fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2025-10-2-118-129fcmedicine-1027Research ArticleВНУТРЕННИЕ БОЛЕЗНИINTERNAL MEDICINEРоль запоров в развитии дислипидемий у пожилыхThe role of constipation in the development of dyslipidemia in the elderlyhttps://orcid.org/0000-0002-5068-9753МартыненкоА. В.MartynenkoA. V.

Мартыненко Александр Владимирович, кандидат медицинских наук, врач-терапевт, гериатр

ул. Тантана, д. 1, г. Ташкент, 100142

Dr. Aleksandr V. Martynenko, MD, Cand. Sci. (Medicine), Therapist, Geriatrician

Tantana Street, 1, Tashkent, 100142

docalex120@gmail.comhttps://orcid.org/0000-0001-5979-8537СибеллинН. П.NunesS. P.

Нунес Перейра Сибелли, врач-терапевт, физиотерапевт, нутрициолог

ул. Университарио Карлос Марсело Пинто, д. 68, г. Жуан-Песоа, 58040-350

Dr. Sibelli P. Nunes, MD, Therapist, Physiotherapist, Nutritionist

68, João Pessoa, 58040-350

ООО «Многофункциональный медицинский центр» M-clinicУзбекистанLLC "Multifunctional Medical Center" M-clinicUzbekistanClínica Cuidar FisioБразилияClínica Cuidar Fisio, University St. Carlos Marcelo PintoBrazil202530062025102118129Copyright © Мартыненко А.В., Сибеллин Н.П., 20252025Мартыненко А.В., Сибеллин Н.П.Martynenko A.V., Nunes S.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/1027

Хронические запоры у пожилых (частота до 40% среди лиц старше 65 лет) часто считаются лишь синдромом качества жизни, однако их роль в развитии дислипидемий через дисбиоз кишечной микробиоты и эндотоксинемию указывает на системный риск. Это состояние может повышать вероятность сердечно-сосудистых заболеваний — ведущей причины смертности в пожилом возрасте, что требует переосмысления подходов к диагностике и терапии. Цель. Оценка хронических запоров как патогенетического фактора развития и усугубления дислипидемий у пациентов пожилого и старческого возраста, с акцентом на механизмы, связанные с дисбиозом кишечной микробиоты и вызываемой им эндотоксинемией. Материалы и методы. Систематический обзор выполнен по рекомендациям PRISMA с использованием схемы отбора исследований. Поиск проводился в PubMed, Scopus и Web of Science (2010–2024 гг.) по ключевым словам: "chronic constipation", "dyslipidemia", "elderly", "gut microbiota", "endotoxemia", "lipid metabolism" и их синонимам. Из 2468 идентифицированных записей после исключения дубликатов (n = 634) и нерелевантных работ (n = 1803) включено 31 исследование: оригинальные (когортные, поперечные), обзоры и рандомизированные испытания, с фокусом на пожилых (≥65 лет) или смешанных когортах с экстраполяцией данных. Качество оценивалось по шкалам NewcastleOttawa (NOS≥5), ROBINS-I и Cochrane Risk of Bias. Применён нарративный синтез данных. Результаты. Хронические запоры способствуют развитию дисбиоза (снижение концентрации бактерий Firmicutes, рост Bacteroidetes, дефицит короткоцепочечных жирных кислот (КЦЖК)), усиливая проницаемость кишечника и эндотоксинемию (повышение липополисахаридов, С-реактивного белка, IL-6, TNF-α в крови). Это нарушает липидный обмен в виде роста липопротеинов низкой плотности (ЛПНП), увеличивая риск сердечно-сосудистых заболеваний (инфаркт миокарда, ишемическая болезнь сердца, инсульт), (HR = 1.34). Также дисбиоз может повышать риск развития синдрома старческой астении и саркопении, как одного из главных синдромов. Прием пробиотиков способствует учащению стула (на 1,3 раза/неделя), а прием полифенолов снижает концентрацию зонулина, улучшая липидный профиль (снижение ЛПНП). Заключение. Запоры у лиц старше 65 лет — системный фактор риска дислипидемий через дисбиоз и эндотоксинемию. Коррекция микробиоты пробиотиками и полифенолами перспективна, но нужны долгосрочные клинические исследования для подтверждения

