Roux-en-Y Gastric Bypass and Vertical Banded Gastroplasty Induce Long-Term Changes on the Human Gut Microbiome Contributing to Fat Mass Regulation
Open accessAbstract
Bariatric surgery is currently the most effective procedure for the treatment of obesity. Given the role of the gut microbiota in regulating host metabolism and adiposity, we investigated the long-term effects of bariatric surgery on the microbiome of patients randomized to Roux-en-Y gastric bypass or vertical banded gastroplasty and matched for weight and fat mass loss. The two surgical procedures induced similar and durable changes on the gut microbiome that were not dependent on body mass index and resulted in altered levels of fecal and circulating metabolites compared with obese controls. By colonizing germ-free mice with stools from the patients, we demonstrated that the surgically altered microbiota promoted reduced fat deposition in recipient mice. These mice also had a lower respiratory quotient, indicating decreased utilization of carbohydrates as fuel. Our results suggest that the gut microbiota may play a direct role in the reduction of adiposity observed after bariatric surgery.
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Written from the paper’s full text.
TL;DR
Bariatric surgery in women randomized to Roux-en-Y gastric bypass (RYGB) or vertical banded gastroplasty (VBG) produced similar, durable gut microbiome changes about 9 years later that were not explained by BMI. Transplanting these surgically altered microbiotas into germ-free mice reduced fat deposition, suggesting the microbiome contributes directly to post-surgery adiposity reduction.
Key findings
- At 9.4 years after randomization, RYGB and VBG patients showed similar microbiome shifts; RYGB versus obese controls differed significantly, with 29 microbial genera differing in abundance, while VBG versus controls and RYGB versus VBG differences were not significant after multiple-testing correction.
- Metagenomic functional content differed: 928 KOs were enriched and 60 depleted in RYGB versus OBS, and 682 KOs were enriched and 33 depleted in VBG versus OBS; only 17 KOs differed between RYGB and VBG, all enriched in VBG.
- Fecal short-chain fatty acid/branched-chain fatty acid ratio decreased after surgery and was significant for RYGB; postprandial bile acid response was pronounced in RYGB, with increased total and conjugated bile acids and increased FGF19 response versus OBS.
- Germ-free mice colonized with RYGB or VBG microbiota for 2 weeks accumulated 43% and 26% less body fat, respectively, than mice colonized with OBS microbiota; RYGB-colonized mice also had a lower respiratory quotient.
Methods
- Cross-sectional human study of fecal samples from 14 women 9.4 years after randomization to RYGB (n = 7) or VBG (n = 7), matched for pre- and post-operative weight, BMI, and body composition, plus non-operated severely obese women (OBS, n = 7) and BMI-matched post-surgical controls (Ob, n = 9).
- Shotgun metagenomic sequencing on Illumina HiSeq 2000; reads aligned to 2,382 reference genomes and the MetaHIT gene catalog, with KEGG ortholog/pathway analysis and multiple-testing correction.
- Fecal SCFAs/BCFAs measured by GC-MS; plasma TMAO, choline, betaine, and bile acids measured by UPLC-MS/MS; fecal microbiota from three RYGB, three VBG, and three OBS patients transplanted into germ-free female mice for 2 weeks, with body composition and indirect calorimetry.
Limitations
- The paper states that the small sample size may explain the lack of distinct microbiota profiles between RYGB and VBG, and that bile acid gene findings need validation in larger cohorts and at shorter time points after surgery.
- The paper states that future studies of microbiome from patients achieving different levels of weight and fat loss are required to validate the findings.
- Evident from the text: the human cohort was small, all female, and diabetes-free, and the human microbiome–adiposity link is supported by mouse transplantation rather than direct human causality.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
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- Findingown data
No significant differences in microbiota composition were observed for RYGB versus VBG samples.
“We observed significant differences in microbiota composition for RYGB versus OBS samples, but not for VBG versus OBS or RYGB versus VBG (Figure 1; Table S3).”
Quote in the paperNot a substantial claim - Findingown data
Reporter pathways for nitrogen metabolism, fatty acid metabolism, and two-component systems were enriched both in RYGB versus OBS and VBG versus OBS microbiomes.
“In addition, the reporter pathways for nitrogen metabolism, fatty acid metabolism, and two-component systems were enriched both in RYGB versus OBS and VBG versus OBS microbiomes (Tables 1 and S4).”
Quote in the paperNot a substantial claim - Findingown data
Reporter pathways for phosphotransferase systems and fluorobenzoate degradation were enriched in RYGB versus OBS microbiomes.
“The reporter pathways for phosphotransferase systems and fluorobenzoate degradation were enriched in RYGB versus OBS microbiomes, and the reporter pathways for flagellar assembly, sulfur relay system, glutathione metabolism, glyoxylate and dicarboxylate metabolism, ABC transporters (in particular for lysine/arginine/ornithine, histidine, and putrescine), and phenylalanine metabolism were enriched”
Quote in the paperNot a substantial claim - Findingown data
Significant differences in microbiota composition were observed for RYGB versus OBS samples.
“We observed significant differences in microbiota composition for RYGB versus OBS samples, but not for VBG versus OBS or RYGB versus VBG (Figure 1; Table S3).”
Quote in the paperSubstantial claim - Findingown data
Two-component systems responding to nitrogen availability (nifA), phosphoglycerate transport (pgtCAP), and short-chain fatty acid metabolism (acetoacetate, atoCE) were specifically enriched in RYGB compared to OBS.
“We found that the two-component systems responding to nitrogen availability (nifA), phosphoglycerate transport (pgtCAP), and short-chain fatty acid (SCFA) metabolism (acetoacetate, atoCE) were specifically enriched in RYGB compared to OBS, while salt stress response and twitching motility were specifically enriched in VBG compared to OBS (Table S4).”
Quote in the paperNot a substantial claim
- Findingown data
The RYGB and VBG patients in the study were not under inflammatory stress as determined by plasma CRP levels.
