Projection of Gut Microbiome Pre- and Post-Bariatric Surgery To Predict Surgery Outcome

Abstract Background: Bariatric surgery is often the preferred method to resolve obesity and diabetes, with ~800,000 cases worldwide yearly and high outcome variability. The ability to predict the long-term BMI change following surgery has important implications on individuals and the health care system in general. Given the tight connection between eating habits, sugar consumption, BMI and the gut microbiome, we tested whether the microbiome before any treatment is associated with different treatment outcomes, as well as other intakes (HDL, Triglycerides, etc.).Results: A projection of the gut microbiome composition of obese (sampled before and after bariatric surgery) and slim patients into principal components was performed and the relation between this projection and surgery outcome was studied. The projection reveals 3 different microbiome profiles belonging to slim, obese and obese who underwent bariatric surgery, with post-surgery more different from the slim than the obese. The same projection allows for a prediction of BMI loss following bariatric surgery, using only the pre-surgery microbiome. A different projection is associated with sugar metabolism and A1C levels. Conclusions: - the gut microbiome can be naturally decomposed into main components depicting the patient's development and predicting in advance the outcome. Those may be translated into a better clinical management of obese individuals planning to undergo metabolic surgery.

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Projection of gut microbiome pre and post-bariatric surgery to predict surgery outcome

10.1101/2020.08.27.271312 ◽

2020 ◽

Author(s):

Meirav Ben Izhak ◽

Adi Eshel ◽

Ruti Cohen ◽

Liora Madar Shapiro ◽

Hamutal Meiri ◽

...

Keyword(s):

Bariatric Surgery ◽

Gut Microbiome ◽

Eating Habits ◽

High Density Lipoproteins ◽

List Type ◽

Microbiome Composition ◽

Surgery Outcome ◽

Post Surgery ◽

Obesity And Diabetes ◽

Before And After

AbstractBackgroundBariatric surgery is often the preferred method to resolve obesity and diabetes, with ~800,000 cases worldwide yearly and high outcome variability. The ability to predict the long-term Body Mass Index (BMI) change following surgery has important implications on individuals and the health care system in general. Given the tight connection between eating habits, sugar consumption, BMI, and the gut microbiome, we tested whether the microbiome before any treatment is associated with different treatment outcomes, as well as other intakes (high-density lipoproteins (HDL), Triglycerides, etc.).ResultsA projection of the gut microbiome composition of obese (sampled before and after bariatric surgery) and slim patients into principal components was performed and the relation between this projection and surgery outcome was studied. The projection reveals 3 different microbiome profiles belonging to slim, obese, and obese who underwent bariatric surgery, with post-surgery more different from the slim than the obese. The same projection allowed for a prediction of BMI loss following bariatric surgery, using only the pre-surgery microbiome.ConclusionsThe gut microbiome can be decomposed into main components depicting the patient’s development and predicting in advance the outcome. Those may be translated into better clinical management of obese individuals planning to undergo metabolic surgery.ImportanceBMI and diabetes can affect the gut microbiome composition.Bariatric surgery has large variabilities in outcome.The microbiome was previously shown to be a good predictor for multiple diseases.We analyzed here the gut microbiome before and after bariatric surgery and show that: The microbiome before surgery can be used to predict surgery outcome.Post-surgery microbiome drifts further away from the slim microbiome than pre-surgery obese patients.These results can lead to a microbiome-based pre-surgery decision whether to perform surgery.

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Gut Microbiome and Metabolites in Patients with NAFLD and after Bariatric Surgery: A Comprehensive Review

Metabolites ◽

10.3390/metabo11060353 ◽

2021 ◽

Vol 11 (6) ◽

pp. 353

Author(s):

Jacqueline Hoozemans ◽

Maurits de Brauw ◽

Max Nieuwdorp ◽

Victor Gerdes

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Metabolic Syndrome ◽

Liver Disease ◽

Gut Microbiome ◽

Clinical Care ◽

Clinical Effects ◽

Alcoholic Fatty Liver ◽

Microbiome Composition

The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing, as are other manifestations of metabolic syndrome such as obesity and type 2 diabetes. NAFLD is currently the number one cause of chronic liver disease worldwide. The pathophysiology of NAFLD and disease progression is poorly understood. A potential contributing role for gut microbiome and metabolites in NAFLD is proposed. Currently, bariatric surgery is an effective therapy to prevent the progression of NAFLD and other manifestations of metabolic syndrome such as obesity and type 2 diabetes. This review provides an overview of gut microbiome composition and related metabolites in individuals with NAFLD and after bariatric surgery. Causality remains to be proven. Furthermore, the clinical effects of bariatric surgery on NAFLD are illustrated. Whether the gut microbiome and metabolites contribute to the metabolic improvement and improvement of NAFLD seen after bariatric surgery has not yet been proven. Future microbiome and metabolome research is necessary for elucidating the pathophysiology and underlying metabolic pathways and phenotypes and providing better methods for diagnostics, prognostics and surveillance to optimize clinical care.

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