Aim. To assess chronic constipation as a pathogenetic factor in the development and exacerbation of dyslipidemia in elderly and senile patients, with a focus on mechanisms involving gut microbiota dysbiosis and endotoxemia. Materials and Methods. A systematic review was conducted following PRISMA guidelines using a study selection flowchart. Searches were performed in PubMed, Scopus, and Web of Science (2010-2024) using the keywords: “chronic constipation,” “dyslipidemia,” “elderly,” “gut microbiota,” “endotoxemia,” “lipid metabolism,” and their synonyms. Of 2,468 identified records, 31 studies were included after removing duplicates (n = 634) and irrelevant articles (n = 1,803). Included studies were original (cohort or crosssectional), reviews, and randomized controlled trials focusing on elderly (≥ 65 years) or mixed cohorts with extrapolated data. Study quality was assessed using the Newcastle–Ottawa Scale (NOS ≥5), ROBINS-I, and the Cochrane Risk of Bias Tool. A narrative data synthesis was applied. Results. Chronic constipation contributes to dysbiosis (i.e., decreased Firmicutes, increased Bacteroidetes, and reduced levels of shortchain fatty acids), which in turn increases intestinal permeability and metabolic endotoxemia (i.e., elevated circulating lipopolysaccharides, C-reactive protein, IL-6, and TNF-α). These changes disrupt lipid metabolism, leading to elevated low-density lipoprotein cholesterol levels that results in an increased risk of cardiovascular disease (coronary artery disease, myocardial infarction, and stroke) with a hazard ratio of 1.34. Dysbiosis may also increase the risk of key geriatric syndromes such as frailty syndrome and sarcopenia. Probiotic supplementation was associated with increased stool frequency (by 1.3 times/week), and polyphenol intake was linked to reduced zonulin levels and improved lipid profiles (decreased low-density lipoprotein cholesterol). Conclusion. Constipation in individuals over 65 years of age represents a systemic risk factor for dyslipidemia through its effects on dysbiosis and endotoxemia. Modulation of the gut microbiota with probiotics and polyphenols holds promise, but long-term clinical trials are needed to confirm these findings

