Gut Microbiota in Patients with Morbid Obesity Before and After Bariatric Surgery: a Ten-Year Review Study (2009–2019)

Koulas, Spyridon; Stefanou, Christos K; Stefanou, Stefanos K; Tepelenis, Kostas; Zikos, Nikolaos; Tepetes, Konstantinos; Kapsoritakis, Andreas

doi:10.1007/s11695-020-05074-2

Cited by 24 publications

(23 citation statements)

References 93 publications

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“…Bariatric surgery not only has effects on clinical status, but also modulatory and reshaping effects on gut microbiota. Our results showed that bariatric surgery modified the gut microbiota profile of the patients with severe obesity, as previously reported [26][27][28][29]. At the phylum level, bariatric surgery reduced the abundance of Firmicutes phylum, whereas Proteobacteria showed an opposite pattern, reinforcing previous studies [30,31].…”

Section: Discussionsupporting

confidence: 91%

Long-Term Effects of Bariatric Surgery on Gut Microbiota Composition and Faecal Metabolome Related to Obesity Remission

et al. 2021

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Obesity is one of the main worldwide public health concerns whose clinical management demands new therapeutic approaches. Bariatric surgery is the most efficient treatment when other therapies have previously failed. Due to the role of gut microbiota in obesity development, the knowledge of the link between bariatric surgery and gut microbiota could elucidate new mechanistic approaches. This study aims to evaluate the long-term effects of bariatric surgery in the faecal metagenome and metabolome of patients with severe obesity. Faecal and blood samples were collected before and four years after the intervention from patients with severe obesity. Biochemical, metagenomic and metabolomic analyses were performed and faecal short-chain fatty acids were measured. Bariatric surgery improved the obesity-related status of patients and significantly reshaped gut microbiota composition. Moreover, this procedure was associated with a specific metabolome profile characterized by a reduction in energetic and amino acid metabolism. Acetate, butyrate and propionate showed a significant reduction with bariatric surgery. Finally, correlation analysis suggested the existence of a long-term compositional and functional gut microbiota profile associated with the intervention. In conclusion, bariatric surgery triggered long-lasting effects on gut microbiota composition and faecal metabolome that could be associated with the remission of obesity.

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Section: Discussionsupporting

confidence: 91%

Long-Term Effects of Bariatric Surgery on Gut Microbiota Composition and Faecal Metabolome Related to Obesity Remission

et al. 2021

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“…The dissimilar impact of the two bariatric surgical approaches on gut microbial composition has been exhaustively reviewed, with consistent results [9,[21][22][23][24][25][26][27]. Alpha diversity dynamics appear not to be reproducible across studies; however, beta diversity analyses consistently nd deeper changes for RYGB, including an expansion of the Pseudomonadota (formerly Proteobacteria) phyla [28][29][30][31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Fecal Metabolome and Bacterial Composition in Severe Obesity: Impact of Diet and Bariatric Surgery

Salazar

Ponce-Alonso

Garriga

et al. 2022

Preprint

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Background: The aim of this study was to monitor the impact of a preoperative diet and bariatric surgery on the bacterial gut microbiota composition and functionality in severe obesity and to compare sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB). The study also aimed to incorporate big data analysis for the omics results and machine learning by a Lasso-based analysis to detect the potential markers for excess weight loss.Methods: Forty patients who underwent bariatric surgery were recruited (14 underwent SG, and 26 underwent RYGB). Each participant contributed 4 fecal samples (baseline, post-diet, 1 month after surgery and 3 months after surgery). The bacterial composition was determined by 16S rDNA massive sequencing using MiSeq (Illumina). Metabolic signatures associated to fecal concentrations of short-chain fatty acids, amino acids, biogenic amines, gamma-aminobutyric acid and ammonium were determined by gas and liquid chromatography. Orange 3 software was employed to correlate the variables, and a Lasso analysis was employed to predict the weight loss at the baseline samples.Results: A correlation between Bacillota (formerly Firmicutes) abundance and excess weight was observed only for the highest body mass indexes. The crash diet had little impact on composition and targeted metabolic activity. RYGB had a deeper impact on bacterial composition and putrefactive metabolism than SG, although the excess weight loss was comparable in the two groups. Significantly higher ammonium concentrations were detected in the feces of the RYGB group. Conclusions: We detected individual signatures of composition and functionality, rather than a gut microbiota characteristic of severe obesity, with opposing tendencies for almost all measured variables in the two surgical approaches. The gut microbiota of the baseline samples was not useful for predicting excess weight loss after the bariatric process.

