Modulation of the Gut Microbiota and Serum Biomarkers After Laparoscopic Sleeve Gastrectomy: a 1-Year Follow-Up Study.

PURPOSE

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).

MATERIALS AND METHODS

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).

RESULTS

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).

CONCLUSION

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.