By Max Bingham, PhD Microencapsulated niacin targeted to the ileocolonic region of the gut appears to result in improved measures of insulin sensitivity, according to Fangmann et al. ( p. 398 ). As a result, they suggest the approach might represent a potential therapy for prediabetes—a claim that will need substantiation in future trials. According to the authors, obese individuals without type 2 diabetes had a lower dietary intake of niacin than nonobese individuals. At the same time, based on DNA sequencing of stool samples, they found that obesity was also associated with reduced gut microbiota α-diversity and Bacteroidetes abundance. Reportedly, a correlation between niacin intake and the bacterial measures did exist. Together with previous evidence, this led them to hypothesize that niacin delivered directly to the ileocolonic region might result in improved metabolic outcomes and that they were somehow mediated by the bacterial phylum Bacteroidetes . Using delayed-release microcapsules with varying doses of either nicotinic acid or nicotinamide, the authors go on to show in a small study of 10 healthy humans that nicotinic acid but not nicotinamide resulted in significant decreases in myostatin, fetuin-A, and osteopontin, which they say are markers for skeletal muscle, liver insulin resistance, and metabolic inflammation, respectively. Concurrently, Bacteroidetes abundance in stool samples reportedly also increased over a 6-week period. Commenting more widely on the research, author Matthias Laudes told Diabetes Care : “We feel that this type of intervention will be a promising approach for the prevention of the progression of prediabetes into type 2 diabetes. The reason is that despite prediabetes prevalence increasing worldwide, and the conversion rate into type 2 diabetes is 5–10%, in most …

中文翻译：

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在本期糖尿病护理中

根据Fangmann等人的研究，Max Bingham博士将微胶囊化的烟酸靶向肠的回肠结肠区域，似乎可以改善胰岛素敏感性。（第398页）。结果，他们认为该方法可能代表了一种针对糖尿病前体的潜在疗法，这一主张在未来的试验中将需要得到证实。这组作者说，没有2型糖尿病的肥胖者的饮食中烟酸的摄入量比非肥胖者低。同时，根据粪便样本的DNA测序结果，他们发现肥胖症还与肠道菌群α多样性降低和拟杆菌数量丰富有关。据报道，烟酸摄入量与细菌措施之间确实存在相关性。连同以前的证据，这导致他们假设烟酸直接输送到回结肠区域可能会改善代谢结果，并且它们某种程度上是由细菌类杆菌介导的。作者使用含有不同剂量烟碱酸或烟酰胺的延迟释放微胶囊，在一项对10名健康人的小型研究中继续表明，烟酸而非烟酰胺会导致肌生长抑制素，胎球蛋白A和骨桥蛋白的显着减少。他们说分别是骨骼肌，肝胰岛素抵抗和代谢性炎症的标志物。同时，据报道粪便中的拟杆菌含量在6周内也有所增加。作者Matthias Laudes对该研究发表了更广泛的评论，他告诉Diabetes Care：“我们认为这种类型的干预将是预防前驱糖尿病发展为2型糖尿病的有前途的方法。原因是，尽管全球范围内糖尿病前期患病率呈上升趋势，但在大多数情况下，向2型糖尿病的转化率仍为5-10％。