“However, the RYGB and VBG patients in our study were not under inflammatory stress as determined by plasma CRP levels (Table S1).”
Quote in the paperNot a substantial claim - Findingown data
Eubacterium rectale and Roseburia intestinalis tended to decrease in VBG compared to OBS.
“E. coli tended to increase, while Eubacterium rectale and Roseburia intestinalis tended to decrease in VBG compared to OBS (Table S3).”
Quote in the paperNot a substantial claim - Findingown data
Levels of three species in the Firmicutes phylum (Clostridium difficile, Clostridium hiranonis, and Gemella sanguinis) were lower in RYGB versus OBS samples.
“The abundance of species belonging to 29 microbial genera differed significantly between RYGB and OBS samples (Figure 1A; Table S3); in particular, the levels of several species in the Gammaproteobacteria class were higher while the levels of three species in the Firmicutes phylum (Clostridium difficile, Clostridium hiranonis, and Gemella sanguinis) were lower in RYGB versus OBS samples (Table S3”
Quote in the paperNot a substantial claim - Findingown data
The two surgical procedures induced similar and durable changes on the gut microbiome.
“The two surgical procedures induced similar and durable changes on the gut microbiome that were not dependent on body mass index and resulted in altered levels of fecal and circulating metabolites compared with obese controls.”
Quote in the paperSubstantial claim- Rests on an assumption: There are no long-term investigations of the stability of gut microbiota changes after bariatric surgery or of the effects of different procedures on the human gut microbiota.
- Findingown data
The abundance of species belonging to 29 microbial genera differed significantly between RYGB and OBS samples.
“The abundance of species belonging to 29 microbial genera differed significantly between RYGB and OBS samples (Figure 1A; Table S3); in particular, the levels of several species in the Gammaproteobacteria class were higher while the levels of three species in the Firmicutes phylum (Clostridium difficile, Clostridium hiranonis, and Gemella sanguinis) were lower in RYGB versus OBS samples (Table S3”
Quote in the paperSubstantial claim - Findingown data
Differences in relative abundance for several species when comparing VBG with OBS and RYGB with VBG were not significant after correction for multiple testing.
“We observed a different relative abundance for several species when comparing VBG with OBS samples, and RYGB with VBG samples, although the differences were not significant after correction for multiple testing (Table S3).”
Quote in the paperNot a substantial claim - Findingown data
No distinct microbiota profiles were observed for RYGB and VBG patients.
“Additionally, despite the obvious differences between the two surgical procedures (Olbers et al., 2006), we did not observe distinct microbiota profiles for RYGB and VBG patients.”
Quote in the paperSubstantial claim - Findingown data
Women who have undergone RYGB had increased abundance of Proteobacteria in comparison to non-operated severely obese women.
“These analyses demonstrated that women who have undergone RYGB had increased abundance of Proteobacteria in comparison to non-operated severely obese women.”
Quote in the paperSubstantial claim - Findingown data
Salt stress response and twitching motility were specifically enriched in VBG compared to OBS.
“We found that the two-component systems responding to nitrogen availability (nifA), phosphoglycerate transport (pgtCAP), and short-chain fatty acid (SCFA) metabolism (acetoacetate, atoCE) were specifically enriched in RYGB compared to OBS, while salt stress response and twitching motility were specifically enriched in VBG compared to OBS (Table S4).”
Quote in the paperNot a substantial claim - Findingown data
The changes on the gut microbiome induced by the two surgical procedures were not dependent on body mass index.
“The two surgical procedures induced similar and durable changes on the gut microbiome that were not dependent on body mass index and resulted in altered levels of fecal and circulating metabolites compared with obese controls.”
Quote in the paperSubstantial claim - Findingown data
928 KOs were enriched and 60 were depleted in RYGB versus OBS samples.
“We observed differences in the microbiome of operated and non-operated severely obese women (Figure 2; Table S4): 928 KOs were enriched and 60 were depleted in RYGB versus OBS samples (Figure 2A; Table S4), while 682 KOs were enriched and 33 were depleted in VBG versus OBS samples (Figure 2B; Table S4).”
Quote in the paperSubstantial claim - Findingown data
Reporter pathways for flagellar assembly, sulfur relay system, glutathione metabolism, glyoxylate and dicarboxylate metabolism, ABC transporters, and phenylalanine metabolism were enriched in VBG versus OBS samples.
“The reporter pathways for phosphotransferase systems and fluorobenzoate degradation were enriched in RYGB versus OBS microbiomes, and the reporter pathways for flagellar assembly, sulfur relay system, glutathione metabolism, glyoxylate and dicarboxylate metabolism, ABC transporters (in particular for lysine/arginine/ornithine, histidine, and putrescine), and phenylalanine metabolism were enriched”
Quote in the paperNot a substantial claim - Findingown data
Klebsiella species tended to increase in RYGB in comparison to VBG.
“Klebsiella species tended to increase, while Bifidobacterium species tended to decrease in RYGB in comparison to VBG (Table S3).”
Quote in the paperNot a substantial claim - Findingown data
The recipient mice had a lower respiratory quotient, indicating decreased utilization of carbohydrates as fuel.
“These mice also had a lower respiratory quotient, indicating decreased utilization of carbohydrates as fuel.”
Quote in the paperNot a substantial claim - Findingown data
Levels of several species in the Gammaproteobacteria class were higher in RYGB versus OBS samples.
“The abundance of species belonging to 29 microbial genera differed significantly between RYGB and OBS samples (Figure 1A; Table S3); in particular, the levels of several species in the Gammaproteobacteria class were higher while the levels of three species in the Firmicutes phylum (Clostridium difficile, Clostridium hiranonis, and Gemella sanguinis) were lower in RYGB versus OBS samples (Table S3”
Quote in the paperNot a substantial claim - Findingown data
No significant differences in microbiota composition were observed for VBG versus OBS samples.
“We observed significant differences in microbiota composition for RYGB versus OBS samples, but not for VBG versus OBS or RYGB versus VBG (Figure 1; Table S3).”
