Comment on ‘Gut microbiota characterisation in obese patients before and after bariatric surgery’

Abstract Current evidence support that the gut microbiota plays a potential role in obesity. Bariatric surgery can reduce excess weight and decrease the risk of life-threatening weight-related health problems and may also influence gut microbiota. In this study, we aimed to investigate the changes in gut microbiota before and after bariatric surgery and evaluate the association of the gut microbial shift and altered body mass index (BMI) after bariatric surgery. Between January 2019 and July 2020, stools from 58 patients scheduled for bariatric surgery were collected. Six months after bariatric surgery, stools from 22 of these patients were re-collected, and the changes in gut microbiota before and after bariatric surgery were evaluated. In addition, the differences in gut microbiota between patients with severe obesity (BMI > 35, n=42) and healthy volunteers with normal BMI (18.8 – 22.8, n=41) were investigated. The gut microbiota of patients who underwent bariatric surgery showed increased α-diversity and differed β-diversity compared with those before surgery. Interestingly, Blautia was decreased and Bacteriodes was increased at the genus level after bariatric surgery. Further, the Blautia/Bacteroides ratio showed a positive correlation with BMI. These results were similar regardless of the surgery type (Roux-en-Y gastric bypass or sleeve gastrectomy). To validate these results, we compared the gut microbiota from severely obese patients with high BMI with those from healthy volunteers and demonstrated that the Blautia/Bacteroides ratio correlated positively with BMI. In the gut microbial analysis of patients who underwent bariatric surgery, we identified that the Blautia/Bacteroides ratio had changed after bariatric surgery and showed a positive correlation with BMI. Based on these results, we suggest that bariatric surgery could change the gut microbiota and specific microbiomes might have a potential role in obese patients.

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Gut microbiota characterisation in obese patients before and after bariatric surgery

Beneficial Microbes ◽

10.3920/bm2017.0152 ◽

2018 ◽

Vol 9 (3) ◽

pp. 367-373 ◽

Cited By ~ 15

Author(s):

G. Campisciano ◽

S. Palmisano ◽

C. Cason ◽

M. Giuricin ◽

M. Silvestri ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Gut Microbiota ◽

Good Health ◽

Normal Weight ◽

Obese Patients ◽

Before And After

Intestinal microbiota analysis of obese patients after bariatric surgery showed that Proteobacteria decreased after laparoscopic sleeve gastrectomy (SG), while it increased after laparoscopic gastric bypass (LGB). Comparing to normal weight (NW) patients, obese patients that were selected for SG showed an almost equal amount of Firmicutes and Bacteroidetes and the ratio was not affected by the surgery. Obese patients before LGB showed a predominance of Bacteroidetes, whose amount regained a relative abundance similar to NW patients after surgery. Obese patients before LGB showed the predominance of Bacteroides, which decreased after surgery in favour of Prevotella, a bacterium associated with a healthy diet. The bacteria detected at the highest percentages belonged to biofilm forming species. In conclusion, in this study, we found that the characterization of the gut microbial communities and the modality of mucosal colonisation have a central role as markers for the clinical management of obesity and promote the maintenance of good health and the weight loss.

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POSTOPERATIVE COMPLIANCE OF BARIATRIC SURGERY PATIENTS REGARDING THE ASSESSMENT OF SERUM LEPTIN LEVELS AND INSULIN RESISTANCE

Medical Connections ◽

10.33311/medcon.2019.49.1.1 ◽

2019 ◽

Vol 49 (1/2019) ◽

Keyword(s):

Insulin Resistance ◽

Bariatric Surgery ◽

Serum Levels ◽

Medical Laboratory ◽

Leptin Resistance ◽

Obese Patients ◽

Laboratory Assessment ◽

Serum Leptin ◽

Before And After ◽

Bariatric Patients

Background and aims: Overweight and obese patients who undergo bariatric surgery require a rigorous clinical and paraclinical assessment both before and after the surgery at 3, 6, and 12 months.The present study aims the assessment of serum leptin levels and insulin resistance status in compliant bariatric patients to scheduled medical laboratory assessment at 6 months after surgery. Material and Method: The study included 109 eligible patients selected for bariatric surgery, 48 of whom attended the scheduled visit at 6 months after the surgery. Laboratory assessing regarded the insulin resistance by determining before meal the serum levels of leptin, glucose and insulin, as well as HOMA 1 and HOMA 2 indexes. Results: Patients who underwent bariatric treatment experienced a significant decrease in insulin resistance status. A higher percentage in the preoperative group was recorded in women, feature which was also recorded in the postoperative group that attended the scheduled visit at 6 months after surgery. Age is also an important factor that significantly influences the behavioral adherence to postoperative visits. Conclusions: Insulin resistance status improved significantly in 6 months after bariatric surgery among the fully compliant patients. The percentage of attendance at scheduled visits is higher among women, and decreases with age. Keywords: obesity surgery, leptin resistance, insulin resistance, HOMA index, compliance

