GUT MICROBIOTA AND ITS ROLE IN THE DEVELOPMENT OF METABOLIC DISEASES IN CHILDREN: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.56238/levv16n53-089Keywords:
Gut Microbiome, Obesity, Children, Metabolic DiseasesAbstract
Introduction: The intestinal microbiota plays a critical role in metabolic homeostasis, influencing nutrient absorption, immune function, and systemic inflammation. Disruptions in gut microbial composition, known as dysbiosis, have been increasingly associated with childhood metabolic diseases such as obesity, insulin resistance, and metabolic syndrome. The first years of life are characterized by intense microbial colonization, and disturbances during this window may have long-term consequences for metabolic health.
Objective: The primary objective of this systematic review was to synthesize current evidence on the relationship between gut microbiota composition and the development of metabolic diseases in children. Secondary objectives included the evaluation of microbial biomarkers linked to metabolic dysregulation and the impact of interventions—such as probiotics, prebiotics, synbiotics, and dietary modifications—on metabolic outcomes and microbiota diversity.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP databases. Inclusion criteria comprised human studies published within the last five years, addressing gut microbiota profiles and metabolic parameters in pediatric populations. When fewer than ten eligible studies were identified, the time window was expanded to ten years. Animal and in vitro studies were analyzed separately for mechanistic insights. Two independent reviewers screened titles, abstracts, and full texts following PRISMA guidelines, extracted data using standardized templates, and assessed risk of bias using RoB 2, ROBINS-I, and QUADAS-2 tools. Certainty of evidence was graded using the GRADE approach.
Results and Discussion: The search identified 1,426 records, of which 38 met inclusion criteria. Studies consistently demonstrated that children with obesity and metabolic syndrome exhibit reduced bacterial diversity, lower Bacteroidetes/Firmicutes ratios, and higher abundance of proinflammatory taxa such as Enterobacteriaceae. Interventional trials with probiotics and synbiotics showed modest improvements in insulin sensitivity, lipid profiles, and inflammatory markers, though heterogeneity and methodological limitations limited generalizability. Evidence certainty was graded as low to moderate, with frequent confounding by diet, age, and antibiotic exposure.
Conclusion: The gut microbiota exerts a significant influence on the development and progression of metabolic diseases in children, though causality remains to be firmly established. Future research should prioritize longitudinal, multi-omics approaches and standardized protocols to clarify microbial-metabolic interactions and inform precision interventions. Integrating microbiota-targeted therapies into pediatric care could represent a promising avenue for early prevention of metabolic disorders.
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