Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran, 13164, Iran.
Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
Obes Surg. 2021 May;31(5):1949-1956. doi: 10.1007/s11695-020-05139-2. Epub 2021 Jan 6.
Bariatric surgery is a treatment option for those affected by severe obesity. This study investigated changes in gut microbiota and serum biomarkers after laparoscopic sleeve gastrectomy (LSG).
A total of 126 patients with morbid obesity who underwent LSG were enrolled in this study. Routine biochemical tests, hormonal (insulin and glucagon), and cytokine levels (IL-6, IL-1β, TNF-α, IL-10, and TGF-β 1) were measured, in addition, real-time PCR (quantitative PCR, qPCR) quantitated gut microbiota. All the parameters were measured pre-operatively, 3, and 12 months post-surgery (F0, F3, and F12, respectively).
At F3, the level of FBS, HbA1c, HOMA-IR, triglyceride, cholesterol, LDL, BUN, creatinine, urea, SGOT, SGPT, IL-1β, IL-6, IFNγ, insulin, glucagon, the abundance of Prevotella and Bacteroides fragilis group, as well as the concentration of Firmicutes spp. showed significant decrease (P < 0.01), and HDL level, Akkermansia muciniphila and Roseburia spp. abundance, and Bacteroidetes and Bifidobacterium spp. concentration showed significant increase (P < 0.0001). The observed pattern continued or remained stable at F12 for all of these variables. IL-10 and TGF-β1 remained unchanged until F3 and showed a significant drop at F12. At F3, Clostridium cluster IV increased significantly and remained at that level afterward. Moreover, concentration of Phylum Actinobacteria showed an initial drop at F3 and a later increase at F12 (P < 0.0001).
LSG is associated with a significant improvement in serum biomarkers, as well as significant changes in fecal microbiota. Future systems biology analyses would shed more light on the underlying interactions of these parameters, and could help in developing novel diagnostic and therapeutic strategies for obesity management.
减重手术是治疗严重肥胖症患者的一种选择。本研究调查了腹腔镜袖状胃切除术（LSG）后肠道微生物群和血清生物标志物的变化。
共纳入 126 例接受 LSG 的病态肥胖患者。除了常规生化检测、激素（胰岛素和胰高血糖素）和细胞因子水平（IL-6、IL-1β、TNF-α、IL-10 和 TGF-β1）外，还采用实时 PCR（定量 PCR，qPCR）定量检测肠道微生物群。所有参数均在术前、术后 3 个月（F0、F3）和 12 个月（F12）进行测量。
在 F3 时，FBS、HbA1c、HOMA-IR、甘油三酯、胆固醇、LDL、BUN、肌酐、尿素、SGOT、SGPT、IL-1β、IL-6、IFNγ、胰岛素、胰高血糖素、普雷沃氏菌属和脆弱拟杆菌群的丰度以及厚壁菌门 spp 的浓度均显著下降（P<0.01），HDL 水平、阿克曼氏菌属和罗斯伯里氏菌属的丰度以及拟杆菌门和双歧杆菌属的浓度均显著升高（P<0.0001）。所有这些变量在 F12 时都保持或继续保持这种模式。IL-10 和 TGF-β1 直到 F3 时才保持不变，在 F12 时显著下降。在 F3 时，梭菌簇 IV 显著增加，此后一直保持在该水平。此外，厚壁菌门浓度在 F3 时略有下降，在 F12 时略有增加（P<0.0001）。
LSG 与血清生物标志物的显著改善以及粪便微生物群的显著变化相关。未来的系统生物学分析将更深入地了解这些参数的相互作用，并有助于开发肥胖症管理的新的诊断和治疗策略。