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Fasting and postprandial acyl and desacyl ghrelin and the acyl/desacyl ratio in obese patients before and after different types of bariatric surgery

Videosurgery and Other Miniinvasive Techniques ◽

10.5114/wiitm.2018.75868 ◽

2018 ◽

Vol 13 (3) ◽

pp. 366-375 ◽

Cited By ~ 1

Author(s):

Jolanta A. Dardzińska ◽

Łukasz Kaska ◽

Monika Proczko-Stepaniak ◽

Maria Szymańska-Gnacińska ◽

Ewa Aleksandrowicz-Wrona ◽

...

Keyword(s):

Bariatric Surgery ◽

Obese Patients ◽

Desacyl Ghrelin ◽

Different Types ◽

Before And After

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Provision of nutritional support to those experiencing complications following bariatric surgery

Proceedings of The Nutrition Society ◽

10.1017/s0029665110001965 ◽

2010 ◽

Vol 69 (4) ◽

pp. 536-542 ◽

Cited By ~ 12

Author(s):

Ella Segaran

Keyword(s):

Bariatric Surgery ◽

Energy Expenditure ◽

Hospital Admissions ◽

Nutrition Support ◽

Considerable Proportion ◽

Obese Patients ◽

Free Living ◽

Protein Requirements ◽

Before And After ◽

Oral Diet

This review details the practicalities of providing nutrition support to obese patients who experience complications following bariatric surgery and highlights some of the nutritional challenges encountered by this group of patients. Bariatric surgery to treat morbid obesity has significantly increased internationally over the past decade with hospital admissions rising annually. The gastric bypass is currently the most commonly performed procedure. The complication rate can be up to 16%, with a considerable proportion having nutritional implications. The treatment can involve avoidance of oral diet and nutrition support, i.e. enteral or parenteral nutrition. Opposition to nutrition support can be encountered. It is useful to clarify the aims of nutrition support, these being: the avoidance of overfeeding and its consequences, preservation of lean body mass and promotion of healing. Evidence suggests that hypoenergic nutrition is not harmful and may actually be beneficial. There is a lack of consensus regarding the optimum method to predict the nutritional requirements in the obese acutely unwell patient. The literature suggests that the predicted equations are fairly accurate compared to measured energy expenditure in free living obese patients before and after bariatric surgery. However, these findings cannot be directly applied to those obese patients experiencing complications of bariatric surgery, who will be acutely unwell exhibiting inflammatory response. It is therefore necessary to refer to the literature on energy expenditure in hospitalized obese patients, to help guide practice. More research examining the energy and protein requirements of obese patients needing nutrition support following bariatric surgery is urgently required.

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Physical Activity and Quality of Life of Obese Patients Before and After Bariatric Surgery

Acta Scientific Gastrointestinal Disorders ◽

10.31080/asgis.2019.02.0056 ◽

2019 ◽

Vol 2 (6) ◽

pp. 10-13

Author(s):

Bruno Leandro de Melo Barreto ◽

Raphael José Perrier Melo ◽

Jones Silva Lima ◽

Rodrigo Conrado de Lorena Medeiros ◽

Jani Cléria Pereira Bezerra

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Bariatric Surgery ◽

Obese Patients ◽

Before And After

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Meta-Analysis of Differential miRNA Expression after Bariatric Surgery

Journal of Clinical Medicine ◽

10.3390/jcm8081220 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1220 ◽

Cited By ~ 2

Author(s):

Gladys Langi ◽

Lukasz Szczerbinski ◽

Adam Kretowski

Keyword(s):