Quote in the paperSubstantial claim - Findingown data
Several facultative anaerobes in the Proteobacteria (e.g., Escherichia, Klebsiella, and Pseudomonas) were present at increased relative abundance in RYGB.
“At the genus level, several facultative anaerobes in the Proteobacteria (e.g., Escherichia, Klebsiella, and Pseudomonas) were present at increased relative abundance in RYGB (Table S3).”
Quote in the paperNot a substantial claim - Findingown data
The gene coding for TMAO reductase (torA, K07811) was enriched in both RYGB and VBG compared to OBS microbiomes.
“Furthermore, the gene coding for TMAO reductase (torA, K07811), which is involved in the respiration of TMAO to TMA, was also enriched in both RYGB and VBG compared to OBS microbiomes (Table S4).”
Quote in the paperNot a substantial claim - Findingown data
E. coli tended to increase in VBG compared to OBS.
“E. coli tended to increase, while Eubacterium rectale and Roseburia intestinalis tended to decrease in VBG compared to OBS (Table S3).”
Quote in the paperNot a substantial claim - Findingown data
Increased plasma concentrations of TMAO were observed only in RYGB and not in VBG women.
“However, we observed increased plasma concentrations of TMAO only in RYGB and not in VBG women (Figure S1A); the levels of choline and betaine, known dietary precursors for TMA production by the gut microbiota, did not differ between the groups (Figures S1B and S1C).”
Quote in the paperNot a substantial claim - Findingown data
The changes on the gut microbiome resulted in altered levels of fecal and circulating metabolites compared with obese controls.
“The two surgical procedures induced similar and durable changes on the gut microbiome that were not dependent on body mass index and resulted in altered levels of fecal and circulating metabolites compared with obese controls.”
Quote in the paperSubstantial claim - Findingown data
Two-component system genes for response to antimicrobial peptides, outer membrane stress, and trimethylamine N-oxide (TMAO) were enriched in both RYGB and VBG compared to OBS microbiomes.
“Two-component system genes for response to antimicrobial peptides, outer membrane stress, and trimethylamine N-oxide (TMAO) were enriched in both RYGB and VBG compared to OBS microbiomes.”
Quote in the paperNot a substantial claim - Findingown data
Bifidobacterium species tended to decrease in RYGB in comparison to VBG.
“Klebsiella species tended to increase, while Bifidobacterium species tended to decrease in RYGB in comparison to VBG (Table S3).”
Quote in the paperNot a substantial claim - Findingown data
Colonizing germ-free mice with stools from the patients demonstrated that the surgically altered microbiota promoted reduced fat deposition in recipient mice.
“By colonizing germ-free mice with stools from the patients, we demonstrated that the surgically altered microbiota promoted reduced fat deposition in recipient mice.”
Quote in the paperSubstantial claim - Findingown data
A significant increase in the relative abundance of three E. coli species was found in VBG.
“We found again an expansion in Proteobacteria and a reduction in several clostridial species after RYGB, and also a significant increase in the relative abundance of three E. coli species in VBG (Figure 4A; Table S5).”
Quote in the paperNot a substantial claim - Findingown data
A blunted postprandial bile acid response was confirmed for OBS women.
“Fasting bile acid concentrations did not differ between RYGB, VBG, and OBS patients, but we confirmed a blunted postprandial bile acid response for OBS women and observed a slight increase in postprandial bile acid levels for VBG patients (Figures 3A and 3B), which was significant only for the secondary bile acid glycine-conjugated lithocholic acid (Figure S3B).”
Quote in the paperNot a substantial claim - Findingown data
A slight increase in postprandial bile acid levels was observed for VBG patients, which was significant only for the secondary bile acid glycine-conjugated lithocholic acid.
“Fasting bile acid concentrations did not differ between RYGB, VBG, and OBS patients, but we confirmed a blunted postprandial bile acid response for OBS women and observed a slight increase in postprandial bile acid levels for VBG patients (Figures 3A and 3B), which was significant only for the secondary bile acid glycine-conjugated lithocholic acid (Figure S3B).”
Quote in the paperNot a substantial claim - Findingown data
Several pathways and KOs enriched in RYGB or VBG compared to OBS were also enriched in comparison to Ob microbiomes.
“Several pathways (e.g., two-component systems, fluorobenzoate degradation, and glyoxylate and dicarboxylate metabolism) and KOs (e.g., nifA, pgtCAP, ato, and deg genes) enriched in RYGB or VBG compared to OBS were also enriched in comparison to Ob microbiomes (Table S5).”
Quote in the paperSubstantial claim - Findingown data
Mice colonized with RYGB and VBG microbiota for 2 weeks accumulated 43% and 26% less body fat, respectively, than mice colonized with OBS microbiota.
“We observed that mice colonized with RYGB and VBG microbiota for 2 weeks accumulated 43% and 26% less body fat, respectively, than mice colonized with OBS microbiota (Figure 5A)”
Quote in the paperSubstantial claim - Findingown data
Differences in the genetic content of RYGB, VBG, and Ob microbiomes were observed.
“We observed differences in the genetic content of RYGB, VBG, and Ob microbiomes (Figure 4B; Table S5).”
Quote in the paperSubstantial claim - Findingown data
GF mice colonized with RYGB microbiota had a lower respiratory quotient (RQ) than mice colonized with OBS microbiota (active phase, Night1) or with VBG microbiota (resting phase).
“GF mice colonized with RYGB microbiota had a lower respiratory quotient ([RQ]; ratio between CO2 produced and O2 consumed) than mice colonized with OBS microbiota (active phase, Night1, Figure 5B) or with VBG microbiota (resting phase, Figure 5C)”
Quote in the paperSubstantial claim - Findingown data
Levels of baiB, baiCD, baiE, baiF, and baiG increased in RYGB compared to OBS, although not significantly.
“We quantified putative microbial genes for bile acid metabolism and showed that levels of bsh genes (for bile salt hydrolases) did not differ, while baiB, baiCD, baiE, baiF, and baiG (genes for the 7α-dehydroxylation of primary bile acids) increased in RYGB compared to OBS, although not significantly (Figure S3A).”
