A specific gut microbiota signature is associated with an enhanced GLP-1 and GLP-2 secretion and improved metabolic control in patients with type 2 diabetes after metabolic Roux-en-Y gastric bypass

被引:9
作者
Hernandez-Montoliu, Laura [1 ]
Rodriguez-Pena, M-Mar [2 ,3 ]
Puig, Rocio [4 ]
Astiarraga, Brenno [2 ,3 ]
Guerrero-Perez, Fernando [1 ]
Virgili, Nuria [1 ]
Lopez-Urdiales, Rafael [1 ]
Osorio, Javier [5 ]
Monseny, Rosa [6 ]
Lazzara, Claudio [5 ]
Sobrino, Lucia [5 ]
Perez-Maraver, Manuel [1 ]
Perez-Prieto, Maria [1 ]
Pellitero, Silvia [7 ,8 ,9 ]
Fernandez-Veledo, Sonia [2 ,3 ]
Vendrell, Joan [2 ,3 ,10 ]
Vilarrasa, Nuria [1 ,3 ]
机构
[1] Bellvitge Univ Hosp, Inst Invest Biomed Bellvitge, Dept Endocrinol & Nutr, Barcelona, Spain
[2] Hosp Univ Joan XXIII Tarragona, Inst Invest Sanitaria Pere Virgili IISPV, Tarragona, Spain
[3] Inst Salud Carlos III ISCIII, CIBER Diabet & Enfermedades Metab Asociadas CIBERD, Madrid, Spain
[4] Inst Recerca Hosp Santa Creu & Sant Pau, Dept Endocrinol Nutr Hosp Santa Creu & Sant Pau, Barcelona, Spain
[5] Bellvitge Univ Hosp, Inst Invest Biomed Bellvitge, Dept Gen & Gastrointestinal Surg, Barcelona, Spain
[6] Bellvitge Univ Hosp, Inst Invest Biomed Bellvitge, Clin Nutr Unit, Barcelona, Spain
[7] Dept Endocrinol & Nutr, Badalona, Spain
[8] Hlth Sci Res Inst, Badalona, Spain
[9] Univ Hosp Germans Trias i Pujol, Badalona, Spain
[10] Univ Rovira i Virgili URV, Dept Med & Surg, Reus, Spain
来源
FRONTIERS IN ENDOCRINOLOGY | 2023年 / 14卷
关键词
incretin; microbiota; type 2 diabetes remission; severe obesity; bariatric surgery; SLEEVE GASTRECTOMY; BARIATRIC SURGERY; BARRIER FUNCTION; MECHANISMS; INFLAMMATION; REMISSION; MELLITUS; OBESITY; MARKER;
D O I
10.3389/fendo.2023.1181744
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To determine changes in incretins, systemic inflammation, intestinal permeability and microbiome modifications 12 months after metabolic RYGB (mRYGB) in patients with type 2 diabetes (T2D) and their relationship with metabolic improvement.Materials and methods: Prospective single-center non-randomized controlled study, including patients with class II-III obesity and T2D undergoing mRYGB. At baseline and one year after surgery we performed body composition measurements, biochemical analysis, a meal tolerance test (MTT) and lipid test (LT) with determination of the area under the curve (AUC) for insulin, C-peptide, GLP-1, GLP-2, and fasting determinations of succinate, zonulin, IL-6 and study of gut microbiota.Results: Thirteen patients aged 52.6 +/- 6.5 years, BMI 39.3 +/- 1.4 kg/m(2), HbA(1c) 7.62 +/- 1.5% were evaluated. After mRYGB, zonulin decreased and an increase in AUC after MTT was observed for GLP-1 (pre 9371 +/- 5973 vs post 15788 +/- 8021 pM, P<0.05), GLP-2 (pre 732 +/- 182 vs post 1190 +/- 447 ng/ml, P<0.001) and C- peptide, as well as after LT. Species belonging to Streptococaceae, Akkermansiacea, Rickenellaceae, Sutterellaceae, Enterobacteriaceae, Oscillospiraceae, Veillonellaceae, Enterobacterales_uc, and Fusobacteriaceae families increased after intervention and correlated positively with AUC of GLP-1 and GLP-2, and negatively with glucose, HbA(1c), triglycerides and adiposity markers. Clostridium perfringens and Roseburia sp. 40_7 behaved similarly. In contrast, some species belonging to Lachnospiraceae, Erysipelotricaceae, and Rumnicocaceae families decreased and showed opposite correlations. Higher initial C-peptide was the only predictor for T2D remission, which was achieved in 69% of patients.Conclusions: Patients with obesity and T2D submitted to mRYGB show an enhanced incretin response, a reduced gut permeability and a metabolic improvement, associated with a specific microbiota signature.
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页数:12
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