Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, 72072 Tübingen, Germany.
Department of General, Visceral and Transplant Surgery, University Hospital, 72072 Tübingen, Germany.
Nutrients. 2020 Aug 10;12(8):2396. doi: 10.3390/nu12082396.
The gastrointestinal (GI) microbiota plays an important role in health and disease, including brain function and behavior. Bariatric surgery (BS) has been reported to result in various changes in the GI microbiota, therefore demanding the investigation of the impact of GI microbiota on treatment success. The goal of this systematic review was to assess the effects of BS on the microbiota composition in humans and other vertebrates, whether probiotics influence postoperative health, and whether microbiota and psychological and behavioral factors interact. A search was conducted using PubMed and Web of Science to find relevant studies with respect to the GI microbiota and probiotics after BS, and later screened for psychological and behavioral parameters. Studies were classified into groups and subgroups to provide a clear overview of the outcomes. Microbiota changes were further assessed for whether they were specific to BS in humans through the comparison to sham operated controls in other vertebrate studies. Changes in alpha diversity appear not to be specific, whereas dissimilarity in overall microbial community structure, and increases in the abundance of the phylum Proteobacteria and spp. within the phylum Verrucomicrobia after surgery were observed in both human and other vertebrates studies and may be specific to BS in humans. Human probiotic studies differed regarding probiotic strains and dosages, however it appeared that probiotic interventions were not superior to a placebo for quality of life scores or weight loss after BS. The relationship between GI microbiota and psychological diseases in this context is unclear due to insufficient available data.
胃肠道（GI）微生物群在健康和疾病中起着重要作用，包括大脑功能和行为。据报道，减肥手术（BS）会导致胃肠道微生物群发生各种变化，因此需要研究胃肠道微生物群对治疗成功的影响。本系统评价的目的是评估 BS 对人类和其他脊椎动物微生物群组成的影响，益生菌是否会影响术后健康，以及微生物群与心理和行为因素是否相互作用。使用 PubMed 和 Web of Science 进行了搜索，以找到与 BS 后胃肠道微生物群和益生菌相关的研究，并进一步筛选出心理和行为参数。对研究进行了分类和分组，以便清楚地了解研究结果。通过与其他脊椎动物研究中的假手术对照进行比较，进一步评估了微生物群变化是否是人类 BS 特有的。多样性的变化似乎不是特定的，而微生物群落结构的整体差异，以及厚壁菌门和疣微菌门内的属丰度增加，在人类和其他脊椎动物的研究中都观察到，这可能是人类 BS 特有的。人类益生菌研究在益生菌菌株和剂量方面存在差异，但益生菌干预似乎并不优于 BS 后的安慰剂对生活质量评分或体重减轻的影响。由于可用数据不足，胃肠道微生物群与该背景下心理疾病之间的关系尚不清楚。