Bariatric Surgery ◽

Target Genes ◽

Web Of Science ◽

Kegg Pathway ◽

Meta Analysis ◽

Obese Patients ◽

Pathway Database ◽

Efficient Treatment ◽

Kegg Pathway Database ◽

Before And After

Bariatric surgery is an efficient treatment for weight loss in obese patients and for resolving obesity comorbidities. However, the mechanisms behind these outcomes are unclear. Recent studies have indicated significant alterations in the transcriptome after surgery, specifically in the differential expression of microRNAs. In order to summarize the recent findings, we conducted a systematic summary of studies comparing microRNA expression levels before and after surgery. We identified 17 animal model and human studies from four databases (Ovid, Scopus, Web of Science, and PubMed) to be enrolled in this meta-analysis. From these studies, we identified 14 miRNAs which had the same direction of modulation of their expression after surgery in at least two studies (downregulated: hsa-miR-93-5p, hsa-miR-106b-5p, hsa-let-7b-5p, hsa-let-7i-5p, hsa-miR-16-5p, hsa-miR-19b-3p, hsa-miR-92a-3p, hsa-miR-222-3p, hsa-miR-142-3p, hsa-miR-140-5p, hsa-miR-155-5p, rno-miR-320-3p; upregulated: hsa-miR-7-5p, hsa-miR-320c). Pathway analysis for these miRNAs was done using database resources (DIANA-TarBase and KEGG pathway database) and their predicted target genes were discussed in relation with obesity and its comorbidities. Discrepancies in study design, such as miRNA source, bariatric surgery type, time of observation after surgery, and miRNA profiling methods, were also discussed.

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Gut Microbiota in Patients with Morbid Obesity Before and After Bariatric Surgery: a Ten-Year Review Study (2009–2019)

Obesity Surgery ◽

10.1007/s11695-020-05074-2 ◽

2020 ◽

Author(s):

Spyridon G. Koulas ◽

Christos K. Stefanou ◽

Stefanos K. Stefanou ◽

Kostas Tepelenis ◽

Nikolaos Zikos ◽

...

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Gut Microbiota ◽

Before And After ◽

Review Study

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Anti-Xa Levels in Morbidly Obese Patients Using Apixaban or Rivaroxaban, Before and After Bariatric Surgery

Obesity Surgery ◽

10.1007/s11695-021-05814-y ◽

2021 ◽

Author(s):

Thom Kok ◽

Hans de Boer ◽

Bart Witteman ◽

Marcel Hovens ◽

Matthijs van Luin ◽

...

Keyword(s):

Bariatric Surgery ◽

Morbidly Obese ◽

Obese Patients ◽

Before And After

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Evaluation of quality of life in severely obese patients after bariatric surgery carried out in the public healthcare system

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302012000100006 ◽

2012 ◽

Vol 56 (1) ◽

pp. 33-38 ◽

Cited By ~ 9

Author(s):

Cristina Khawali ◽

Marcos Bosi Ferraz ◽

Maria Tereza Zanella ◽

Sandra R. G. Ferreira

Keyword(s):

Bariatric Surgery ◽

Healthcare System ◽

Short Form ◽

Public Healthcare ◽

Obese Patients ◽

Public Healthcare System ◽

Post Surgery ◽

Sf 36 ◽

Before And After ◽

Severely Obese

OBJECTIVES: To assess QoL of obese patients in the Brazilian public healthcare system, before and after bariatric surgery, and to determine the appropriateness of the Moorehead-Ardelt Questionnaire II (M-A-QoLQII) compared with the Short-Form Health Survey (SF-36). SUBJECTS AND METHODS: Forty-one severe obese patients in a waiting-list, and 84 patients who underwent bariatric surgery were included. Correlations were tested and reliability determined by the Cronbach's coefficient. RESULTS: BMI differed between the pre- and post-surgery groups (52.3 ± 8.3 kg/m² vs. 32.5 ± 6.4 kg/m², p < 0.001). The latter showed better scores in the SF-36 domains than in the pre-surgery. SF-36 and M-A-QoLQII categories were correlated (r = 0.53, 0.49 and 0.47, for vitality, mental health, and general health domains, p < 0.001). In the logistic regression, age, previous BMI, and loss of excess weight were associated with functional capacity. CONCLUSIONS: The outcomes of bariatric surgery obtained in a Brazilian public healthcare center were successful. M-A-QoLII represents a useful tool to assess surgery outcomes, including QoL.

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