Separating “good” from “bad” faecal dysbiosis – evidence from two cross-sectional studies

Valeur

2020

Nutrients

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The gut microbiota and their metabolites, e.g., short-chain fatty acids (SCFA), are associated with obesity. The primary aims were to study faecal SCFA levels and the changes in SCFA levels after weight-loss interventions in subjects with obesity, and secondarily, to study factors associated with the faecal SCFA levels. In total, 90 subjects (men / women: 15/75) with a mean age of 44.4 (SD 8.4) years, BMI 41.7 (SD 3.7) kg/m 2 and morbid obesity (BMI > 40 or > 35 kg/m 2 with obesity-related complications) were included. Faecal SCFA and other variables were measured at inclusion and after a six-month conservative weight-loss intervention followed by bariatric surgery (Roux-en-Y gastric bypass or gastric sleeve). Six months after surgery, the total amount of SCFA was reduced, the total and relative amounts of the main straight SCFA (acetic-, propionic-, and butyric-acids) were reduced, and the total and relative amounts of branched SCFA (isobutyric-, isovaleric-, and isocaproicacids) were increased. The changes indicate a shift toward a proteolytic fermentation pattern with unfavorable health effects. The amount of SCFA was associated with the diet but not with metabolic markers or makers of the faecal microbiota composition. Dietary interventions could counteract the unfavorable effects.Nutrients 2020, 12, 802 2 of 12 between SCFA and the diet, the faecal microbiome composition and some metabolic and inflammatory biomarkers (HbA1c, CRP, and s-zonulin). Materials and Methods Study DesignConsecutive subjects with morbid obesity referred to Innlandet Hospital Trust, Gjøvik, Norway for evaluation of bariatric surgery were evaluated for inclusion in this prospective cohort study. After inclusion (T 1) and before bariatric surgery, the subjects completed a six-month conservative treatment period. This is standard procedure, and the conservative weight loss intervention helps the subjects to adapt to lifestyle changes. There was a follow-up visit six months after surgery (T 2). Inclusion CriteriaSubjects 18-65 years of age with morbid obesity (defined as BMI > 40 kg/m 2 or > 35 kg/m 2 with obesity-related complications) were available for inclusion. Subjects with previous major gastrointestinal surgery, organic gastrointestinal disorders, alcohol and drug abuse, major psychiatric disorders, and serious somatic disorders not related to obesity were excluded.

Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Changes in Faecal Short-Chain Fatty Acids after Weight-Loss Interventions in Subjects with Morbid Obesity

Valeur

2020

Nutrients

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“…NNS have been associated with metabolic disorders in observational studies [27]. That NNS may impact the intestinal permeability through alterations in the gut microbiota is a hypothesis that could be explored further [28].…”

Section: Fig 1 Inclusion Of Participantsmentioning

confidence: 99%

Changes in serum zonulin in individuals with morbid obesity after weight-loss interventions: a prospective cohort study

Aasbrenn

Lydersen²,

2020

BMC Endocr Disord

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Background: Zonulin is a biomarker of impaired intestinal permeability, which has been associated with various disorders. The primary aim was to study serum zonulin (s-zonulin) in individuals with morbid obesity before and after a conservative weight loss intervention followed by bariatric surgery. The secondary aims were to explore predictors of s-zonulin, and the associations between the changes of the predictors and changes in s-zonulin, and to compare the associations in the two treatment periods. Methods: Individuals with morbid obesity were included. Data before any weight loss interventions, after a 6 months' conservative weight loss intervention, and 6 months after bariatric surgery were used. S-zonulin was measured with an ELISA method from Immundiagnostik AB, Bensheim, Germany. Data were analysed with mixed models. Results: The mean body mass index was 42.1 kg/m 2 (SD 3.8) at inclusion and was reduced to 38.7 kg/m 2 (SD 3.8) and 29.8 kg/m 2 (SD 3.8) after the conservative treatment and bariatric surgery respectively. S-zonulin was 63 ng/mL (SD 32) at inclusion and was reduced with 19 ng/ml (95% CI 12 to 26, p < 0.001) after conservative treatment and 11 ng/ml (95% CI 0 to 21, p = 0.04) after bariatric surgery. At inclusion, s-zonulin was significantly associated with factors including p-glucose (B = 2.21, 95% CI 1.09 to 3.33, p < 0.001), c-reactive protein (B = 1.02, 95% CI 0.45 to 1.58, p < 0.001) and the intake of proteins (B = 0.23, 95% CI 0.08 to 0.38, p = 0.003) and non-nutritive sweeteners (B = 0.68, 95% CI 0.19 to 1.17, p = 0.007). The reduction in s-zonulin after the conservative weight loss intervention was significantly associated with improvement in diarrhoea (B = 6.6, 95% CI 1.3 to 11.8, p = 0.02), HbA1c (B = 9.7, 95% CI 1.1 to 18.3, p = 0.03), p-glucose (B = 3.5, 95% CI 1.2 to 5.9, p = 0.004) and gamma-GT (B = 0.28, 95% CI 0.09 to 0.47, p = 0.004), but not associated with the change in body mass index (B = 0.9, 95% CI − 1.5 to 3.3, p = 0.46). Conclusions: S-zonulin was markedly reduced after the conservative weight loss intervention, and further reduced after bariatric surgery. The reduction in s-zonulin was associated with improvement of diarrhoea, markers of glucose intolerance and liver disease, but not associated with the change in body mass index.

“…The data used were a subset of data from in a study in subjects with morbid obesity, the MO-BiPS study (Morbid Obesity-Bio-Psycho-Social disorders) [10][11][12][13].…”

Section: Methodsmentioning

confidence: 99%

Are the Results of a Combined Behavioural and Surgical Treatment of Morbid Obesity Satisfactory and Predictable?

2020

Nutrients

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Treatment of subjects with morbid obesity (Body Mass Index (BMI) > 40 kg/m2 or > 35 kg/m2 with obesity-related complications) often fails. This study explored the biopsychosocial predictors of dropout and weight loss during a combined behavioural and surgical weight-reduction program. Behavioural treatment for six months was followed by bariatric surgery and a visit six months after surgery. The success criterion was the loss of ≥50% of excess BMI above 25 kg/m2 (%EBMIL). Thirty-one men and 113 women with BMI 43.5 kg/m2 (SD 4.3) and 41.8 kg/m2 (SD 3.6), respectively, were included; 115 underwent bariatric surgery (Gastric sleeve: 23; Roux-en-Y gastric bypass: 92), and 98 had a follow-up visit six months after surgery. The mean %EBMIL at follow-up was 71.2% (SD 18.5). Treatment success was achieved in 86 subjects. Assuming success in 17 subjects who did not attend the follow-up visit (best possible outcome), 103 out of 144 subjects (72%) achieved successful weight reduction. Cohabitation was the only predictor of accomplishing surgery. Neither weight loss during behavioural therapy nor biopsychosocial factors were found to be clinically significant predictors of weight loss after surgery. The success rate of less than three in four subjects was unsatisfactory. There is a need to improve the regimen and to determine effective alternative interventions.