запорыдислипидемияпожилой возрастмикробиотаэндотоксинемиялипидный обменconstipationdyslipidemiaelderlymicrobiotaendotoxemialipid metabolismReferencesSalari N., Ghasemianrad M., Ammari-Allahyari M., Rasoulpoor S., Shohaimi S., Mohammadi M. Global prevalence of constipation in older adults: a systematic review and meta-analysis. Wien. Klin. Wochenschr. 2023;135(15-16):389–398. https://doi.org/10.1007/s00508-023-02156-wSalari N., Ghasemianrad M., Ammari-Allahyari M., Rasoulpoor S., Shohaimi S., Mohammadi M. Global prevalence of constipation in older adults: a systematic review and meta-analysis. Wien. Klin. Wochenschr. 2023;135(15-16):389–398. https://doi.org/10.1007/s00508-023-02156-wDong Q., Chen D., Zhang Y., Xu Y., Yan L., Jiang J. Constipation and cardiovascular disease: A two-sample Mendelian randomization analysis. Front. Cardiovasc. Med. 2023;10:1080982. https://doi.org/10.3389/fcvm.2023.1080982Dong Q., Chen D., Zhang Y., Xu Y., Yan L., Jiang J. Constipation and cardiovascular disease: A two-sample Mendelian randomization analysis. Front. Cardiovasc. Med. 2023;10:1080982. https://doi.org/10.3389/fcvm.2023.1080982Zhang D., Jian Y.P., Zhang Y.N., Li Y., Gu L.T., Sun H.H. et al. Short-chain fatty acids in diseases. Cell Commun. Signal. 2023;21(1):212. https://doi.org/10.1186/s12964-023-01219-9Zhang D., Jian Y.P., Zhang Y.N., Li Y., Gu L.T., Sun H.H. et al. Short-chain fatty acids in diseases. Cell Commun. Signal. 2023;21(1):212. https://doi. org/10.1186/s12964-023-01219-9Vinchurkar K., Kumar B., Mane S. Gastrointestinal tract motility and transport. In: Parambath A., eds. Polymers for oral drug delivery technologies. Woodhead Publishing Series in Biomaterials. Oxford: Elsevier Science Ltd, 2025:65–84. https://doi.org/10.1016/B978-0-443-13774-7.00002-5Vinchurkar K., Kumar B., Mane S. Gastrointestinal tract motility and transport. In: Parambath A., eds. Polymers for oral drug delivery technologies. Woodhead Publishing Series in Biomaterials. Oxford: Elsevier Science Ltd, 2025:65–84. https://doi.org/10.1016/B978-0-443-13774-7.00002-5Di Vincenzo F., Del Gaudio A., Petito V., Lopetuso L.R., Scaldaferri F. Gut microbiota, intestinal permeability, and systemic inflammation: a narrative review. Intern. Emerg. Med. 2024;19(2):275–293. https://doi.org/10.1007/s11739-023-03374-wDi Vincenzo F., Del Gaudio A., Petito V., Lopetuso L.R., Scaldaferri F. Gut microbiota, intestinal permeability, and systemic inflammation: a narrative review. Intern. Emerg. Med. 2024;19(2):275–293. https://doi.org/10.1007/s11739-023-03374-wYoshida N., Emoto T., Yamashita T., Watanabe H., Hayashi T., Tabata T. et al. Bacteroides vulgatus and Bacteroides dorei Reduce Gut Microbial Lipopolysaccharide Production and Inhibit Atherosclerosis. Circulation. 2018;138(22):2486–2498. https://doi.org/10.1161/CIRCULATIONAHA.118.033714Yoshida N., Emoto T., Yamashita T., Watanabe H., Hayashi T., Tabata T. et al. Bacteroides vulgatus and Bacteroides dorei Reduce Gut Microbial Lipopolysaccharide Production and Inhibit Atherosclerosis. Circulation. 2018;138(22):2486–2498. https://doi.org/10.1161/CIRCULATIONAHA.118.033714Khaledi M., Poureslamfar B., Alsaab H.O., Tafaghodi S., Hjazi A., Singh R. et al. The role of gut microbiota in human metabolism and inflammatory diseases: a focus on elderly individuals. Ann. Microbiol. 2024;74(1):1. https://doi.org/10.1186/s13213-023-01744-5Khaledi M., Poureslamfar B., Alsaab H.O., Tafaghodi S., Hjazi A., Singh R. et al. The role of gut microbiota in human metabolism and inflammatory diseases: a focus on elderly individuals. Ann. Microbiol. 2024;74(1):1. https://doi.org/10.1186/s13213-023-01744-5Cheever C.R., Shams R.B., Willingham K.R., Sim H., Cook L.M., Ahmidouch M.Y. et al. Understanding constipation as a geriatric syndrome. Geriatr. Nurs. 2025;61:440–448. https://doi.org/10.1016/j.gerinurse.2024.12.012Cheever C.R., Shams R.B., Willingham K.R., Sim H., Cook L.M., Ahmidouch M.Y. et al. Understanding constipation as a geriatric syndrome. Geriatr. Nurs. 2025;61:440–448. https://doi.org/10.1016/j.gerinurse.2024.12.012Mari A., Mahamid M., Amara H., Baker F.A., Yaccob A. Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management. Korean J. Fam. Med. 2020;41(3):139–145. https://doi.org/10.4082/kjfm.18.0182Mari A., Mahamid M., Amara H., Baker F.A., Yaccob A. Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management. Korean J. Fam. Med. 2020;41(3):139–145. https://doi.org/10.4082/kjfm.18.0182De Giorgio R., Ruggeri E., Stanghellini V., Eusebi L.H., Bazzoli F., Chiarioni G. Chronic constipation in the elderly: a primer for the gastroenterologist. BMC Gastroenterol. 2015;15:130. https://doi.org/10.1186/s12876-015-0366-3De Giorgio R., Ruggeri E., Stanghellini V., Eusebi L.H., Bazzoli F., Chiarioni G. Chronic constipation in the elderly: a primer for the gastroenterologist. BMC Gastroenterol. 2015;15:130. https://doi.org/10.1186/s12876-015-0366-3Guo M., Yao J., Yang F., Liu W., Bai H., Ma J. et al. The composition of intestinal microbiota and its association with functional constipation of the elderly patients. Future Microbiol. 2020;15:163–175. https://doi.org/10.2217/fmb-2019-0283Guo M., Yao J., Yang F., Liu W., Bai H., Ma J. et al. The composition of intestinal microbiota and its association with functional constipation of the elderly patients. Future Microbiol. 2020;15:163–175. https://doi.org/10.2217/fmb-2019-0283Zhu L., Liu W., Alkhouri R., Baker R.D., Bard J.E., Quigley E.M. et al. Structural changes in the gut microbiome of constipated patients. Physiol. Genomics. 2014;46(18):679–686. https://doi.org/10.1152/physiolgenomics.00082.2014Zhu L., Liu W., Alkhouri R., Baker R.D., Bard J.E., Quigley E.M. et al. Structural changes in the gut microbiome of constipated patients. Physiol. Genomics. 2014;46(18):679–686. https://doi.org/10.1152/physiolgenomics.00082.2014Tian H., Ye C., Yang B., Cui J., Zheng Z., Wu C. et al. Gut Metagenome as a Potential Diagnostic and Predictive Biomarker in Slow Transit Constipation. Front. Med. (Lausanne). 2022;8:777961. https://doi.org/10.3389/fmed.2021.777961Tian H., Ye C., Yang B., Cui J., Zheng Z., Wu C. et al. Gut Metagenome as a Potential Diagnostic and Predictive Biomarker in Slow Transit Constipation. Front. Med. (Lausanne). 2022;8:777961. https://doi.org/10.3389/fmed.2021.777961Ohkusa T., Koido S., Nishikawa Y., Sato N. Gut Microbiota and Chronic Constipation: A Review and Update. Front. Med. (Lausanne). 2019;6:19. https://doi.org/10.3389/fmed.2019.00019Ohkusa T., Koido S., Nishikawa Y., Sato N. Gut Microbiota and Chronic Constipation: A Review and Update. Front. Med. (Lausanne). 2019;6:19. https://doi.org/10.3389/fmed.2019.00019Feng C., Gao G., Wu K., Weng X. Causal relationship between gut microbiota and constipation: a bidirectional Mendelian randomization study. Front. Microbiol. 2024;15:1438778. https://doi.org/10.3389/fmicb.2024.1438778Feng C., Gao G., Wu K., Weng X. Causal relationship between gut microbiota and constipation: a bidirectional Mendelian randomization study. Front. Microbiol. 2024;15:1438778. https://doi.org/10.3389/fmicb.2024.1438778Vaiserman A., Romanenko M., Piven L., Moseiko V., Lushchak O., Kryzhanovska N. et al. Differences in the gut Firmicutes to Bacteroidetes ratio across age groups in healthy Ukrainian population. BMC Microbiol. 2020;20(1):221. https://doi.org/10.1186/s12866-020-01903-7Vaiserman A., Romanenko M., Piven L., Moseiko V., Lushchak O., Kryzhanovska N. et al. Differences in the gut Firmicutes to Bacteroidetes ratio across age groups in healthy Ukrainian population. BMC Microbiol. 2020;20(1):221. https://doi.org/10.1186/s12866-020-01903-7Liu X., Wang Y., Shen L., Sun Y., Zeng B., Zhu B. et al. Dai F. Association between frailty and chronic constipation and chronic diarrhea among American older adults: National Health and Nutrition Examination Survey. BMC Geriatr. 