Differential changes in gut microbiota after gastric bypass and sleeve gastrectomy bariatric surgery vary according to diabetes remission
Abstract
Background It is unclear whether specific gut microbiota is associated with remission of type 2 diabetes (T2D) after distinct types of bariatric surgery.Aims The aim of this study is to examine gut microbiota changes after laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery in obese patients with T2D.Methods Whole-metagenome shotgun sequencing of DNA fragments using Illumina HiSeq2000 was obtained from stool samples collected from 14 obese T2D patients pre-operatively (while on very low calorie diet) and 1 year after randomisation to laparoscopic SG (n = 7) or RYGB (n = 7). Resulting shotgun reads were annotated with Kyoto Encyclopedia of Genes and Genomes (KEGG).Results Body weight reduction and dietary change was similar 1 year after both surgery types. Identical proportions (n = 5/7) achieved diabetes remission (HbA1c < 48 mmol/mol without medications) 1 year after RYGB and SG. RYGB resulted in increased Firmicutes and Actinobacteria phyla but decreased Bacteroidetes phyla. SG resulted in increased Bacteroidetes phyla. Only an increase in Roseburia species was observed among those achieving diabetes remission, common to both surgery types. KEGG Orthology and pathway analysis predicted contrasting and greater gut microbiota metabolism changes after diabetes remission following RYGB than after SG. Those with persistent diabetes post-operatively had higher Desulfovibrio species pre-operatively.Conclusions Overall, RYGB produces greater and more predicted favourable changes in gut microbiota functional capacity than SG. An increase in Roseburia species was the only compositional change common to both types of surgery among those achieving diabetes remission.
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Altered gut barrier function through either reduced bowel permeability from chronically increased secretion of GLP-2 or shifts in the intestinal microflora after surgery may be a second factor in the reductions in endotoxemia/inflammation after bariatric surgery.
“A second factor may be the altered gut barrier function through either reduced bowel permeability from chronically increased secretion of GLP-2 or shifts in the intestinal microflora after surgery [130-132].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [131]
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- Authors
- Murphy, R., Tsai, P., Jüllig, M., Liu, A., Plank, L., & Booth, M.
- Affiliations
- University of Auckland (NZ)
- Greenlane Clinical Centre (NZ)
- North Shore Hospital (NZ)
- Corresponding author
- Murphy, Rinki
- Venue
- Obesity Surgery
- Published
- 2016-10-13
- Volume
- 27
- Issue
- 4
- Pages
- 917-925
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W2529872601
- Cited by
- 285
- References
- 37
- Citations by year
- 2026: 12 · 2025: 22 · 2024: 20 · 2023: 27 · 2022: 53 · 2021: 37 · 2020: 39 · 2019: 36 · 2018: 28 · 2017: 11
- FWCI
- 12.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- ResearchSpace (University of Auckland) (submittedVersion)
- Funders
- Maurice Wilkins Centre (Flexible research seeding programme)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- gut microbiota, type 2 diabetes remission
- MeSH terms
- Gastrointestinal Microbiome, Adult, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Gastrectomy, Humans, Male, Middle Aged, Obesity, Laparoscopy, Postoperative Period, Remission Induction, Gastric Bypass, Treatment Outcome
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