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减重手术与粪便次级胆汁酸浓度降低及其代谢微生物酶相关:一项初步研究。

Bariatric Surgery Is Associated with Lower Concentrations of Fecal Secondary Bile Acids and Their Metabolizing Microbial Enzymes: A Pilot Study.

机构信息

Division of Gastroenterology, Department of Internal Medicine, University of California, Davis, Sacramento, CA, 95616, USA.

The UC Davis Comprehensive Cancer Center, Sacramento, CA, 95616, USA.

出版信息

Obes Surg. 2024 Sep;34(9):3420-3433. doi: 10.1007/s11695-024-07420-0. Epub 2024 Jul 23.


DOI:10.1007/s11695-024-07420-0
PMID:39042309
Abstract

INTRODUCTION: Excess body fat elevates colorectal cancer risk. While bariatric surgery (BRS) induces significant weight loss, its effects on the fecal stream and colon biology are poorly understood. Specifically, limited data exist on the impact of bariatric surgery (BRS) on fecal secondary bile acids (BA), including lithocholic acid (LCA), a putative promotor of colorectal carcinogenesis. METHODS: This cross-sectional case-control study included 44 patients with obesity; 15 pre-BRS (controls) vs. 29 at a median of 24.1 months post-BRS. We examined the fecal concentrations of 11 BA by liquid chromatography and gene abundance of BA-metabolizing bacterial enzymes through fecal metagenomic sequencing. Differences were quantified using non-parametric tests for BA levels and linear discriminant analysis (LDA) effect size (LEfSe) for genes encoding BA-metabolizing enzymes. RESULTS: Total fecal secondary BA concentrations trended towards lower levels post- vs. pre-BRS controls (p = 0.07). Individually, fecal LCA concentrations were significantly lower post- vs. pre-BRS (8477.0 vs. 11,914.0 uM/mg, p < 0.008). Consistent with this finding, fecal bacterial genes encoding BA-metabolizing enzymes, specifically 3-betahydroxycholanate-3-dehydrogenase (EC 1.1.1.391) and 3-alpha-hydroxycholanate dehydrogenase (EC 1.1.1.52), were also lower post- vs. pre-BRS controls (LDA of - 3.32 and - 2.64, respectively, adjusted p < 0.0001). Post-BRS fecal BA concentrations showed significant inverse correlations with weight loss, a healthy diet quality, and increased physical activity. CONCLUSIONS: Concentrations of LCA, a secondary BA, and bacterial genes needed for BA metabolism are lower post-BRS. These changes can impact health and modulate the colorectal cancer cascade. Further research is warranted to examine how surgical alterations and the associated dietary changes impact bile acid metabolism.

摘要

简介:体脂肪过多会增加结直肠癌的风险。虽然减重手术(BRS)可显著减轻体重,但人们对其对粪便流和结肠生物学的影响知之甚少。具体来说,关于减重手术(BRS)对粪便次级胆汁酸(BA)的影响,包括胆酸(LCA)的数据有限,LCA 是结直肠癌变的潜在促进剂。 方法:本横断面病例对照研究纳入 44 例肥胖患者;15 例术前(对照组)与 29 例术后中位数为 24.1 个月。我们通过液相色谱法检测 11 种 BA 的粪便浓度,并通过粪便宏基因组测序检测 BA 代谢细菌酶的基因丰度。使用非参数检验和线性判别分析(LDA)效应大小(LEfSe)对 BA 代谢酶编码基因进行量化。 结果:与术前对照组相比,术后总粪便次级 BA 浓度呈下降趋势(p=0.07)。单独来看,术后粪便 LCA 浓度明显低于术前(8477.0 与 11914.0 uM/mg,p<0.008)。与此发现一致的是,粪便中编码 BA 代谢酶的细菌基因,特别是 3-β-羟胆酸-3-脱氢酶(EC 1.1.1.391)和 3-α-羟胆酸脱氢酶(EC 1.1.1.52),术后也低于术前对照组(LDA 分别为-3.32 和-2.64,调整后的 p<0.0001)。术后粪便 BA 浓度与体重减轻、健康饮食质量和增加体力活动呈显著负相关。 结论:术后 LCA 等次级 BA 的浓度和 BA 代谢所需的细菌基因均降低。这些变化可能会影响健康并调节结直肠癌级联反应。需要进一步研究手术改变和相关饮食变化如何影响胆汁酸代谢。

相似文献

[1]
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Obes Surg. 2024-9

[2]
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[3]
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J Nutr. 2025-3

[4]
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Cochrane Database Syst Rev. 2014-8-8

[5]
The role of bile acids in reducing the metabolic complications of obesity after bariatric surgery: a systematic review.

Int J Obes (Lond). 2015-11

[6]
A microbial signature following bariatric surgery is robustly consistent across multiple cohorts.

Gut Microbes. 2021

[7]
The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation.

Health Technol Assess. 2009-9

[8]
Prepregnancy Roux-en-Y gastric bypass vs sleeve gastrectomy: a systematic review, pairwise, and network meta-analysis of obstetrical and neonatal outcomes.

Am J Obstet Gynecol MFM. 2023-6

[9]
Intestinal Energy Harvest Mediates Gut Microbiota-Associated Weight Loss Following Bariatric Surgery.

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[10]
Biological gender difference of bile acid metabolism in susceptibility to cholelithiasis in patients with nonalcoholic fatty liver disease.

J Steroid Biochem Mol Biol. 2025-10

本文引用的文献

[1]
Breast Cancer Risk After Bariatric Surgery and Influence of Insulin Levels: A Nonrandomized Controlled Trial.

JAMA Surg. 2024-8-1

[2]
Semaglutide vs Endoscopic Sleeve Gastroplasty for Weight Loss.

JAMA Netw Open. 2024-4-1

[3]
Sex- and operation-dependent effects on 5-year weight loss results of bariatric surgery.

Surg Obes Relat Dis. 2024-7

[4]
The intestinal microbiota as mediators between dietary contaminants and host health.

Exp Biol Med (Maywood). 2023-11

[5]
Early-onset Colon Cancer Shows a Distinct Intestinal Microbiome and a Host-Microbe Interaction.

Cancer Prev Res (Phila). 2024-1-4

[6]
Effects of obesity, and of weight loss following bariatric surgery, on methylation of DNA from the rectal mucosa and in cell-free DNA from blood.

Int J Obes (Lond). 2023-12

[7]
Distinctive patterns of sulfide- and butyrate-metabolizing bacteria after bariatric surgery: potential implications for colorectal cancer risk.

Gut Microbes. 2023-12

[8]
Association of Overweight, Obesity, and Recent Weight Loss With Colorectal Cancer Risk.

JAMA Netw Open. 2023-4-3

[9]
Does Bariatric Surgery Reduce the Risk of Colorectal Cancer in Individuals with Morbid Obesity? A Systematic Review and Meta-Analysis.

Nutrients. 2023-1-16

[10]
Effect of sleeve gastrectomy and Roux-en-Y gastric bypass on gastrointestinal physiology.

Eur J Pharm Biopharm. 2023-2

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