2023;23(1):745. https://doi.org/10.1186/s12877-023-04438-4Liu X., Wang Y., Shen L., Sun Y., Zeng B., Zhu B. et al. Dai F. Association between frailty and chronic constipation and chronic diarrhea among American older adults: National Health and Nutrition Examination Survey. BMC Geriatr. 2023;23(1):745. https://doi.org/10.1186/s12877-023-04438-4Hairul Hisham H.I., Lim S.M., Neoh C.F., Abdul Majeed A.B., Shahar S., Ramasamy K. Effects of non-pharmacological interventions on gut microbiota and intestinal permeability in older adults: A systematic review: Non-pharmacological interventions on gut microbiota/barrier. Arch. Gerontol. Geriatr. 2025;128:105640. https://doi.org/10.1016/j.archger.2024.105640Hairul Hisham H.I., Lim S.M., Neoh C.F., Abdul Majeed A.B., Shahar S., Ramasamy K. Effects of non-pharmacological interventions on gut microbiota and intestinal permeability in older adults: A systematic review: Non-pharmacological interventions on gut microbiota/barrier. Arch. Gerontol. Geriatr. 2025;128:105640. https://doi.org/10.1016/j.archger.2024.105640Del Bo' C., Bernardi S., Cherubini A., Porrini M., Gargari G., Hidalgo- Liberona N. et al. A polyphenol-rich dietary pattern improves intestinal permeability, evaluated as serum zonulin levels, in older subjects: The MaPLE randomised controlled trial. Clin. Nutr. 2021;40(5):3006–3018. https://doi.org/10.1016/j.clnu.2020.12.014Del Bo' C., Bernardi S., Cherubini A., Porrini M., Gargari G., Hidalgo- Liberona N. et al. A polyphenol-rich dietary pattern improves intestinal permeability, evaluated as serum zonulin levels, in older subjects: The MaPLE randomised controlled trial. Clin. Nutr. 2021;40(5):3006–3018. https://doi.org/10.1016/j.clnu.2020.12.014Peron G., Gargari G., Meroño T., Miñarro A., Lozano E.V., Escuder P.C. et al. Crosstalk among intestinal barrier, gut microbiota and serum metabolome after a polyphenol-rich diet in older subjects with "leaky gut": The MaPLE trial. Clin. Nutr. 2021;40(10):5288–5297. https://doi.org/10.1016/j.clnu.2021.08.027Peron G., Gargari G., Meroño T., Miñarro A., Lozano E.V., Escuder P.C. et al. Crosstalk among intestinal barrier, gut microbiota and serum metabolome after a polyphenol-rich diet in older subjects with "leaky gut": The MaPLE trial. Clin. Nutr. 2021;40(10):5288–5297. https://doi.org/10.1016/j.clnu.2021.08.027Moreno-Navarrete J.M., Manco M., Ibáñez J., García-Fuentes E., Ortega F., Gorostiaga E. et al. Metabolic endotoxemia and saturated fat contribute to circulating NGAL concentrations in subjects with insulin resistance. Int. J. Obes. (Lond). 2010;34(2):240–249. https://doi.org/10.1038/ijo.2009.242Moreno-Navarrete J.M., Manco M., Ibáñez J., García-Fuentes E., Ortega F., Gorostiaga E. et al. Metabolic endotoxemia and saturated fat contribute to circulating NGAL concentrations in subjects with insulin resistance. Int. J. Obes. (Lond). 2010;34(2):240–249. https://doi.org/10.1038/ijo.2009.242Liu X., Lu L., Yao P., Ma Y., Wang F., Jin Q. et al. Lipopolysaccharide binding protein, obesity status and incidence of metabolic syndrome: a prospective study among middle-aged and older Chinese. Diabetologia. 2014;57(9):1834–1841. https://doi.org/10.1007/s00125-014-3288-7Liu X., Lu L., Yao P., Ma Y., Wang F., Jin Q. et al. Lipopolysaccharide binding protein, obesity status and incidence of metabolic syndrome: a prospective study among middle-aged and older Chinese. Diabetologia. 2014;57(9):1834–1841. https://doi.org/10.1007/s00125-014-3288-7Gonzalez-Quintela A., Alonso M., Campos J., Vizcaino L., Loidi L., Gude F. Determinants of serum concentrations of lipopolysaccharide-binding protein (LBP) in the adult population: the role of obesity. PLoS One. 2013;8(1):e54600. https://doi.org/10.1371/journal.pone.0054600Gonzalez-Quintela A., Alonso M., Campos J., Vizcaino L., Loidi L., Gude F. Determinants of serum concentrations of lipopolysaccharide-binding protein (LBP) in the adult population: the role of obesity. PLoS One. 2013;8(1):e54600. https://doi.org/10.1371/journal.pone.0054600Lei L., Zhao N., Zhang L., Chen J., Liu X., Piao S. Gut microbiota is a potential goalkeeper of dyslipidemia. Front. Endocrinol. (Lausanne). 