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Obes Surg. 2019 Jun 29. doi: 10.1007/s11695-019-03976-4. [Epub ahead of print]

Changes in Gut Microbiome after Bariatric Surgery Versus Medical Weight Loss in a Pilot Randomized Trial.

Author information

1
Divisions of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, 1830 E. Monument St, Baltimore, MD, 21287, USA. clee158@jhmi.edu.
2
Division of General Internal Medicine, The Johns Hopkins University, Baltimore, MD, USA.
3
Center for Computational Biology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
4
Bloomberg-Kimmel Institute for Cancer Immunotherapy, The Johns Hopkins University, Baltimore, MD, USA.
5
Division of Infectious Diseases, The Johns Hopkins University Baltimore, Baltimore, MD, USA.
6
Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
7
Division of Gastroenterology and Hepatology, The Johns Hopkins University, Baltimore, MD, USA.
8
Department of Surgery, The Johns Hopkins University, Baltimore, MD, USA.

Abstract

BACKGROUND:

Gut microbiota likely impact obesity and metabolic diseases. We evaluated the changes in gut microbiota after surgical versus medical weight loss in adults with diabetes and obesity.

METHODS:

We performed 16S rRNA amplicon sequencing to identify the gut microbial composition at baseline and at 10% weight loss in adults with diabetes who were randomized to medical weight loss (MWL, n = 4), adjustable gastric banding (AGB, n = 4), or Roux-en-Y gastric bypass (RYGB, n = 4).

RESULTS:

All participants were female, 75% reported black race with mean age of 51 years. At similar weight loss amount and glycemic improvement, the RYGB group had the most number of bacterial species (10 increased, 1 decreased) that significantly changed (p < 0.05) in relative abundance. Alpha-diversity at follow-up was significantly lower in AGB group compared to MWL and RYGB (observed species for AGB vs. MWL, p = 0.0093; AGB vs. RYGB, p = 0.0093). The relative abundance of Faecalibacterium prausnitzii increased in 3 participants after RYGB, 1 after AGB, and 1 after MWL.

CONCLUSIONS:

At similar weight loss and glycemic improvement, the greatest alteration in gut microbiota occurred after RYGB with an increase in the potentially beneficial bacterium, F. prausnitzii. Gut microbial diversity tended to decrease after AGB and increase after RYGB and MWL. Future studies are needed to determine the impact and durability of gut microbial changes over time and their role in long-term metabolic improvement after bariatric surgery in adults with type 2 diabetes.

CLINICAL TRIAL REGISTRATION:

NCTDK089557- ClinicalTrials.gov.

KEYWORDS:

Diabetes; Gastric band; Gastric bypass; Gut microbiome; Obesity; Randomized controlled trial

PMID:
31256356
DOI:
10.1007/s11695-019-03976-4

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