Quote in the paperNot a substantial claim - Findingown data
Levels of bsh genes did not differ between groups.
“We quantified putative microbial genes for bile acid metabolism and showed that levels of bsh genes (for bile salt hydrolases) did not differ, while baiB, baiCD, baiE, baiF, and baiG (genes for the 7α-dehydroxylation of primary bile acids) increased in RYGB compared to OBS, although not significantly (Figure S3A).”
Quote in the paperNot a substantial claim - Findingreasoning
The changes in the microbiome were not dependent on BMI or degree of weight and fat mass loss.
“Importantly, the changes in the microbiome were not dependent on BMI or degree of weight and fat mass loss”
Quote in the paperSubstantial claim - Findingown data
The levels of choline and betaine did not differ between the groups.
“However, we observed increased plasma concentrations of TMAO only in RYGB and not in VBG women (Figure S1A); the levels of choline and betaine, known dietary precursors for TMA production by the gut microbiota, did not differ between the groups (Figures S1B and S1C).”
Quote in the paperSubstantial claim - Findingown data
A decrease in the SCFA/BCFA ratio was observed for bariatric surgery samples, which was significant for RYGB.
“As a result, we observed a decrease in the SCFA/BCFA ratio for bariatric surgery samples, which was significant for RYGB (Figure S2H).”
Quote in the paperSubstantial claim - Findingown data
Bariatric surgery has long-term effects on the composition and functional capacity of the gut microbiota.
“Our study shows that bariatric surgery has long-term effects on the composition and functional capacity of the gut microbiota”
Quote in the paperSubstantial claim - Findingown data
Fasting bile acid concentrations did not differ between RYGB, VBG, and OBS patients.
“Fasting bile acid concentrations did not differ between RYGB, VBG, and OBS patients, but we confirmed a blunted postprandial bile acid response for OBS women and observed a slight increase in postprandial bile acid levels for VBG patients (Figures 3A and 3B), which was significant only for the secondary bile acid glycine-conjugated lithocholic acid (Figure S3B).”
Quote in the paperNot a substantial claim - Findingown data
The BCFAs isobutyrate and isovalerate either showed no change or a slight tendency to increase in RYGB and VBG samples.
“The SCFAs acetate, propionate, and butyrate were present in comparable proportions, but their concentrations tended to decrease in RYGB and VBG samples (Figures S2A–S2D), while the BCFAs isobutyrate and isovalerate, produced from the amino acids valine and leucine, respectively, either showed no change or a slight tendency to increase in RYGB and VBG samples (Figures S2E–S2G).”
Quote in the paperNot a substantial claim - Findingown data
The increased bile acid levels in RYGB women were attributable to increases in both primary and secondary conjugated bile acids.
“The increased bile acid levels in RYGB women were attributable to increases in both primary and secondary conjugated bile acids (Figure S3B, ANOVA p < 0.05).”
Quote in the paperNot a substantial claim - Findingown data
An increased FGF19 response was observed in RYGB women compared to OBS.
“We observed an increased FGF19 response in RYGB women compared to OBS (Figure 3C), indicating increased FXR signaling.”
Quote in the paperSubstantial claim - Findingown data
torA (K07811) was enriched in RYGB and VBG compared to both OBS and Ob.
“In particular, torA (K07811) was enriched in RYGB and VBG compared to both OBS and Ob (Figure S4).”
Quote in the paperNot a substantial claim - Findingown data
The OBS and Ob microbiomes were similar.
“These results indicate that the differences in gut microbiota composition and genetic content result from bariatric surgery and not BMI per se, since the OBS and Ob microbiomes were similar (Figure 4; Table S5).”
Quote in the paperSubstantial claim - Findingown data
Two different bariatric surgery procedures, RYGB and VBG, have similar long-term effects on the gut microbiome in women matched for BMI and fat mass loss.
“Our results also show that two different bariatric surgery procedures, namely RYGB and VBG, have similar long-term effects on the gut microbiome in women matched for BMI and fat mass loss.”
Quote in the paperSubstantial claim - Findingown data
Mice colonized with RYGB microbiota had the highest average increase in lean mass.
“while mice colonized with RYGB microbiota had the highest average increase in lean mass (Figures S5A–S5C)”
Quote in the paperNot a substantial claim - Interpretationown data
The gut microbiota may play a direct role in the reduction of adiposity observed after bariatric surgery.
“Our results suggest that the gut microbiota may play a direct role in the reduction of adiposity observed after bariatric surgery.”
Quote in the paperSubstantial claim- Rests on an assumption: The causal link between alterations to the microbiota and the reduction in adiposity observed after bariatric surgery has not been previously analyzed in humans.
- Premisecitation
Increases in pH promote the growth of E. coli in vitro.
“For example, increases in pH have been shown to promote the growth of E. coli in vitro (Duncan et al., 2009), and both RYGB and VBG are associated with reduced luminal exposure to gastric acidity.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Duncan et al., 2009 source
Not checked in the free run.
- Premisecitation
The gut microbiota may mediate some of the beneficial effects of bariatric surgery.
“Recent work has also indicated that the gut microbiota may mediate some of the beneficial effects of bariatric surgery, and changes in the composition and diversity of the gut microbiota have been observed in the short term after RYGB in humans (Furet et al., 2010; Graessler et al., 2013; Kong et al., 2013; Zhang et al., 2009), as well as after vertical sleeve gastrectomy and RYGB in mice (Liou et”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationcitation
The increase in tor genes likely reflects the high levels of E. coli in both RYGB and VBG samples.
“The increase in tor genes likely reflects the high levels of E. coli in both RYGB and VBG samples, as E. coli can use TMAO as a terminal electron acceptor (Barrett and Kwan, 1985).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Barrett and Kwan, 1985 source
Not checked in the free run.
- Premisecitation
Bariatric surgery is currently the most effective procedure for the treatment of obesity.
