Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
Sci Rep. 2019 Jul 29;9(1):10979. doi: 10.1038/s41598-019-47332-z.
Bariatric surgery in morbid obesity, either through sleeve gastrectomy (SG) or Roux-Y gastric bypass (RYGB), leads to sustainable weight loss, improvement of metabolic disorders and changes in intestinal microbiota. Yet, the relationship between changes in gut microbiota, weight loss and surgical procedure remains incompletely understood. We determined temporal changes in microbiota composition in 45 obese patients undergoing crash diet followed by SG (n = 22) or RYGB (n = 23). Intestinal microbiota composition was determined before intervention (baseline, S1), 2 weeks after crash diet (S2), and 1 week (S3), 3 months (S4) and 6 months (S5) after surgery. Relative to S1, the microbial diversity index declined at S2 and S3 (p < 0.05), and gradually returned to baseline levels at S5. Rikenellaceae relative abundance increased and Ruminococcaceae and Streptococcaceae abundance decreased at S2 (p < 0.05). At S3, Bifidobacteriaceae abundance decreased, whereas those of Streptococcaceae and Enterobacteriaceae increased (p < 0.05). Increased weight loss between S3-S5 was not associated with major changes in microbiota composition. No significant differences appeared between both surgical procedures. In conclusion, undergoing a crash diet and bariatric surgery were associated with an immediate but temporary decline in microbial diversity, with immediate and permanent changes in microbiota composition, independent of surgery type.
肥胖症患者行减重手术（袖状胃切除术[SG]或 Roux-en-Y 胃旁路术[RYGB]）后，可获得可持续的体重减轻、代谢紊乱改善和肠道微生物群变化。然而，肠道微生物群的变化、体重减轻与手术之间的关系仍不完全清楚。我们对 45 名接受快速节食后行 SG（n = 22）或 RYGB（n = 23）的肥胖患者进行了研究，以确定其肠道微生物群组成的时间变化。在干预前（基线，S1）、快速节食 2 周后（S2）、1 周（S3）、3 个月（S4）和 6 个月（S5）后测定肠道微生物群组成。与 S1 相比，S2 和 S3 时微生物多样性指数下降（p < 0.05），并在 S5 时逐渐恢复至基线水平。S2 时 Rikenellaceae 相对丰度增加，Ruminococcaceae 和 Streptococcaceae 丰度降低（p < 0.05）。S3 时双歧杆菌科丰度降低，而链球菌科和肠杆菌科丰度增加（p < 0.05）。S3-S5 期间体重减轻增加与微生物群组成无明显变化相关。两种手术之间没有明显差异。总之，快速节食和减重手术会导致微生物多样性的立即但暂时下降，并导致肠道微生物群组成的即时和永久性变化，而与手术类型无关。
