Sorysz Zofia, Kowalewski Piotr, Walędziak Maciej, Różańska-Walędziak Anna
Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, 01-938 Warsaw, Poland.
Department of General Surgery, Military Institute of Medicine-National Research Institute, Zegrzyńska 8, 05-119 Legionowo, Poland.
Medicina (Kaunas). 2025 May 5;61(5):849. doi: 10.3390/medicina61050849.
The human gastrointestinal tract is estimated to be populated by 38 trillion bacteria from almost 1000 different species. The dominant phyla are Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria. However, the diversity and amount of gut microbiota depends on various factors. The importance of gut microbiota is increasingly noticed due to the influence of bacteria on energy homeostasis, the immune system, general health, and metabolism. Bariatric surgery is the mainstay treatment for patients with obesity. Two of the most common mechanisms are reducing gastric volume and decreasing ghrelin secretion. This literature review aims to depict the diverse impact of different bariatric procedures on gut microbiota. The original research papers were collected from the PubMed, Cochrane, and Elsevier databases. This literature review is focused on human studies. However, several references include animal models, specifically rats and germ-free mice. The findings suggest that bariatric surgery causes changes in the diversity of gut microbiota. However, the specificity of the changes depends on the type of bariatric surgery. The Firmicutes/Bacteroidetes ratio is elevated in the groups of patients with obesity compared to lean individuals. Bariatric surgery lowers the ratios impact on metabolism and energy absorption. Gut microbiota produces short-chain fatty acids, of which butyrate is responsible for strengthening the gut barrier, and acetate is correlated with fat deposition and lipogenesis. Moreover, changes in short-chain fatty acids influence insulin resistance and inflammation. In conclusion, bariatric surgery impacts gut microbiota, resulting in metabolic changes in patients, and the need for further study regarding long-term microbiota alterations post-operation is notable.
据估计，人类胃肠道中存在着来自近1000个不同物种的38万亿个细菌。主要的门类有厚壁菌门、拟杆菌门、放线菌门和变形菌门。然而，肠道微生物群的多样性和数量取决于多种因素。由于细菌对能量稳态、免疫系统、总体健康和新陈代谢的影响，肠道微生物群的重要性日益受到关注。减肥手术是肥胖患者的主要治疗方法。两种最常见的机制是减少胃容量和降低胃饥饿素分泌。这篇文献综述旨在描述不同减肥手术对肠道微生物群的多种影响。原始研究论文是从PubMed、Cochrane和爱思唯尔数据库收集的。这篇文献综述聚焦于人体研究。然而，一些参考文献包括动物模型，特别是大鼠和无菌小鼠。研究结果表明，减肥手术会导致肠道微生物群多样性的变化。然而，变化的特异性取决于减肥手术的类型。与瘦人相比，肥胖患者组的厚壁菌门/拟杆菌门比率升高。减肥手术会降低这些比率对新陈代谢和能量吸收的影响。肠道微生物群会产生短链脂肪酸，其中丁酸负责加强肠道屏障，而乙酸与脂肪沉积和脂肪生成相关。此外，短链脂肪酸的变化会影响胰岛素抵抗和炎症。总之，减肥手术会影响肠道微生物群，导致患者代谢发生变化，并且值得对术后长期微生物群改变进行进一步研究。
