Obesity and cardiovascular risk: the role of bariatric surgery in modulating intestinal microbiota

In recent years, increasing attention has been given to the gut microbiota because of its role in metabolic diseases, cardiovascular health, gastrointestinal disorders, and cancers. In individuals suffering from obesity, a reduction in the richness, diversity, and composition of the intestinal microbiota has often been observed, and this has been associated with metabolic traits and low-grade systemic inflammation. Bariatric surgery has emerged as a valuable approach for reducing cardiometabolic risk. Recently, the number of bariatric surgeries has increased in parallel with the growing prevalence of severe obesity. Metabolic surgery, such as Roux-en-Y gastric bypass or Sleeve Gastrectomy, has shown promising results in terms of long-term weight loss, improved metabolic status, and even remission of comorbidities. However, it is important to note that these positive results cannot be attributed solely to food intake restriction or malabsorption. Emerging evidence suggests that bariatric surgery leads to significant changes in the intestinal microbiome, which may contribute to the beneficial effects observed on obesity-related complications. These changes could play a crucial role in reducing cardiovascular disease. Therefore, the main objective of this review is to better understand the links between the composition of the gut microbiota after bariatric surgery and improved cardiovascular health. By exploring this complex relationship, research teams aim to shed light on the underlying mechanisms and pave the way for novel therapeutic strategies to improve cardiovascular health in patients who have undergone bariatric surgery. (c) 2023 Societe francophone nutrition clinique et metabolisme (SFNCM). Published by Elsevier Masson SAS. All rights reserved.