Hisham Hussan, Mohamed R Ali, Victoria Lyo, Amy Webb, Maciej Pietrzak, Jiangjiang Zhu, Fouad Choueiry, Hong Li, Bethany P Cummings, Maria L Marco, Valentina Medici, Steven K Clinton
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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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Bariatric Surgery Is Associated with Lower Concentrations of Fecal Secondary Bile Acids and Their Metabolizing Microbial Enzymes: A Pilot Study.\",\"authors\":\"Hisham Hussan, Mohamed R Ali, Victoria Lyo, Amy Webb, Maciej Pietrzak, Jiangjiang Zhu, Fouad Choueiry, Hong Li, Bethany P Cummings, Maria L Marco, Valentina Medici, Steven K Clinton\",\"doi\":\"10.1007/s11695-024-07420-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Total fecal secondary BA concentrations trended towards lower levels post- vs. pre-BRS controls (p = 0.07). 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引用次数: 0
摘要
导言：体内脂肪过多会增加患结直肠癌的风险。虽然减肥手术（BRS）能显著减轻体重，但人们对其对粪便流和结肠生物学的影响却知之甚少。具体来说，减肥手术（BRS）对粪便中二级胆汁酸（BA）（包括石胆酸（LCA））影响的数据有限，而石胆酸是结肠直肠癌发生的推定促进因素：这项横断面病例对照研究纳入了 44 名肥胖症患者，其中 15 名患者在 BRS 前（对照组），29 名患者在 BRS 后中位 24.1 个月。我们通过液相色谱法检测了粪便中 11 种 BA 的浓度，并通过粪便元基因组测序法检测了 BA 代谢细菌酶的基因丰度。采用非参数检验对 BA 含量和编码 BA 代谢酶的基因的线性判别分析（LDA）效应大小（LEfSe）进行量化：结果：BRS 后与 BRS 前对照组相比，粪便次级 BA 总浓度呈降低趋势（p = 0.07）。单个粪便中的 LCA 浓度在 BRS 后明显低于 BRS 前（8477.0 vs. 11,914.0 uM/mg，p 结论：粪便中的 LCA（乙酰胆碱酯酶）浓度在 BRS 后明显低于 BRS 前：BRS后，LCA（一种次级BA）和BA代谢所需的细菌基因的浓度较低。这些变化会影响健康并调节结肠直肠癌级联反应。有必要开展进一步的研究，探讨手术改变和相关饮食变化如何影响胆汁酸代谢。
Bariatric Surgery Is Associated with Lower Concentrations of Fecal Secondary Bile Acids and Their Metabolizing Microbial Enzymes: A Pilot Study.
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.
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.
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