Department of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
PLoS One. 2018 Nov 5;13(11):e0206930. doi: 10.1371/journal.pone.0206930. eCollection 2018.
Long term effects of subtotal gastrectomy on gut microbiota modifications with subsequent metabolic profiles are limited. We aimed to investigate and compare long-term effects of metabolic profiles and microbiota status in early gastric cancer patients post curative subtotal gastrectomy to the controls. In this cross-sectional study, we analyzed type II diabetes mellitus and metabolic syndrome occurrence in two groups: 111 patients after curative subtotal gastrectomy with Billroth II (BII) anastomosis and Roux-en-Y gastrojejuno (RYGJ) anastomosis and 344 age-sex matched controls. Fecal samples from those with BII, RYGJ, and controls were analyzed by next-generation sequencing method. Metabolic syndrome and type II diabetes mellitus occurrences were significantly lower in patients after subtotal gastrectomy with RYGJ than in controls over the long term (> 8 years) follow-up (P < 0.05). The richness and diversity of gut microbiota significantly increased after subtotal gastrectomy with RYGJ (P < 0.05). Compared with the control group, the principal component analysis revealed significant differences in bacterial genera abundance after subtotal gastrectomy with BII and RYGJ (P < 0.001). Genera of Oscillospira, Prevotella, Coprococcus, Veillonella, Clostridium, Desulfovibrio, Anaerosinus, Slackia, Oxalobacter, Victivallis, Butyrivibrio, Sporobacter, and Campylobacter shared more abundant roles both in the RYGJ group and BII groups. Early gastric cancer patients after subtotal gastrectomy with RYGJ had a lower occurrence of metabolic syndrome and type II diabetes mellitus than the controls during long term follow-up. In parallel with the metabolic improvements, gut microbial richness and diversity also significantly increased after subtotal gastrectomy with RYGJ.
根治性胃大部切除术后对肠道微生物群改变及其后续代谢谱的长期影响是有限的。我们旨在研究和比较早期胃癌患者根治性胃大部切除术后（Billroth II [BII]吻合和 Roux-en-Y 胃空肠吻合术）与对照组的长期代谢谱和微生物群状态的影响。在这项横断面研究中，我们分析了两组患者的 2 型糖尿病和代谢综合征的发生情况：111 例根治性胃大部切除术后 Billroth II （BII）吻合和 Roux-en-Y 胃空肠吻合术（RYGJ）吻合的患者和 344 例年龄性别匹配的对照组。通过下一代测序方法分析了 BII、RYGJ 和对照组患者的粪便样本。在长期（> 8 年）随访中，RYGJ 组患者的代谢综合征和 2 型糖尿病的发生率明显低于对照组（P < 0.05）。RYGJ 胃大部切除术后，肠道微生物群的丰富度和多样性显著增加（P < 0.05）。与对照组相比，BII 和 RYGJ 胃大部切除术后，主成分分析显示细菌属丰度有显著差异（P < 0.001）。与对照组相比，Oscillospira、Prevotella、Coprococcus、Veillonella、Clostridium、Desulfovibrio、Anaerosinus、Slackia、Oxalobacter、Victivallis、Butyrivibrio、Sporobacter 和 Campylobacter 等属在 RYGJ 组和 BII 组中的丰度均有所增加。在长期随访中，RYGJ 胃大部切除术后的早期胃癌患者发生代谢综合征和 2 型糖尿病的发生率低于对照组。与代谢改善平行的是，RYGJ 胃大部切除术后肠道微生物的丰富度和多样性也显著增加。
