Sleeve Gastrectomy and Gastric Bypass Impact in Patient's Metabolic, Gut Microbiome, and Immuno-inflammatory Profiles-A Comparative Study.

IF 2.9 3区医学 Q1 SURGERY

Obesity Surgery Pub Date : 2025-03-01 Epub Date: 2025-01-28 DOI:10.1007/s11695-025-07708-9

Andre Lazaro, Igor Tiago, Joao Mendes, Joana Ribeiro, Antonio Bernardes, Fernando Oliveira, Fernando Regateiro, Francisco Caramelo, Henriqueta Silva

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引用次数: 0

Abstract

Background: Bariatric surgery is the most long-term effective treatment option for severe obesity. The role of gut microbiome (GM) in either the development of obesity or in response to obesity management strategies has been a matter of debate. This study aims to compare the impact of two of the most popular procedures, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (GB), on metabolic syndrome parameters and gut bacterial microbiome and in systemic immuno-inflammatory response.

Methods: A prospective observational study enrolled 24 patients with severe obesity, 14 underwent SG and 10 GB. Evaluations before (0 M) and 6 months (6 M) after surgical procedures included clinical and biochemical parameters, expression of 17 immuno-inflammatory genes in peripheral blood leukocytes, and assessment of gut microbiome profile using 16 s rRNA next-generation sequencing approach. Statistical significance was set to a p value < 0.05 with an FDR < 0.1.

Results: A significant and similar decrease in weight-associated parameters and for most metabolic markers was achieved with both surgeries. Considering the gut microbiome in the whole study population, there was an increase in alpha diversity at family-level taxa. Beta diversity between SG and GB at 6 M showed near significant differences (p = 0.042) at genus levels. Analysis of the relative abundance of individual taxonomic groups highlighted differences between pre- and post-surgical treatment and between both approaches, namely, a higher representation of family Enterobacteriaceae and genera Veillonella and Enterobacteriaceae_unclassified after GB. Increased expression of immune-inflammatory genes was observed mainly for SG patients.

Conclusions: We conclude that SG and GB have similar clinical and metabolic outcomes but different impacts in the gut bacterial microbiome. Results also suggest reactivation of immune response after bariatric surgery.

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袖式胃切除术和胃旁路手术对患者代谢、肠道微生物组和免疫炎症的影响——一项比较研究。

背景：减肥手术是重度肥胖最长期有效的治疗选择。肠道微生物组（GM）在肥胖的发展或对肥胖管理策略的反应中的作用一直是一个有争议的问题。本研究旨在比较两种最流行的手术——袖式胃切除术（SG）和Roux-en-Y胃旁路术（GB）对代谢综合征参数、肠道细菌微生物群和全身免疫炎症反应的影响。方法：前瞻性观察研究纳入24例重度肥胖患者，其中14例接受SG治疗，10例接受GB治疗。手术前（0 M）和术后6个月（6 M）的评估包括临床和生化参数、外周血白细胞中17种免疫炎症基因的表达，以及使用16s rRNA新一代测序方法评估肠道微生物组谱。结果：两种手术均实现了体重相关参数和大多数代谢指标的显著且相似的降低。考虑到整个研究人群的肠道微生物组，在科级分类群中α多样性有所增加。在6 M的属水平上，SG和GB的β多样性差异接近显著（p = 0.042）。个体分类群的相对丰度分析突出了术前和术后以及两种方法之间的差异，即在GB后未分类的Enterobacteriaceae和Veillonella属和enterobacteriaceae_gb中具有更高的代表性。免疫炎性基因表达增加主要见于SG患者。结论：我们认为SG和GB具有相似的临床和代谢结果，但对肠道细菌微生物组的影响不同。结果还表明，减肥手术后免疫反应的重新激活。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.