Department of Medicine, Faculty of medical and health sciences, University of Auckland, Auckland, New Zealand.
Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand.
Obes Surg. 2020 Sep;30(9):3536-3548. doi: 10.1007/s11695-020-04684-0.
Distinct anatomical rearrangements of the gastrointestinal tract achieved by various types of bariatric surgery cause changes in nutrient intake and gut microbiota. The contribution of such gut microbiota changes to remission of type 2 diabetes (T2D) remains unclear.
We examined gut microbiota changes following banded Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) in a randomised study, in relation to T2D remission.
Whole-metagenome shotgun sequencing was carried out on paired stool samples at pre- and 1-year post-surgery collected from 44 participants with T2D randomised to banded Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Taxonomic composition and predicted functional potential of the gut bacteria were identified using HUMANn2, and annotated using MetaCyc. Five-day dietary records (analysed using FoodWorks v8.0), body weight and diabetes status were recorded at both time points.
RYGB participants had higher percentage excess weight loss than SG (p = 0.01), even though dietary intake was similar at 1-year post-surgery. Similar proportions achieved diabetes remission (HbA1c < 48 mmol/mol without medications) after either RYGB (68%) or SG (59%). RYGB resulted in increased abundances of Firmicutes and Proteobacteria, while SG resulted in increased Bacteroidetes. Pre-surgery, an increased abundance of Eubacteriaceae (p = 0.01) and Alistipes putredinis (p = 0.01) was observed in those who went on to remit from T2D post-surgery. Following surgery, Lachnospiraceae (p = 0.04) and Roseburia (p = 0.01) species were more abundant in those who had achieved T2D remission.
Specific stool bacterial taxa may signal likelihood of T2D remission after bariatric surgery which is potentially mediated by increases in Lachnospiraceae and Roseburia.
各种类型的减重手术对胃肠道进行不同的解剖重排，导致营养摄入和肠道微生物群发生变化。肠道微生物群的这种变化对 2 型糖尿病（T2D）的缓解作用仍不清楚。
我们在一项随机研究中检查了接受带式 Roux-en-Y 胃旁路术（RYGB）或袖状胃切除术（SG）的患者的肠道微生物群变化与 T2D 缓解的关系。
对 44 例 T2D 患者进行了随机分组，分别接受带式 Roux-en-Y 胃旁路术（RYGB）或袖状胃切除术（SG），在术前和术后 1 年采集配对粪便样本，进行全宏基因组鸟枪法测序。使用 HUMANn2 鉴定肠道细菌的分类组成和预测功能潜力，并使用 MetaCyc 进行注释。在这两个时间点记录了 5 天的饮食记录（使用 FoodWorks v8.0 进行分析）、体重和糖尿病状况。
RYGB 组的体重多余百分比丢失高于 SG 组（p=0.01），尽管术后 1 年的饮食摄入相似。无论是 RYGB（68%）还是 SG（59%），都有相似比例的患者实现了糖尿病缓解（HbA1c<48mmol/mol，无需药物治疗）。RYGB 导致厚壁菌门和变形菌门的丰度增加，而 SG 导致拟杆菌门的丰度增加。术前，观察到那些术后 T2D 缓解的患者中，真杆菌科（p=0.01）和 Alistipes putredinis（p=0.01）的丰度增加。手术后，Lachnospiraceae（p=0.04）和 Roseburia（p=0.01）的丰度在那些实现 T2D 缓解的患者中更高。
特定的粪便细菌类群可能预示着减重手术后 T2D 的缓解，这可能是通过 Lachnospiraceae 和 Roseburia 的增加介导的。
