The First Affiliated Hospital, Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, Guangdong, China.
Joint Institute of Metabolic Medicine between Jinan University and the University of Hong Kong, Huangpu Avenue West 613, Tianhe District, Guangzhou, Guangdong, China.
Obes Surg. 2020 Jun;30(6):2345-2361. doi: 10.1007/s11695-020-04494-4.
To explore the intestinal microbiota composition affected by the two most widely used procedures of bariatric surgery, laparoscopic sleeve gastrectomy (LSG) and laparoscopic roux-en-Y gastric bypass (LRYGB), in Chinese obesity patients.
Stool samples were collected from the obese patients before (n = 87) and with follow-up after the surgery (n = 53). After DNA extraction, 16S rDNA (V3 + V4 regions) sequencing was completed on Illumina HiSeq 2500 sequencing platform. The samples were analyzed base on four groups, pre-LSG (n = 54), pre-LRYGB (n = 33), post-LSG (n = 33), and post-LRYGB (n = 20). The linear mixed models were used to analyze the alteration of intestinal microbiota before and after the surgeries of LSG or LRYGB. Student's t test and χ test were used for analysis of independent groups; Metastats analysis was used to compare the relative abundance of bacteria, and Pearson correlation and Spearman correlation analysis were used to test the correlation between indicated groups.
87 patients were included and 53 (60.92%) of them completed the follow-up (9.60 ± 3.92 months). Body mass index (BMI) decreased from 37.84 ± 6.16 kg/m to 26.22 ± 4.33 kg/m after LSG and from 45.75 ± 14.26 kg/m to 33.15 ± 10.99 kg/m after LRYGB. The relative abundance of 5 phyla and 42 genera were altered after the surgery in the cohort. Although no alteration of Firmicutes was observed at phylum level, 54.76% of the altered genera belong to phylum Firmicutes. Both LSG and LRYGB procedures increased the richness and evenness of intestinal microbiota in obese patients after the surgery. Particularly, 33 genera altered after LSG and 19 genera altered after LRYGB, in which 11 genera were common alterations in both procedures.
Both LSG and LRYGB altered the composition of intestinal microbiota in Chinese obesity patients, and particularly increased the richness and evenness of microbiota. Genera belonging to phylum Firmicutes were the most altered bacteria by bariatric surgery. The procedure of LSG resulted in much more pronounced alteration of the intestinal microbiota abundance than that observed in LRYGB. While different genera were altered after LSG and LRYGB procedures, 10 genera were the common altered genera in both procedures. Bacteria altered after LSG and LRYGB were functionally associated with BMI, and with relieving of the metabolic syndromes.
探索两种最广泛使用的减肥手术，腹腔镜袖状胃切除术（LSG）和腹腔镜 Roux-en-Y 胃旁路术（LRYGB），对中国肥胖患者肠道微生物组成的影响。
收集 87 例肥胖患者手术前（n=87）和手术后（n=53）的粪便样本。提取 DNA 后，在 Illumina HiSeq 2500 测序平台上完成 16S rDNA（V3+V4 区）测序。根据术前 LSG（n=54）、术前 LRYGB（n=33）、术后 LSG（n=33）和术后 LRYGB（n=20）4 组进行分析。使用线性混合模型分析 LSG 或 LRYGB 手术后肠道微生物的变化。使用 Student's t 检验和 χ 检验进行独立组分析；使用 Metastats 分析比较细菌的相对丰度，使用 Pearson 相关和 Spearman 相关分析测试指示组之间的相关性。
纳入 87 例患者，其中 53 例（60.92%）完成随访（9.60±3.92 个月）。LSG 术后体重指数（BMI）从 37.84±6.16 kg/m2 降至 26.22±4.33 kg/m2，LRYGB 术后从 45.75±14.26 kg/m2 降至 33.15±10.99 kg/m2。术后队列中有 5 个门和 42 个属的相对丰度发生了改变。虽然门水平上没有观察到厚壁菌门的变化，但54.76%的改变属属于厚壁菌门。LSG 和 LRYGB 手术均增加了肥胖患者术后肠道微生物的丰富度和均匀度。特别是，LSG 后有 33 个属发生改变，LRYGB 后有 19 个属发生改变，其中 11 个属在两种手术中均有共同改变。
LSG 和 LRYGB 均改变了中国肥胖患者肠道微生物的组成，特别是增加了微生物的丰富度和均匀度。属Firmicutes 的细菌变化最明显。LSG 术后肠道微生物丰度的变化比 LRYGB 更为明显。虽然 LSG 和 LRYGB 手术后有不同的细菌发生改变，但有 10 个属是两种手术共有的改变细菌。LSG 和 LRYGB 后改变的细菌与 BMI 有关，与代谢综合征的缓解有关。
