Metabolic surgery profoundly influences gut microbial-host metabolic cross-talk

被引：322

作者：

Li, Jia V. ^{[1
,2
]}

Ashrafian, Hutan ^{[1
,3
]}

Bueter, Marco ^{[3
,4
]}

Kinross, James ^{[1
,2
]}

Sands, Caroline ^{[2
]}

le Roux, Carel W. ^{[3
]}

Bloom, Stephen R. ^{[3
]}

Darzi, Ara ^{[1
]}

Athanasiou, Thanos ^{[1
]}

Marchesi, Julian R. ^{[5
]}

Nicholson, Jeremy K. ^{[1
,2
]}

Holmes, Elaine ^{[2
]}

机构：

[1] Univ London Imperial Coll Sci Technol & Med, Dept Surg & Canc, Sect Biosurg & Surg Technol, London SW7 2AZ, England

[2] Univ London Imperial Coll Sci Technol & Med, Sect Biomol Med, London SW7 2AZ, England

[3] Univ London Imperial Coll Sci Technol & Med, Sect Invest Med, Div Diabet Endocrinol & Metab, Dept Med,Fac Med, London SW7 2AZ, England

[4] Univ Zurich Hosp, Dept Surg, Div Visceral & Transplantat Surg, CH-8091 Zurich, Switzerland

[5] Cardiff Univ, Sch Biosci, Cardiff CF10 3AT, S Glam, Wales

来源：

GUT | 2011年 / 60卷 / 09期

基金：

英国生物技术与生命科学研究理事会; 英国惠康基金;

关键词：

Y GASTRIC BYPASS; WEIGHT-LOSS; BARIATRIC SURGERY; NMR-SPECTROSCOPY; SYSTEMS BIOLOGY; BLOOD-PRESSURE; OBESITY; PLASMA; DIET; METABONOMICS;

D O I：

10.1136/gut.2010.234708

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and aims Bariatric surgery is increasingly performed worldwide to treat morbid obesity and is also known as metabolic surgery to reflect its beneficial metabolic effects especially with respect to improvement in type 2 diabetes. Understanding surgical weight loss mechanisms and metabolic modulation is required to enhance patient benefits and operative outcomes. Methods The authors applied a parallel and statistically integrated bacterial profiling and metabonomic approach to characterise Roux-en-Y gastric bypass (RYGB) effects in a non-obese rat model. Results Substantial shifts of the main gut phyla towards higher concentrations of Proteobacteria (52-fold), specifically Enterobacter hormaechei, are shown. Low concentrations of Firmicutes (4.5-fold) and Bacteroidetes (twofold) in comparison with sham-operated rats were also found. Faecal extraction studies revealed a decrease in faecal bile acids and a shift from protein degradation to putrefaction through decreased faecal tyrosine with concomitant increases in faecal putrescine and diaminoethane. Decreased urinary amines and cresols were found and indices of modulated energy metabolism were demonstrated after RYGB, including decreased urinary succinate, 2-oxoglutarate, citrate and fumarate. These changes could also indicate renal tubular acidosis, which is associated with increased flux of mitochondrial tricarboxylic acid cycle intermediates. A surgically induced effect on the gut-brain-liver metabolic axis is inferred from modulated faecal gamma-aminobutyric acid and glutamate. Conclusion This profound co-dependence of mammalian and microbial metabolism, which is systematically altered after RYGB surgery, suggests that RYGB exerts local and global metabolic effects. The effect of RYGB surgery on the host metabolic-microbial cross-talk augments our understanding of the metabolic phenotype of bariatric procedures and can facilitate enhanced treatments for obesity-related diseases.

引用

页码：1214 / 1223

页数：10

共 63 条

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