intestinal microbiome contribute to development of metabolic diseases, and recent advances, such as the effects of the microbiome on lipid metabolism. Strategies have been developed to modify the intestinal microbiome and reverse metabolic alterations, which might be used as therapies. We discuss approaches that have shown effects in mouse models of obesity and metabolic disorders, and how these might be translated to humans to improve metabolic health.

Keywords: Insulin Resistance; Intestinal Microbiome; Lipids; Microbial-Derived Metabolites; Obesity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / microbiology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / therapy
  • Disease Models, Animal
  • Gastrointestinal Microbiome / drug effects
  • Gastrointestinal Microbiome / genetics
  • Gastrointestinal Microbiome / physiology*
  • Humans
  • Insulin Resistance / physiology
  • Lipid Metabolism / physiology*
  • Metabolic Diseases / metabolism*
  • Metabolic Diseases / microbiology
  • Metabolic Diseases / physiopathology
  • Metabolic Diseases / therapy
  • Mice
  • Obesity / metabolism*
  • Obesity / microbiology
  • Obesity / physiopathology
  • Obesity / therapy