“Bariatric surgery is currently the most effective procedure for the treatment of obesity.”
- Also stated in: § Introduction · plain
“Bariatric surgery is currently the best treatment for sustained weight loss and reduction of obesity-related comorbidities (Sjöström et al., 2007, 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Sjöström et al., 2007, 2012
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Also stated in: § Introduction · plain
- Interpretationown data
The similar SCFA/BCFA ratio and the analysis of pathways enriched in RYGB and VBG compared to OBS subjects reveal some common effects of the two bariatric surgery procedures.
“The similar SCFA/BCFA ratio and the analysis of pathways enriched in RYGB and VBG compared to OBS subjects reveal some common effects of the two bariatric surgery procedures and indicate altered intestinal fermentation shifted toward reduced production of SCFAs and increased amino acid fermentation after bariatric surgery.”
Quote in the paperSubstantial claim - Interpretationown data
The enrichment of KOs related to phosphoglycerate, acetoacetate, and SCFAs transporters and to phosphotransferase systems pointed to increased energy flux into sugar metabolism and glycolysis in RYGB microbiomes.
“The enrichment of KOs related to phosphoglycerate, acetoacetate, and SCFAs transporters and to phosphotransferase systems pointed to increased energy flux into sugar metabolism and glycolysis in RYGB microbiomes.”
Quote in the paperSubstantial claim - Interpretationown data
The lower SCFA/BCFA ratio was not a consequence of dietary consumption.
“Importantly, total fiber intake did not differ, while protein intake decreased for RYGB and VBG women (Table S1), indicating that the lower SCFA/BCFA ratio was not a consequence of dietary consumption.”
Quote in the paperSubstantial claim - Interpretationcitation
The results are consistent with a mouse study showing a reduced ability of the RYGB microbiota to promote adiposity.
“These results are also consistent with a mouse study showing a reduced ability of the RYGB microbiota to promote adiposity (Liou et al., 2013).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Liou et al., 2013 source
Not checked in the free run.
- Interpretationown data
The results provide evidence for an increased abundance in RYGB microbiomes of microbial genes involved in the dehydroxylation of primary to secondary bile acids.
“Our results provide evidence for an increased abundance in RYGB microbiomes of microbial genes involved in the dehydroxylation of primary to secondary bile acids, which is in line with the increased response of secondary bile acids in RYGB patients.”
Quote in the paperSubstantial claim - Interpretationreasoning
The enrichment of pathways for amino acid uptake and metabolism and for glyoxylate metabolism pointed to the utilization of amino acids and acetate for energy production by the VBG microbiome.
“By contrast, the enrichment of pathways for amino acid uptake and metabolism and for glyoxylate metabolism pointed to the utilization of amino acids and acetate for energy production by the VBG microbiome.”
Quote in the paperSubstantial claim - Interpretationown data
The increased abundance of dehydroxylation genes is in line with the increased response of secondary bile acids in RYGB patients.
“Our results provide evidence for an increased abundance in RYGB microbiomes of microbial genes involved in the dehydroxylation of primary to secondary bile acids, which is in line with the increased response of secondary bile acids in RYGB patients.”
Quote in the paperSubstantial claim - Interpretationcitation
The decreased SCFAs levels in RYGB and VBG fecal samples point to reduced energy harvest from the diet.
“In particular the decreased SCFAs levels in RYGB and VBG fecal samples also point to reduced energy harvest from the diet, as previously proposed (Turnbaugh et al., 2006).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Turnbaugh et al., 2006 source
Not checked in the free run.
- Interpretationown data
The human adiposity phenotype is transmissible through the gut microbiota.
“thus adding evidence for the transmissibility of the human adiposity phenotype through the gut microbiota.”
Quote in the paperSubstantial claim - Interpretationreasoning
The shifts in the gut microbiota were specific to bariatric surgery.
“thus revealing shifts in the gut microbiota that were specific to bariatric surgery.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed microbiome shifts are attributable to bariatric surgery rather than to unmeasured differences in diet or other lifestyle factors.
- Interpretationown data
The results point to a diet-independent adaptation of the gut microbiota to bariatric surgery.
“As the total fiber intake was similar for RYGB, VBG, and OBS patients, our results point to a diet-independent adaptation of the gut microbiota to bariatric surgery.”
Quote in the paperSubstantial claim - Premisecitation
Increased circulating levels of primary and secondary bile acids have been observed after RYGB.
“Increased circulating levels of primary and secondary bile acids have been observed after RYGB (Ahmad et al., 2013; Glicksman et al., 2010; Kohli et al., 2013; Patti et al., 2009) and have been linked to increased GLP-1 and reduced glucose and triglyceride levels (Nakatani et al., 2009; Patti et al., 2009; Pournaras et al., 2012; Simonen et al., 2012).”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Increased circulating bile acids have been linked to increased GLP-1 and reduced glucose and triglyceride levels.
“Increased circulating levels of primary and secondary bile acids have been observed after RYGB (Ahmad et al., 2013; Glicksman et al., 2010; Kohli et al., 2013; Patti et al., 2009) and have been linked to increased GLP-1 and reduced glucose and triglyceride levels (Nakatani et al., 2009; Patti et al., 2009; Pournaras et al., 2012; Simonen et al., 2012).”
Quote in the paperNot a substantial claim0 of 3 sources checked - Interpretationown data
The increased FGF19 response in RYGB women indicates increased FXR signaling.
“We observed an increased FGF19 response in RYGB women compared to OBS (Figure 3C), indicating increased FXR signaling.”
Quote in the paperSubstantial claim - Interpretationown data
The differences in gut microbiota composition and genetic content result from bariatric surgery and not BMI per se.
“These results indicate that the differences in gut microbiota composition and genetic content result from bariatric surgery and not BMI per se, since the OBS and Ob microbiomes were similar (Figure 4; Table S5).”
