Georgiou Konstantinos, Belev Nikolay A, Koutouratsas Tilemachos, Katifelis Hector, Gazouli Maria
The First Propaedeutic Surgical Unit, Hippocrateion Athens General Hospital, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece.
Medical Simulation Training Center, Research Institute of Medical University of Plovdiv, and UMPHAT "Eurohospital", Medical University of Plovdiv, Plovdiv 4002, Bulgaria.
World J Gastrointest Pathophysiol. 2022 May 22;13(3):59-72. doi: 10.4291/wjgp.v13.i3.59.
Obesity is increasingly prevalent in the post-industrial era, with increased mortality rates. The gut microbiota has a central role in immunological, nutritional and metabolism mediated functions, and due to its multiplexity, it is considered an independent organ. Modern high-throughput sequencing techniques have allowed phylogenetic exploration and quantitative analyses of gut microbiome and improved our current understanding of the gut microbiota in health and disease. Its role in obesity and its changes following bariatric surgery have been highlighted in several studies. According to current literature, obesity is linked to a particular microbiota profile that grants the host an augmented potential for calorie release, while limited diversity of gut microbiome has also been observed. Moreover, bariatric surgery procedures represent effective interventions for sustained weight loss and restore a healthier microbiota, contributing to the observed fat mass reduction and lean mass increase. However, newer evidence has shown that gut microbiota is only partially recovered following bariatric surgery. Moreover, several targets including FGF15/19 (a gut-derived peptide), could be responsible for the favorable metabolic changes of bariatric surgery. More randomized controlled trials and larger prospective studies that include well-defined cohorts are required to better identify associations between gut microbiota, obesity, and bariatric surgery.
肥胖症在后工业化时代日益普遍，死亡率也在上升。肠道微生物群在免疫、营养和代谢介导的功能中起着核心作用，因其具有多样性，被视为一个独立的器官。现代高通量测序技术使人们能够对肠道微生物组进行系统发育探索和定量分析，并增进了我们目前对健康和疾病状态下肠道微生物群的理解。多项研究强调了其在肥胖症中的作用以及减肥手术后的变化。根据当前文献，肥胖与特定的微生物群特征有关，这种特征使宿主具有更大的卡路里释放潜力，同时也观察到肠道微生物组的多样性有限。此外，减肥手术是实现持续体重减轻的有效干预措施，并能恢复更健康的微生物群，有助于减少脂肪量和增加瘦体重。然而，新的证据表明，减肥手术后肠道微生物群仅部分恢复。此外，包括FGF15/19（一种肠道衍生肽）在内的几个靶点可能是减肥手术产生有利代谢变化的原因。需要更多的随机对照试验和更大规模的前瞻性研究，纳入明确界定的队列，以更好地确定肠道微生物群、肥胖症和减肥手术之间的关联。
