Jiao Yuxuan, Zhu Shaohui, Xue Huichao, Wang Yihao, Wang Yanfang, Hou Dong
The Department of General Surgery, First Affiliated Hospital of Henan Medical University, Xinxiang City, Henan Province, China.
Eat Weight Disord. 2025 Sep 2;30(1):73. doi: 10.1007/s40519-025-01784-7.
Bariatric surgery has proven effective in enhancing metabolic health and achieving sustainable weight loss for individuals with obesity. However, some patients experience adverse psychological outcomes and reduced quality-of-life post-surgery, potentially linked to changes in the gut-brain axis. This review aims to synthesize current evidence on the interplay between bariatric surgery-induced gut-brain axis modifications and patients' psychological status.
A systematic literature search was conducted across PubMed, Web of Science, and Embase, prioritizing clinical studies, mechanistic investigations, and meta-analyses. Inclusion criteria encompassed English-language articles examining psychological parameters, gut-derived hormones, and gut microbiota in adults after Roux-en-Y gastric bypass or sleeve gastrectomy.
Bariatric surgery fundamentally reprograms gut-brain communication through anatomical, endocrine, and neural plasticity mechanisms, a process associated with dual-edged metabolic benefits and neuropsychiatric risks. Mechanistic analyses suggest that postoperative dysregulation of GLP-1/PYY secretion, altered vagal afferent signaling, and sustained microbiota dysbiosis (reduced Bifidobacterium, elevated Proteobacteria) may represent potential correlates of these outcomes.
Studies have demonstrated significant associations between mood, quality of life, psychological status, and gut-derived hormones or microbiota. A comprehensive understanding of how bariatric surgery impacts gut-brain signaling pathways is critical for optimizing long-term therapeutic outcomes and enhancing patient quality of life.
This manuscript is a Narrative Review. According to the grading criteria of the Oxford Centre for Evidence-Based Medicine (OCEBM), this manuscript is categorized as Level III-IV evidence.
减肥手术已被证明对改善肥胖个体的代谢健康和实现可持续体重减轻有效。然而，一些患者术后会出现不良心理后果和生活质量下降，这可能与肠脑轴的变化有关。本综述旨在综合目前关于减肥手术引起的肠脑轴改变与患者心理状态之间相互作用的证据。
在PubMed、科学网和Embase上进行了系统的文献检索，优先检索临床研究、机制研究和荟萃分析。纳入标准包括研究Roux-en-Y胃旁路术或袖状胃切除术后成人心理参数、肠道衍生激素和肠道微生物群的英文文章。
减肥手术通过解剖、内分泌和神经可塑性机制从根本上重新编程肠脑通讯，这一过程伴随着双重代谢益处和神经精神风险。机制分析表明，术后GLP-1/PYY分泌失调、迷走神经传入信号改变和持续的微生物群失调（双歧杆菌减少，变形菌增加）可能是这些结果的潜在相关因素。
研究表明情绪、生活质量、心理状态与肠道衍生激素或微生物群之间存在显著关联。全面了解减肥手术如何影响肠脑信号通路对于优化长期治疗效果和提高患者生活质量至关重要。
本手稿为叙述性综述。根据牛津循证医学中心（OCEBM）的分级标准，本手稿归类为III-IV级证据。