Quote in the paperSubstantial claim - Premisecitation
Previous studies of the gut microbiota during dietary interventions for weight loss have not reported an increase in Proteobacteria but a shift in taxa such as Bacteroidetes, Eubacterium/Roseburia, and Eubacterium rectale.
“Indeed, previous studies of the gut microbiota during dietary interventions for weight loss have not reported an increase in Proteobacteria but a shift in taxa such as Bacteroidetes (Ley et al., 2006), Eubacterium/Roseburia (Duncan et al., 2008), and Eubacterium rectale (Cotillard et al., 2013).”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationreasoning
The changes in the gut microbiota have the potential to modulate host metabolic regulation.
“and that these changes have the potential to modulate host metabolic regulation”
Quote in the paperSubstantial claim
- May combine two claims. 22
- Classified as probably not a substantial claim. 18
May combine two claims.
Findingown data682 KOs were enriched and 33 were depleted in VBG versus OBS samples.
“We observed differences in the microbiome of operated and non-operated severely obese women (Figure 2; Table S4): 928 KOs were enriched and 60 were depleted in RYGB versus OBS samples (Figure 2A; Table S4), while 682 KOs were enriched and 33 were depleted in VBG versus OBS samples (Figure 2B; Table S4).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataOnly 17 KOs were differentially abundant between RYGB and VBG samples, all enriched in VBG.
“However, only 17 KOs were differentially abundant between RYGB and VBG samples, all enriched in VBG (Figure 2C; Table S4).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataTotal fiber intake did not differ, while protein intake decreased for RYGB and VBG women.
“Importantly, total fiber intake did not differ, while protein intake decreased for RYGB and VBG women (Table S1), indicating that the lower SCFA/BCFA ratio was not a consequence of dietary consumption.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe SCFAs acetate, propionate, and butyrate were present in comparable proportions, but their concentrations tended to decrease in RYGB and VBG samples.
“The SCFAs acetate, propionate, and butyrate were present in comparable proportions, but their concentrations tended to decrease in RYGB and VBG samples (Figures S2A–S2D), while the BCFAs isobutyrate and isovalerate, produced from the amino acids valine and leucine, respectively, either showed no change or a slight tendency to increase in RYGB and VBG samples (Figures S2E–S2G).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAn expansion in Proteobacteria and a reduction in several clostridial species were found after RYGB.
“We found again an expansion in Proteobacteria and a reduction in several clostridial species after RYGB, and also a significant increase in the relative abundance of three E. coli species in VBG (Figure 4A; Table S5).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataBody weight gain and food intake did not differ between the groups during the 2-week colonization period.
“body weight gain and food intake did not differ between the groups during the 2-week colonization period (Figures S5D and S5E)”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataRYGB patients had significantly reduced fasting insulin compared with OBS, whereas there was a trend toward reduction in the VBG patients.
“However, the RYGB patients had significantly reduced fasting insulin compared with OBS, whereas there was a trend toward reduction in the VBG patients (Table S1).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataA pronounced postprandial bile acid response was observed in RYGB compared to OBS patients, with a significant increase in total and glycine- and taurine-conjugated bile acids, but not unconjugated bile acids.
“However, we observed a pronounced postprandial bile acid response in RYGB compared to OBS patients, with a significant increase in total and glycine- and taurine-conjugated bile acids, but not unconjugated bile acids (Figures 3A and 3B).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataO2 consumption, body weight gain, and food intake did not differ during the measurements.
“Although O2 consumption, body weight gain, and food intake did not differ during the measurements (Figures S5F–S5I)”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationDietary weight loss interventions increase gene richness of the microbiota and shift its composition toward that of lean individuals.
“In addition, dietary weight loss interventions have been shown to increase gene richness of the microbiota and shift its composition toward that of lean individuals (Cotillard et al., 2013; Ley et al., 2006).”
Quote in the paperNot a substantial claim0 of 2 sources checkedClassified as probably not a substantial claim.
PremisecitationChanges in the composition and diversity of the gut microbiota have been observed in the short term after RYGB in humans.
“Recent work has also indicated that the gut microbiota may mediate some of the beneficial effects of bariatric surgery, and changes in the composition and diversity of the gut microbiota have been observed in the short term after RYGB in humans (Furet et al., 2010; Graessler et al., 2013; Kong et al., 2013; Zhang et al., 2009), as well as after vertical sleeve gastrectomy and RYGB in mice (Liou et”
Quote in the paperSubstantial claim0 of 3 sources checkedClassified as probably not a substantial claim. May combine two claims.
PremisecitationObesity has been associated with altered gut microbiota composition, reduced microbial diversity, and reduced gene richness.
“Indeed, obesity has been associated with altered gut microbiota composition, reduced microbial diversity, and reduced gene richness (Le Chatelier et al., 2013; Ley et al., 2005; Turnbaugh et al., 2009).”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationChanges in the composition and diversity of the gut microbiota have been observed after vertical sleeve gastrectomy and RYGB in mice.
“Recent work has also indicated that the gut microbiota may mediate some of the beneficial effects of bariatric surgery, and changes in the composition and diversity of the gut microbiota have been observed in the short term after RYGB in humans (Furet et al., 2010; Graessler et al., 2013; Kong et al., 2013; Zhang et al., 2009), as well as after vertical sleeve gastrectomy and RYGB in mice (Liou et”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe results are in agreement with previous findings showing an expansion of Proteobacteria shortly after RYGB in humans and mice.
“Moreover, our results are in agreement with previous findings showing an expansion of Proteobacteria shortly after RYGB, both in humans (Furet et al., 2010; Graessler et al., 2013; Kong et al., 2013; Zhang et al., 2009) and mice (Liou et al., 2013).”
Quote in the paperNot a substantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationRYGB is considered one of the most effective bariatric surgery procedures, promoting both weight reduction and improvement of metabolism.
“There are a number of bariatric surgery procedures, of which Roux-en-Y gastric bypass (RYGB) is considered one of the most effective, promoting both weight reduction and improvement of metabolism (Sjöström et al., 2007; Werling et al., 2013a).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Sjöström et al., 2007 source
Not checked in the free run.
