减肥手术后与医学减肥法对肠道微生物组影响的初步随机试验
Changes in Gut Microbiome after Bariatric Surgery Versus Medical Weight Loss in a Pilot Randomized Trial.
机构信息
Divisions of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, 1830 E. Monument St, Baltimore, MD, 21287, USA.
Division of General Internal Medicine, The Johns Hopkins University, Baltimore, MD, USA.
出版信息
Obes Surg. 2019 Oct;29(10):3239-3245. doi: 10.1007/s11695-019-03976-4.
BACKGROUND
Gut microbiota likely impact obesity and metabolic diseases. We evaluated the changes in gut microbiota after surgical versus medical weight loss in adults with diabetes and obesity.
METHODS
We performed 16S rRNA amplicon sequencing to identify the gut microbial composition at baseline and at 10% weight loss in adults with diabetes who were randomized to medical weight loss (MWL, n = 4), adjustable gastric banding (AGB, n = 4), or Roux-en-Y gastric bypass (RYGB, n = 4).
RESULTS
All participants were female, 75% reported black race with mean age of 51 years. At similar weight loss amount and glycemic improvement, the RYGB group had the most number of bacterial species (10 increased, 1 decreased) that significantly changed (p < 0.05) in relative abundance. Alpha-diversity at follow-up was significantly lower in AGB group compared to MWL and RYGB (observed species for AGB vs. MWL, p = 0.0093; AGB vs. RYGB, p = 0.0093). The relative abundance of Faecalibacterium prausnitzii increased in 3 participants after RYGB, 1 after AGB, and 1 after MWL.
CONCLUSIONS
At similar weight loss and glycemic improvement, the greatest alteration in gut microbiota occurred after RYGB with an increase in the potentially beneficial bacterium, F. prausnitzii. Gut microbial diversity tended to decrease after AGB and increase after RYGB and MWL. Future studies are needed to determine the impact and durability of gut microbial changes over time and their role in long-term metabolic improvement after bariatric surgery in adults with type 2 diabetes.
CLINICAL TRIAL REGISTRATION
NCTDK089557- ClinicalTrials.gov.
背景
肠道微生物群可能会影响肥胖和代谢性疾病。我们评估了糖尿病和肥胖成年人接受手术和药物减重后肠道微生物群的变化。
方法
我们对接受药物减重（MWL，n=4）、可调胃束带术（AGB，n=4）或 Roux-en-Y 胃旁路术（RYGB，n=4）的糖尿病成年人在基线和减重 10%时进行了 16S rRNA 扩增子测序，以确定肠道微生物组成。
结果
所有参与者均为女性，75%为黑种人，平均年龄为 51 岁。在相同的减重量和血糖改善的情况下，RYGB 组有最多数量的细菌种类（10 种增加，1 种减少），其相对丰度显著改变（p<0.05）。与 MWL 和 RYGB 相比，AGB 组在随访时的α多样性显著降低（AGB 与 MWL 相比，p=0.0093；AGB 与 RYGB 相比，p=0.0093）。3 例 RYGB 后、1 例 AGB 后和 1 例 MWL 后粪肠球菌的相对丰度增加。
结论
在相似的减重和血糖改善情况下，RYGB 后肠道微生物群发生了最大的改变，有益菌粪肠球菌增加。AGB 后肠道微生物多样性趋于降低，RYGB 和 MWL 后增加。需要进一步研究以确定肠道微生物变化随时间的影响和持久性及其在 2 型糖尿病成人减重手术后长期代谢改善中的作用。
临床试验注册
NCTDK089557-ClinicalTrials.gov。
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