Department of Medical, Surgical and Health Sciences, University of Trieste, Strada di Fiume, 447, Trieste, Italy.
General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy.
J Gastrointest Surg. 2020 Aug;24(8):1736-1746. doi: 10.1007/s11605-019-04321-x. Epub 2019 Aug 6.
Recently, the link between obesity and gut microbiota has become a focus for research. This study shed some light on the modification of postoperative gut microbial composition after bariatric surgery.
A prospective longitudinal study on healthy lean subjects and patients who underwent bariatric surgery (Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy) was carried out. Anthropometric and metabolic data, smoking, food preferences data, and stool samples were collected from lean subjects and from obese patients before and 3 and 6 months after surgery (T0, T3, and T6, respectively).
We collected stool samples from 25 obese patients before surgery and 3 and 6 months thereafter and from 25 normal weight patients. After Roux-en-Y gastric bypass, Yokenella regensburgei (p < 0.05), Fusobacterium varium (p < 0.05), Veillonella dispar/atypica (p < 0.05), and Streptococcus australis/gordonii (p < 0.05) were transiently identified in the gut at T3. Roux-en-Y gastric bypass patients had a permanent increase in Akkermansia muciniphila (p < 0.05), which is associated with healthy metabolism, both at T3 and T6. There were no significant changes in gut microbiota in laparoscopic sleeve gastrectomy patients.
In our study, Roux-en-Y gastric bypass induced major microbial differences and greater weight loss compared with laparoscopic sleeve gastrectomy. Analyzing the microbiota composition, a proliferation of potential pathogens and the onset of beneficial bacteria was observed. The effects of these bacteria on human health are still far from clear. Understanding the mechanisms of action of these bacteria could be the keystone in developing new therapeutic strategies for obesity.
最近，肥胖与肠道微生物群之间的联系成为研究的焦点。本研究探讨了减重手术后肠道微生物组成的改变。
对健康瘦受试者和接受减重手术（Roux-en-Y 胃旁路术和腹腔镜袖状胃切除术）的患者进行前瞻性纵向研究。收集瘦受试者和肥胖患者的人体测量和代谢数据、吸烟、食物偏好数据和粪便样本，分别在术前（T0）和术后 3 个月（T3）和 6 个月（T6）时进行。
我们收集了 25 名肥胖患者术前和术后 3 个月和 6 个月的粪便样本，以及 25 名正常体重患者的粪便样本。在 Roux-en-Y 胃旁路术后，Yokenella regensburgei（p<0.05）、Fusobacterium varium（p<0.05）、Veillonella dispar/atypica（p<0.05）和 Streptococcus australis/gordonii（p<0.05）在 T3 时在肠道中短暂存在。Roux-en-Y 胃旁路术患者的 Akkermansia muciniphila 永久性增加（p<0.05），这与 T3 和 T6 时的健康代谢有关。腹腔镜袖状胃切除术患者的肠道微生物群没有明显变化。
在我们的研究中，与腹腔镜袖状胃切除术相比，Roux-en-Y 胃旁路术引起了主要的微生物差异和更大的体重减轻。分析微生物群落组成，观察到潜在病原体的增殖和有益细菌的出现。这些细菌对人类健康的影响还远不清楚。了解这些细菌的作用机制可能是开发肥胖新治疗策略的关键。