- cites Werling et al., 2013a
Not checked in the free run.
May combine two claims.
Study design and conductreasoningRYGB and VBG patients were matched for pre- and post-operative weight, BMI, and body composition, and had thus experienced similar weight and fat mass loss.
“RYGB and VBG patients were matched for pre- and post-operative weight, BMI, and body composition, and had thus experienced similar weight and fat mass loss.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductnone givenFor microbiota transplantations, stool samples were selected from three RYGB, three VBG, and three OBS patients who did not use medications and did not receive cholecystectomy.
“For microbiota transplantations, we selected stool samples from three RYGB, three VBG, and three OBS patients who did not use medications and did not receive cholecystectomy and used these samples to colonize GF Swiss Webster female mice in three independent experiments.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationRYGB is associated with a lower cardiovascular disease risk.
“These observations are of interest because high TMAO levels linked to TMA oxidation by the human hepatic flavin monooxygenase FMO3 have been associated with cardiovascular diseases (CVDs) (Tang et al., 2013; Wang et al., 2011), while it is known that RYGB is associated with a lower CVD risk (Sjöström et al., 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Sjöström et al., 2012 source
Not checked in the free run.
May combine two claims.
InterpretationreasoningBariatric surgery produces a specific shift in the microbiota that persists for up to a decade after surgery and is different from shifts related to dietary interventions for weight loss.
“Together with these observations, our results suggest that bariatric surgery produces a specific shift in the microbiota that persists for up to a decade after surgery and is different from shifts related to dietary interventions for weight loss.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenAll study participants were informed verbally and in writing and signed a consent form.
“All study participants were informed verbally and in writing and signed a consent form.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationBile acids are cholesterol metabolites that facilitate the absorption of dietary fat and fat-soluble molecules and are regulators of energy metabolism through activation of the receptors TGR5 and FXR.
“Bile acids are cholesterol metabolites that facilitate the absorption of dietary fat and fat-soluble molecules and are now also recognized as regulators of energy metabolism through activation of the receptors TGR5 and FXR (Hylemon et al., 2009; Lefebvre et al., 2009).”
Quote in the paperNot a substantial claim0 of 2 sources checkedClassified as probably not a substantial claim.
PremisecitationHigh TMAO levels linked to TMA oxidation by the human hepatic flavin monooxygenase FMO3 have been associated with cardiovascular diseases.
“These observations are of interest because high TMAO levels linked to TMA oxidation by the human hepatic flavin monooxygenase FMO3 have been associated with cardiovascular diseases (CVDs) (Tang et al., 2013; Wang et al., 2011), while it is known that RYGB is associated with a lower CVD risk (Sjöström et al., 2012).”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningThe increased levels of TMAO in RYGB samples might be the consequence of a less anaerobic metabolism in the RYGB intestine.
“The increased levels of TMAO in RYGB samples might be the consequence of a less anaerobic metabolism in the RYGB intestine, which is supported by the broad increase of facultative anaerobes in RYGB microbiomes, and could occur due to the shortening of the small bowel.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataRecipients of RYGB microbiota show decreased utilization of carbohydrates and increased utilization of lipids as fuel.
“thus indicating decreased utilization of carbohydrates and increased utilization of lipids as fuel in recipients of RYGB microbiota.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationThe postprandial bile acid response is blunted in obesity and enhanced after RYGB.
“The postprandial bile acid response is blunted in obesity and enhanced after RYGB, indicating that this response might be important for inducing satiety, reduced food intake, and lower body weight (Ahmad et al., 2013; Glicksman et al., 2010).”
Quote in the paperSubstantial claim0 of 2 sources checkedClassified as probably not a substantial claim.
Study design and conductown dataThe gut microbiome of RYGB and VBG patients was compared with that of non-operated women (Ob, n = 9) with BMI matched to the post-surgical BMI of the RYGB and VBG patients.
“To control for differences in BMI, we compared the gut microbiome of RYGB and VBG patients with that of non-operated women (Ob, n = 9) with BMI matched to the post-surgical BMI of the RYGB and VBG patients (BMI = 31.9 ± 2.7 [SD]) (Table S1 and S5).”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationcitationThe reduced fat mass gain in GF mice transplanted with RYGB and VBG microbiota is in agreement with the paper's results on the composition of the gut microbiome and with a short-term human study showing an inverse correlation between E. coli abundance and fat mass after RYGB.
“The reduced fat mass gain in GF mice transplanted with RYGB and VBG microbiota is in agreement with our results on the composition of the gut microbiome and with a short-term human study showing an inverse correlation between E. coli abundance and fat mass after RYGB (Furet et al., 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Furet et al., 2010 source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductnone givenThe 21 women in the study did not use antibiotics for at least 6 weeks before inclusion.
“The 21 women in our study did no use antibiotics for at least 6 weeks before inclusion in the study.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenAll animal experiments were approved by the Gothenburg Animal Ethics Committee.
“All animal experiments were approved by the Gothenburg Animal Ethics Committee.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationReduced RQ has been observed in humans after RYGB and associated to reduced glucose oxidation, increased lipid oxidation, and increased plasma levels of conjugated bile acids.
“Reduced RQ has been observed in humans after RYGB and associated to reduced glucose oxidation, increased lipid oxidation, and increased plasma levels of conjugated bile acids (Simonen et al., 2012).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Simonen et al., 2012 source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductcitationAll p values were corrected for multiple testing with the method from Benjamini and Hochberg (1995).
“All p values were corrected for multiple testing with the method from Benjamini and Hochberg (1995).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Benjamini and Hochberg (1995) source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenThe studies were performed in accordance with the Declaration of Helsinki and were approved by the Regional Ethical Review Board in Gothenburg, Sweden.
“The studies were performed in accordance with the Declaration of Helsinki and were approved by the Regional Ethical Review Board in Gothenburg, Sweden (no: 359-09 and 740-10).”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataAltered intestinal fermentation shifted toward reduced production of SCFAs and increased amino acid fermentation after bariatric surgery.