2022;13:950826. https://doi.org/10.3389/fendo.2022.950826Lei L., Zhao N., Zhang L., Chen J., Liu X., Piao S. Gut microbiota is a potential goalkeeper of dyslipidemia. Front. Endocrinol. (Lausanne). 2022;13:950826. https://doi.org/10.3389/fendo.2022.950826Guevara-Cruz M., Flores-López A.G., Aguilar-López M., Sánchez-Tapia M., Medina-Vera I., Díaz D. Improvement of Lipoprotein Profile and Metabolic Endotoxemia by a Lifestyle Intervention That Modifies the Gut Microbiota in Subjects With Metabolic Syndrome. J. Am. Heart Assoc. 2019;8(17):e012401. https://doi.org/10.1161/JAHA.119.012401Guevara-Cruz M., Flores-López A.G., Aguilar-López M., Sánchez-Tapia M., Medina-Vera I., Díaz D. Improvement of Lipoprotein Profile and Metabolic Endotoxemia by a Lifestyle Intervention That Modifies the Gut Microbiota in Subjects With Metabolic Syndrome. J. Am. Heart Assoc. 2019;8(17):e012401. https://doi.org/10.1161/JAHA.119.012401Judkins C.P., Wang Y., Jelinic M., Bobik A., Vinh A., Sobey C.G. et al. Association of constipation with increased risk of hypertension and cardiovascular events in elderly Australian patients. Sci. Rep. 2023;13(1):10943. https://doi.org/10.1038/s41598-023-38068-yJudkins C.P., Wang Y., Jelinic M., Bobik A., Vinh A., Sobey C.G. et al. Association of constipation with increased risk of hypertension and cardiovascular events in elderly Australian patients. Sci. Rep. 2023;13(1):10943. https://doi.org/10.1038/s41598-023-38068-yNagata N., Xu L., Kohno S., Ushida Y., Aoki Y., Umeda R. et al. Glucoraphanin Ameliorates Obesity and Insulin Resistance Through Adipose Tissue Browning and Reduction of Metabolic Endotoxemia in Mice. Diabetes. 2017;66(5):1222–1236. https://doi.org/10.2337/db16-0662Nagata N., Xu L., Kohno S., Ushida Y., Aoki Y., Umeda R. et al. Glucoraphanin Ameliorates Obesity and Insulin Resistance Through Adipose Tissue Browning and Reduction of Metabolic Endotoxemia in Mice. Diabetes. 2017;66(5):1222–1236. https://doi.org/10.2337/db16-0662Anhê F.F., Roy D., Pilon G., Dudonné S., Matamoros S., Varin T.V. et al. A polyphenol-rich cranberry extract protects from diet-induced obesity, insulin resistance and intestinal inflammation in association with increased Akkermansia spp. population in the gut microbiota of mice. Gut. 2015;64(6):872–883. https://doi.org/10.1136/gutjnl-2014-307142Anhê F.F., Roy D., Pilon G., Dudonné S., Matamoros S., Varin T.V. et al. A polyphenol-rich cranberry extract protects from diet-induced obesity, insulin resistance and intestinal inflammation in association with increased Akkermansia spp. population in the gut microbiota of mice. Gut. 2015;64(6):872–883. https://doi.org/10.1136/gutjnl-2014-307142Gomes A.C., Hoffmann C., Mota J.F. The human gut microbiota: Metabolism and perspective in obesity. Gut Microbes. 2018;9(4):308–325. https://doi.org/10.1080/19490976.2018.1465157Gomes A.C., Hoffmann C., Mota J.F. The human gut microbiota: Metabolism and perspective in obesity. Gut Microbes. 2018;9(4):308–325. https://doi.org/10.1080/19490976.2018.1465157Kim J.S., Kirkland R.A., Lee S.H., Cawthon C.R., Rzepka K.W., Minaya D.M., et al. Gut microbiota composition modulates inflammation and structure of the vagal afferent pathway. Physiol. Behav. 2020;225:113082. https://doi.org/10.1016/j.physbeh.2020.113082Kim J.S., Kirkland R.A., Lee S.H., Cawthon C.R., Rzepka K.W., Minaya D.M., et al. Gut microbiota composition modulates inflammation and structure of the vagal afferent pathway. Physiol. Behav. 