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“…These molecules include lipopolysaccharide (LPS), a component of Gram-negative bacteria whose signaling cascades lead to the production of pro-inflammatory cytokines. LPS is associated with the development of obesity and increased insulin resistance, and obese patients have elevated plasma LPS levels [ 157 , 158 ]. Other small microbial molecules, including ethanol, trimethylamine (TMA), phenylacetate, and imidazole propionate, are also associated with metabolic dysregulation [ 156 ].…”

Section: Effects Of Bariatric Surgery On the Gut Microbiotamentioning

confidence: 99%

“…BAs have been shown to regulate glucose metabolism by increasing insulin sensitivity and reducing gluconeogenesis [ 130 ]; in particular, taurine-conjugated BAs promote GLP-1 secretion and energy balance by activating TGR5 [ 191 ]. In addition, BAs regulate the composition of microbial communities and the final outcome of surgical obesity in terms of body weight [ 158 ]. There is a double correlation between BAs and bacterial overgrowth; indeed, the lower concentration of BAs delivered to the colon due to entero-hepatic cycle diversion affects the composition of the gut microbiota, and the gut microbiota itself is involved in the modulation of BA metabolism [ 184 ].…”

Section: Effects Of Bariatric Surgery On the Gut Microbiotamentioning

confidence: 99%

Bariatric Surgery and Liver Disease: General Considerations and Role of the Gut–Liver Axis

et al. 2021

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Weight loss is a therapeutic solution for many metabolic disorders, such as obesity and its complications. Bariatric surgery aims to achieve lasting weight loss in all patients who have failed after multiple dietary attempts. Among its many benefits, it has been associated with the regression of non-alcoholic fatty liver disease (NAFLD), which is often associated with obesity, with evidence of substantial improvement in tissue inflammation and fibrosis. These benefits are mediated not only by weight loss, but also by favorable changes in systemic inflammation and in the composition of the gut microbiota. Changes in microbial metabolites such as short-chain fatty acids (SCFAs), capable of acting as endocrine mediators, and bile acids (BAs) as well as modifications of the gut-brain axis, are among the involved mechanisms. However, not all bariatric surgeries show beneficial effects on the liver; those leading to malabsorption can cause liver failure or a marked worsening of fibrosis and the development of cirrhosis. Nevertheless, there are still many unclear aspects, including the extent of the benefits and the magnitude of the risks of bariatric surgery in cirrhotic patients. In addition, the usefulness and the safety of these procedures in patients who are candidates to or who have undergone liver transplant need solid supporting evidence. This paper aims to review literature data on the use of bariatric surgery in the setting of chronic liver disease.

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Gut Microbiota in Patients with Morbid Obesity Before and After Bariatric Surgery: a Ten-Year Review Study (2009–2019)

Cited by 24 publications

References 93 publications

Long-Term Effects of Bariatric Surgery on Gut Microbiota Composition and Faecal Metabolome Related to Obesity Remission

Long-Term Effects of Bariatric Surgery on Gut Microbiota Composition and Faecal Metabolome Related to Obesity Remission

Fecal Metabolome and Bacterial Composition in Severe Obesity: Impact of Diet and Bariatric Surgery

Bariatric Surgery and Liver Disease: General Considerations and Role of the Gut–Liver Axis

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