“The similar SCFA/BCFA ratio and the analysis of pathways enriched in RYGB and VBG compared to OBS subjects reveal some common effects of the two bariatric surgery procedures and indicate altered intestinal fermentation shifted toward reduced production of SCFAs and increased amino acid fermentation after bariatric surgery.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenNone of the women included in the study had diabetes.
“None of the women included in our study had diabetes.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
There are no long-term investigations of the stability of gut microbiota changes after bariatric surgery or of the effects of different procedures on the human gut microbiota.
“However, there are no long-term investigations of the stability of these changes or of the effects of different procedures on the human gut microbiota.”
The paper relies on this without support.
The causal link between alterations to the microbiota and the reduction in adiposity observed after bariatric surgery has not been previously analyzed in humans.
“Additionally, the causal link between the alterations to the microbiota and the reduction in adiposity observed after bariatric surgery has not been previously analyzed in humans.”
The paper relies on this without support.
Both RYGB and VBG are associated with reduced luminal exposure to gastric acidity.
“For example, increases in pH have been shown to promote the growth of E. coli in vitro (Duncan et al., 2009), and both RYGB and VBG are associated with reduced luminal exposure to gastric acidity.”
The paper relies on this without support.
The observed microbiome shifts are attributable to bariatric surgery rather than to unmeasured differences in diet or other lifestyle factors.
“Importantly, the changes in the microbiome were not dependent on BMI or degree of weight and fat mass loss, thus revealing shifts in the gut microbiota that were specific to bariatric surgery.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Amelioration of obesity by bariatric or Roux-en-Y gastric bypass surgery results in change in gut microbial composition.
“In addition, amelioration of obesity by bariatric or Roux-en-Y gastric bypass surgery results in a change in gut microbial composition (Gralka et al., 2015;Tremaroli et al., 2015;Zhang et al., 2009), even though this is not the case for weight gain in anorexia nervosa (Mack et al., 2016).”
From The Microbiota-Gut-Brain Axis (2019) · cites this paper as Tremaroli et al., 2015
The same weight-increasing effect is observed when microbiota from obese or lean humans is transferred to germ-free mice.
“This observation also holds true when the microbiota from obese or lean humans is transferred to germ-free mice (Ridaura et al., 2013; Tremaroli et al., 2015).”
From Understanding the Holobiont: How Microbial Metabolites Affect Human Health and Shape the Immune System (2017) · cites this paper as Tremaroli et al., 2015
Microbiota alterations in obese humans can confer obese or adiposity phenotypes when transferred to mice.
“reports of alterations in the gut microbiota of obese people4,13–15, which confer the obese or adiposity phenotypes when transferred to mice14,16”
From Diet–microbiota interactions as moderators of human metabolism (2016) · cites this paper as [16]
Transplantation of fecal microbiota from patients with obesity, steatosis or type 2 diabetes can partly reproduce the donor's metabolic phenotype in mouse recipients.
“transplantation of the fecal microbiota from patients with obesity, steatosis or type 2 diabetes can partly reproduce the donor’s metabolic phenotype in mouse recipients [4–7].”
From Dietary lipids, gut microbiota and lipid metabolism (2019) · cites this paper as [6]
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“…are of interest because high TMAO levels linked to TMAoxidation by the human hepatic flavinmonooxygenase FMO3 have been associated with cardiovascular diseases (CVDs) (Tang et al., 2013; Wang et al., 2011), while it is known that RYGB is associated with a lower CVD risk (Sjöström et al., 2012).”
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Self-citationGut Microbiota Dysbiosis in Human Obesity: Impact of Bariatric Surgery
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Impact of Gut Microbiota and Diet on the Development of Atherosclerosis in Apoe −/− Mice
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Self-citationEmerging concepts in intestinal immune control of obesity-related metabolic disease
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Gut microbiota link dietary fiber intake and short-chain fatty acid metabolism with eating behavior
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- Authors
- Tremaroli, V., Karlsson, F., Werling, M., Ståhlman, M., Kovatcheva-Datchary, P., Olbers, T., Fändriks, L., le Roux, C. W., Nielsen, J., & Bäckhed, F.
- Affiliations
- University of Gothenburg (SE)
- Chalmers University of Technology (SE)
- Sahlgrenska University Hospital (SE)
- University of Copenhagen (DK)
- Corresponding author
- Bäckhed, Fredrik
- ORCID
- Venue
- Cell Metabolism
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 22
- Issue
- 2
- Pages
- 228-238
- ISSN
- 1550-4131 (ISSN-L)
- PMC
- PMC4537510
- OpenAlex
- W2103218211
- Cited by
- 757
- References
- 59
- Citations by year
- 2026: 26 · 2025: 37 · 2024: 43 · 2023: 68 · 2022: 79 · 2021: 72 · 2020: 100 · 2019: 86 · 2018: 76 · 2017: 82 · 2016: 73 · 2015: 14 · 2014: 1
- FWCI
- 35.42
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Cell Metabolism (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- Chalmers Publication Library (Chalmers University of Technology) (submittedVersion)
- Chalmers Research (Chalmers University of Technology) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Funders
- Hjärt-Lungfonden
- Knut och Alice Wallenbergs Stiftelse
- Vetenskapsrådet
- Sahlgrenska Universitetssjukhuset
- Göteborgs Universitet
- Institut National Du Cancer
- Novo Nordisk Fonden (NNF13OC0008163, NNF13SA0006017)
- 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 › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- Roux-en-Y gastric bypass, vertical banded gastroplasty, bariatric surgery, gut microbiota, obesity, adiposity, fecal metabolites, circulating metabolites, germ-free mice, fat deposition, respiratory quotient, carbohydrate utilization
- MeSH terms
- Animals, Female, Follow-Up Studies, Humans, Intestines, Obesity, Gastric Bypass, Body Mass Index, Adiposity, Mice, Microbiota
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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