The role of small intestinal bacterial overgrowth in obesity and its related diseases

Biochem Pharmacol. 2023 Jun:212:115546. doi: 10.1016/j.bcp.2023.115546. Epub 2023 Apr 10.


Obesity has become a major public health problem worldwide and its occurrence is increasing globally. Obesity has also been shown to be involved in the occurrence and development of many diseases and pathological conditions, such as nonalcoholic fatty liver disease (NAFLD), type 2 diabetes mellitus (T2DM), insulin resistance (IR). In recent years, gut microbiota has received extensive attention as an important regulatory part involved in host diseases and health status. A growing body of evidence suggests that gut microbiota dysbiosis has a significant adverse effect on the host. Small intestinal bacterial overgrowth (SIBO), a type of intestinal microbial dysbiosis, has been gradually revealed to be associated with obesity and its related diseases. The presence of SIBO may lead to the destruction of intestinal barrier integrity, increased intestinal permeability, increased endotoxin levels, activation of inflammatory responses, and translocation of bacteria from the colon to the small intestine. However, the causal relationship between SIBO and obesity and the specific mechanisms have not been well elucidated. This review discusses the cross-talk between SIBO and obesity and its related diseases, and expounds its potential mechanisms and interventions, which may help to discover new therapeutic targets for obesity and its related diseases and develop treatment options.

Keywords: Gut microbiota; Nonalcoholic fatty liver disease; Obesity; Small intestinal bacterial overgrowth; Type 2 diabetes mellitus.

Publication types

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

MeSH terms

  • Diabetes Mellitus, Type 2*
  • Dysbiosis / complications
  • Humans
  • Intestines / microbiology
  • Non-alcoholic Fatty Liver Disease* / drug therapy
  • Obesity / complications