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Background <p>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.</p> Methods <p>A prospective observational study enrolled 24 patients with severe obesity, 14 underwent SG and 10&#xa0;GB. Evaluations before (0&#xa0;M) and 6&#xa0;months (6&#xa0;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&#xa0;s rRNA next-generation sequencing approach. Statistical significance was set to a <i>p</i> value &lt; 0.05 with an FDR &lt; 0.1.</p> Results <p>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&#xa0;M showed near significant differences (<i>p</i> = 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 <i>Enterobacteriaceae</i> and genera <i>Veillonella</i> and <i>Enterobacteriaceae_unclassified</i> after GB. Increased expression of immune-inflammatory genes was observed mainly for SG patients.</p> Conclusions <p>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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月28日

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

摘要

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.