Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University, Columbus, Ohio, USA.
Division of Gastroenterology, University of California Davis, Sacramento, CA, USA.
Clin Transl Gastroenterol. 2022 Jul 1;13(7):e00508. doi: 10.14309/ctg.0000000000000508. Epub 2022 Jun 7.
Intragastric balloons (IGBs) are a safe and effective treatment for obesity. However, limited knowledge exists on the underlying biological changes with IGB placement.
This single-institution study was part of an adjustable IGB randomized controlled trial. Subjects with obesity were randomized in a 2 is to 1 ratio to 32 weeks of IGB with diet/exercise counseling (n = 8) vs counseling alone (controls, n = 4). Diet/exercise counseling was continued for 24 weeks post-IGB removal to assess weight maintenance. We used mass spectrometry for nontargeted plasma lipidomics analysis and 16S rRNA sequencing to profile the fecal microbiome.
Subjects with IGBs lost 15.5% of their body weight at 32 weeks vs 2.59% for controls (P < 0.05). Maintenance of a 10.5% weight loss occurred post-IGB explant. IGB placement, followed by weight maintenance, led to a -378.9 μM/L reduction in serum free fatty acids compared with pre-IGB (95% confidence interval: 612.9, -145.0). This reduction was mainly in saturated, mono, and omega-6 fatty acids when compared with pre-IGB. Polyunsaturated phosphatidylcholines also increased after IGB placement (difference of 27 μM/L; 95% confidence interval: 1.1, 52.8). Compared with controls, saturated and omega-6 free fatty acids (linoleic and arachidonic acids) were reduced after IGB placement. The fecal microbiota changed post-IGB placement and weight maintenance vs pre-IGB (P < 0.05). Further analysis showed a possible trend toward reduced Firmicutes and increased Bacteroidetes post-IGB and counseling, a change that was not conclusively different from counseling alone.
IGB treatment is associated with an altered fecal microbiome profile and may have a better effect on obesity-related lipidome than counseling alone.
胃内球囊（IGB）是治疗肥胖症的一种安全有效的方法。然而，对于 IGB 放置后潜在的生物学变化知之甚少。
本单中心研究是可调节胃内球囊随机对照试验的一部分。将肥胖患者以 2:1 的比例随机分为 IGB 组（n=8）和对照组（n=4）。IGB 组接受 32 周 IGB 治疗+饮食/运动咨询，对照组仅接受饮食/运动咨询。IGB 取出后继续进行 24 周饮食/运动咨询，以评估体重维持情况。我们使用非靶向性血浆脂质组学分析的质谱法和 16S rRNA 测序来分析粪便微生物组。
IGB 组患者在 32 周时体重减轻了 15.5%，而对照组仅减轻了 2.59%（P<0.05）。IGB 取出后体重维持了 10.5%的减轻。与 IGB 放置前相比，IGB 放置后（95%置信区间：612.9，-145.0）血清游离脂肪酸减少了-378.9 μM/L。与 IGB 放置前相比，这种减少主要发生在饱和、单不饱和和 omega-6 脂肪酸中。多不饱和磷脂酰胆碱在 IGB 放置后也增加（差异为 27 μM/L；95%置信区间：1.1，52.8）。与对照组相比，IGB 放置后饱和和 omega-6 游离脂肪酸（亚油酸和花生四烯酸）减少。与 IGB 放置前相比，IGB 放置后和体重维持期间粪便微生物群发生了变化（P<0.05）。进一步分析显示，IGB 和咨询后可能有Firmicutes 减少和 Bacteroidetes 增加的趋势，但与单独咨询相比，这种变化没有明显差异。
IGB 治疗与粪便微生物群谱的改变有关，并且可能比单独咨询对肥胖相关脂质组有更好的效果。
