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<p>Faecal microbiota transplantation (FMT) has been explored as a potential treatment for obesity, but its long-term effects on metabolic health remain unclear. Here, we report 4-year follow-up findings from a double-blind, randomised, placebo-controlled trial assessing FMT in adolescents with obesity (ACTRN12615001351505, Australian New Zealand Clinical Trials Registry). This unblinded follow-up study evaluated 63% (55/87) of the original participants (27 FMT, 28 placebo). There was no difference in BMI between the two groups, after adjusting for sex, age, diet, and physical activity (−3.6 kg/m<sup>2</sup>, <i>p</i> = 0.095). However, FMT recipients showed clinical improvements in body composition and metabolic health compared to the placebo group. Specifically, FMT recipients had smaller waist circumference (−10.0 cm, <i>p</i> = 0.026), total body fat (−4.8%, <i>p</i> = 0.024), metabolic syndrome severity score (−0.58, <i>p</i> = 0.003), and systemic inflammation (−68% hs-CRP, <i>p</i> = 0.002) and higher levels of HDL cholesterol (0.16 mmol/L, <i>p</i> = 0.037). No group differences were observed in glucose markers, or other lipid parameters. Shotgun metagenomic sequencing revealed sustained long-term alterations in gut microbiome richness, composition and functional capacity, with persistence of donor-derived bacterial and bacteriophage strains. These findings highlight the potential relevance of FMT as a microbiome-augmenting intervention for obesity management and metabolic health, warranting further investigation.</p>

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Long-term health outcomes in adolescents with obesity treated with faecal microbiota transplantation: 4-year follow-up

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月28日

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  • Brooke C. Wilson,
  • Michele Zuppi,
  • José G. B. Derraik,
  • Benjamin B. Albert,
  • Ry Y. Tweedie-Cullen,
  • Karen S. W. Leong,
  • Kathryn L. Beck,
  • Tommi Vatanen,
  • Justin M. O’Sullivan,
  • Wayne S. Cutfield,
  • Benjamin Albert,
  • Kathryn Beck,
  • Valentina Chiavaroli,
  • Cathryn Conlon,
  • Christine Creagh,
  • Wayne Cutfield,
  • Frankie Day,
  • Marysia Depczynski,
  • José Derraik,
  • Taygen Edwards,
  • David Holland,
  • Thilini Jayasinghe,
  • Yannan Jiang,
  • Karen Leong,
  • Justin O’Sullivan,
  • Chris Pook,
  • Theo Portlock,
  • William Schierding,
  • Darren Svirskis,
  • Ry Tweedie-Cullen,
  • Mark Vickers,
  • Brooke Wilson

摘要

Faecal microbiota transplantation (FMT) has been explored as a potential treatment for obesity, but its long-term effects on metabolic health remain unclear. Here, we report 4-year follow-up findings from a double-blind, randomised, placebo-controlled trial assessing FMT in adolescents with obesity (ACTRN12615001351505, Australian New Zealand Clinical Trials Registry). This unblinded follow-up study evaluated 63% (55/87) of the original participants (27 FMT, 28 placebo). There was no difference in BMI between the two groups, after adjusting for sex, age, diet, and physical activity (−3.6 kg/m2, p = 0.095). However, FMT recipients showed clinical improvements in body composition and metabolic health compared to the placebo group. Specifically, FMT recipients had smaller waist circumference (−10.0 cm, p = 0.026), total body fat (−4.8%, p = 0.024), metabolic syndrome severity score (−0.58, p = 0.003), and systemic inflammation (−68% hs-CRP, p = 0.002) and higher levels of HDL cholesterol (0.16 mmol/L, p = 0.037). No group differences were observed in glucose markers, or other lipid parameters. Shotgun metagenomic sequencing revealed sustained long-term alterations in gut microbiome richness, composition and functional capacity, with persistence of donor-derived bacterial and bacteriophage strains. These findings highlight the potential relevance of FMT as a microbiome-augmenting intervention for obesity management and metabolic health, warranting further investigation.