2020;225:113082. https://doi.org/10.1016/j.physbeh.2020.113082Ticinesi A., Tana C., Nouvenne A., Prati B., Lauretani F., Meschi T. Gut microbiota, cognitive frailty and dementia in older individuals: a systematic review. Clin. Interv. Aging. 2018;13:1497–1511. https://doi.org/10.2147/CIA.S139163Ticinesi A., Tana C., Nouvenne A., Prati B., Lauretani F., Meschi T. Gut microbiota, cognitive frailty and dementia in older individuals: a systematic review. Clin. Interv. Aging. 2018;13:1497–1511. https://doi.org/10.2147/CIA.S139163Casati M., Ferri E., Azzolino D., Cesari M., Arosio B. Gut microbiota and physical frailty through the mediation of sarcopenia. Exp. Gerontol. 2019;124:110639. https://doi.org/10.1016/j.exger.2019.110639Casati M., Ferri E., Azzolino D., Cesari M., Arosio B. Gut microbiota and physical frailty through the mediation of sarcopenia. Exp. Gerontol. 2019;124:110639. https://doi.org/10.1016/j.exger.2019.110639Ticinesi A., Nouvenne A., Cerundolo N., Catania P., Prati B., Tana C. et al. Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia. Nutrients. 2019;11(7):1633. https://doi.org/10.3390/nu11071633Ticinesi A., Nouvenne A., Cerundolo N., Catania P., Prati B., Tana C. et al. Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia. Nutrients. 2019;11(7):1633. https://doi.org/10.3390/nu11071633Dimidi E., Christodoulides S., Fragkos K.C., Scott S.M., Whelan K. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am. J. Clin. Nutr. 2014;100(4):1075–1084. https://doi.org/10.3945/ajcn.114.089151Dimidi E., Christodoulides S., Fragkos K.C., Scott S.M., Whelan K. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am. J. Clin. Nutr. 2014;100(4):1075–1084. https://doi.org/10.3945/ajcn.114.089151Ford A.C., Quigley E.M., Lacy B.E., Lembo A.J., Saito Y.A., Schiller L.R. et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am. J. Gastroenterol. 2014;109(10):1547–1561. https://doi.org/10.1038/ajg.2014.202Ford A.C., Quigley E.M., Lacy B.E., Lembo A.J., Saito Y.A., Schiller L.R. et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am. J. Gastroenterol. 2014;109(10):1547–1561. https://doi.org/10.1038/ajg.2014.202Gil-Cardoso K., Ginés I., Pinent M., Ardévol A., Blay M., Terra X. The co-administration of proanthocyanidins and an obesogenic diet prevents the increase in intestinal permeability and metabolic endotoxemia derived to the diet. J. Nutr. Biochem. 2018;62:35–42. https://doi.org/10.1016/j.jnutbio.2018.07.012Gil-Cardoso K., Ginés I., Pinent M., Ardévol A., Blay M., Terra X. The co-administration of proanthocyanidins and an obesogenic diet prevents the increase in intestinal permeability and metabolic endotoxemia derived to the diet. J. Nutr. Biochem. 2018;62:35–42. https://doi.org/10.1016/j.jnutbio.2018.07.012Dey P., Sasaki G.Y., Wei P., Li J., Wang L., Zhu J. et al. Green tea extract prevents obesity in male mice by alleviating gut dysbiosis in association with improved intestinal barrier function that limits endotoxin translocation and adipose inflammation. J. Nutr. Biochem. 2019;67:78–89. https://doi.org/10.1016/j.jnutbio.2019.01.017Dey P., Sasaki G.Y., Wei P., Li J., Wang L., Zhu J. et al. Green tea extract prevents obesity in male mice by alleviating gut dysbiosis in association with improved intestinal barrier function that limits endotoxin translocation and adipose inflammation. J. Nutr. Biochem. 2019;67:78–89. https://doi.org/10.1016/j.jnutbio.2019.01.017Acharya B., Tofthagen M., Maciej-Hulme M.L., Suissa M.R., Karlsson N.G. Limited support for a direct connection between prebiotics and intestinal permeability - a systematic review. Glycoconj J. 2024;41(4-5):323– 342. https://doi.org/10.1007/s10719-024-10165-8Acharya B., Tofthagen M., Maciej-Hulme M.L., Suissa M.R., Karlsson N.G. Limited support for a direct connection between prebiotics and intestinal permeability - a systematic review. Glycoconj J. 2024;41(4-5):323– 342. https://doi.org/10.1007/s10719-024-10165-8

The authors declare that there are no conflicts of interest present.