Major microbiota dysbiosis in severe obesity: fate after bariatric surgery
Open accessAbstract
Objectives: Decreased gut microbial gene richness (MGR) and compositional changes are associated with adverse metabolism in overweight or moderate obesity, but lack characterisation in severe obesity. Bariatric surgery (BS) improves metabolism and inflammation in severe obesity and is associated with gut microbiota modifications. Here, we characterised severe obesity-associated dysbiosis (ie, MGR, microbiota composition and functional characteristics) and assessed whether BS would rescue these changes. Design: Sixty-one severely obese subjects, candidates for adjustable gastric banding (AGB, n=20) or Roux-en-Y-gastric bypass (RYGB, n=41), were enrolled. Twenty-four subjects were followed at 1, 3 and 12 months post-BS. Gut microbiota and serum metabolome were analysed using shotgun metagenomics and liquid chromatography mass spectrometry (LC-MS). Confirmation groups were included. Results: Low gene richness (LGC) was present in 75% of patients and correlated with increased trunk-fat mass and comorbidities (type 2 diabetes, hypertension and severity). Seventy-eight metagenomic species were altered with LGC, among which 50% were associated with adverse body composition and metabolic phenotypes. Nine serum metabolites (including glutarate , 3-methoxyphenylacetic acid and L-histidine ) and functional modules containing protein families involved in their metabolism were strongly associated with low MGR. BS increased MGR 1 year postsurgery, but most RYGB patients remained with low MGR 1 year post-BS, despite greater metabolic improvement than AGB patients. Conclusions: We identified major gut microbiota alterations in severe obesity, which include decreased MGR and related functional pathways linked with metabolic deteriorations. The lack of full rescue post-BS calls for additional strategies to improve the gut microbiota ecosystem and microbiome–host interactions in severe obesity. Trial registration number: NCT01454232 .
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Studies in moderately obese Danish individuals without diabetes and severely obese French women found changes in gut microbiota composition and microbial gene richness that correlated with increased fat mass, pro-inflammatory biomarkers, and insulin resistance.
“studies conducted in moderately obese Danish individuals without diabetes115 and in severely obese French women116 found changes in gut microbiota composition and microbial gene richness that were correlated with increased fat mass, pro-inflammatory biomarkers and insulin resistance.”
From Chronic inflammation in the etiology of disease across the life span (2019) · cites this paper as [116]
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- Authors
- Aron-Wisnewsky, J., Prifti, E., Belda, E., Ichou, F., Kayser, B. D., Dao, M. C., Verger, E. O., Hedjazi, L., Bouillot, J.-L., Chevallier, J.-M., Pons, N., Le Chatelier, E., Levenez, F., Ehrlich, S. D., Dore, J., Zucker, J.-D., & Clément, K.
- Affiliations
- Sorbonne Université, INSERM, NutriOmics Team, ICAN, Paris, France
- Sorbonne Université (FR)
- Pitié-Salpêtrière Hospital (FR)
- Inserm (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Université Paris-Saclay (FR)
- MGP MetaGénoPolis, INRA, Université Paris-Saclay, Jouy-en-Josas, France
- Corresponding author
- Clément, Karine
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2018-06-13
- Volume
- 68
- Issue
- 1
- Pages
- 70-82
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC7143256
- OpenAlex
- W2808516166
- Cited by
- 418
- References
- 63
- Citations by year
- 2026: 26 · 2025: 33 · 2024: 50 · 2023: 46 · 2022: 65 · 2021: 86 · 2020: 64 · 2019: 40 · 2018: 8
- FWCI
- 17.59
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Fondation Nestlé
- Institut Appert
- Programme Hospitalier de Recherche Clinique
- Fondation de l’Avenir pour la Recherche Médicale Appliquée
- FP7 Health
- Aviesan alliance nationale pour les sciences de la vie et de la santé ITMO santé publique
- Human Nutrition Research Center (CRNH Ile de France), Pitié-Salpêtrière Hospital
- 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
- morbid obesity, gut dysbiosis, bariatric surgery, gastric banding, Roux-en-Y gastric bypass, serum metabolome, metabolic phenotypes, type 2 diabetes, body composition, microbiome-host interactions
- MeSH terms
- Gastrointestinal Microbiome, Adult, Chromatography, Liquid, Female, Humans, Male, Obesity, Morbid, Phenotype, Prospective Studies, Risk Factors, Mass Spectrometry, Biomarkers, Comorbidity, Bariatric Surgery, Metagenomics, Dysbiosis
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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