Abstract
Obesity is one of the main worldwide public health concerns whose clinical management demands new therapeutic approaches. Bariatric surgery is the most efficient treatment when other therapies have previously failed. Due to the role of gut microbiota in obesity development, the knowledge of the link between bariatric surgery and gut microbiota could elucidate new mechanistic approaches. This study aims to evaluate the long-term effects of bariatric surgery in the faecal metagenome and metabolome of patients with severe obesity. Faecal and blood samples were collected before and four years after the intervention from patients with severe obesity. Biochemical, metagenomic and metabolomic analyses were performed and faecal short-chain fatty acids were measured. Bariatric surgery improved the obesity-related status of patients and significantly reshaped gut microbiota composition. Moreover, this procedure was associated with a specific metabolome profile characterized by a reduction in energetic and amino acid metabolism. Acetate, butyrate and propionate showed a significant reduction with bariatric surgery. Finally, correlation analysis suggested the existence of a long-term compositional and functional gut microbiota profile associated with the intervention. In conclusion, bariatric surgery triggered long-lasting effects on gut microbiota composition and faecal metabolome that could be associated with the remission of obesity.
Highlights
IntroductionObesity is one of the main public concerns worldwide, linked to increased rates of morbidity and mortality besides high resources demanding for public health systems [1]
The characteristics and clinical data, as well as the evolution in body weight loss of the participants of the study before and after bariatric surgery are depicted in Table 1 and Table S1
Bariatric technique enhanced biochemical and anthropometric parameters compared with measurements before surgery, showing statistical differences between patients with obesity before and after the intervention in the main parameters associated with obesity and metabolic syndrome
Summary
Obesity is one of the main public concerns worldwide, linked to increased rates of morbidity and mortality besides high resources demanding for public health systems [1]. Clinical management of overweight and obesity is traditionally based on lifestyle interventions due to the limited availability and efficacy of pharmacological therapies [2]. Bariatric surgery is considered the gold standard treatment when nonsurgical alternatives have failed, with great performance in remedying pathology in the short and in the long term [3,4]. Benefits of bariatric surgery exceed simple weight loss, counteracting other features of the metabolic dysfunction associated with obesity, including type 2 diabetes mellitus or hypertension [5]
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