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Roux-en-Y Gastric Bypass and Vertical Banded Gastroplasty Induce Long-Term Changes on the Human Gut Microbiome Contributing to Fat Mass Regulation.

Tremaroli V, Karlsson F, Werling M, Ståhlman M, Kovatcheva-Datchary P, Olbers T, Fändriks L, le Roux CW, Nielsen J, Bäckhed F - Cell Metab. (2015)

Bottom Line: The two surgical procedures induced similar and durable changes on the gut microbiome that were not dependent on body mass index and resulted in altered levels of fecal and circulating metabolites compared with obese controls.By colonizing germ-free mice with stools from the patients, we demonstrated that the surgically altered microbiota promoted reduced fat deposition in recipient mice.These mice also had a lower respiratory quotient, indicating decreased utilization of carbohydrates as fuel.

View Article: PubMed Central - PubMed

Affiliation: The Wallenberg Laboratory and Sahlgrenska Center for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, SE-413 45 Gothenburg, Sweden.

No MeSH data available.


Related in: MedlinePlus

Postprandial Bile Acid and FGF19 Responses in RYGB, VBG, and OBS Women(A) Circulating concentrations of total bile acids (Total BA), total conjugated primary (G+T primary), total conjugated secondary (G+T secondary), glycine-conjugated primary (G-primary), glycine-conjugated secondary (G-secondary), taurine-conjugated primary (T-primary), taurine-conjugated secondary (T-secondary), unconjugated primary, and unconjugated secondary bile acids.(B) Tukey box plots showing the area under the curve (AUC) as a measure of the bile acid postprandial responses.(C) Circulating concentrations of FGF19 and AUC showing FGF19 postprandial response in RYGB, VBG, and OBS women.Plasma samples were collected during fasting and every 30 min for 2.5 hr after a standard meal. Samples from colecystectomized patients (one in the RYGB and one in the VBG group) were excluded from the analysis, and plasma from one VBG woman could not be obtained, so the results represent the mean ± SEM for six RYGB, five VBG, and seven OBS women. a p < 0.05 according to one-way ANOVA with Tukey’s correction for multiple comparisons for RYGB compared to OBS. See also Figure S3.
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fig3: Postprandial Bile Acid and FGF19 Responses in RYGB, VBG, and OBS Women(A) Circulating concentrations of total bile acids (Total BA), total conjugated primary (G+T primary), total conjugated secondary (G+T secondary), glycine-conjugated primary (G-primary), glycine-conjugated secondary (G-secondary), taurine-conjugated primary (T-primary), taurine-conjugated secondary (T-secondary), unconjugated primary, and unconjugated secondary bile acids.(B) Tukey box plots showing the area under the curve (AUC) as a measure of the bile acid postprandial responses.(C) Circulating concentrations of FGF19 and AUC showing FGF19 postprandial response in RYGB, VBG, and OBS women.Plasma samples were collected during fasting and every 30 min for 2.5 hr after a standard meal. Samples from colecystectomized patients (one in the RYGB and one in the VBG group) were excluded from the analysis, and plasma from one VBG woman could not be obtained, so the results represent the mean ± SEM for six RYGB, five VBG, and seven OBS women. a p < 0.05 according to one-way ANOVA with Tukey’s correction for multiple comparisons for RYGB compared to OBS. See also Figure S3.

Mentions: Because the composition of the bile acid pool is regulated by the gut microbiota (Sayin et al., 2013), we examined the relationship between the altered gut microbiota and bile acid pool composition after bariatric surgery. We quantified putative microbial genes for bile acid metabolism and showed that levels of bsh genes (for bile salt hydrolases) did not differ, while baiB, baiCD, baiE, baiF, and baiG (genes for the 7α-dehydroxylation of primary bile acids) increased in RYGB compared to OBS, although not significantly (Figure S3A). Fasting bile acid concentrations did not differ between RYGB, VBG, and OBS patients, but we confirmed a blunted postprandial bile acid response for OBS women and observed a slight increase in postprandial bile acid levels for VBG patients (Figures 3A and 3B), which was significant only for the secondary bile acid glycine-conjugated lithocholic acid (Figure S3B). However, we observed a pronounced postprandial bile acid response in RYGB compared to OBS patients, with a significant increase in total and glycine- and taurine-conjugated bile acids, but not unconjugated bile acids (Figures 3A and 3B). The increased bile acid levels in RYGB women were attributable to increases in both primary and secondary conjugated bile acids (Figure S3B, ANOVA p < 0.05). Finally, we measured the circulating levels of FGF19, an intestinal factor that regulates bile acid, carbohydrate, lipid, and energy metabolism through bile acid-mediated activation of FXR (Beenken and Mohammadi, 2009). We observed an increased FGF19 response in RYGB women compared to OBS (Figure 3C), indicating increased FXR signaling.


Roux-en-Y Gastric Bypass and Vertical Banded Gastroplasty Induce Long-Term Changes on the Human Gut Microbiome Contributing to Fat Mass Regulation.

Tremaroli V, Karlsson F, Werling M, Ståhlman M, Kovatcheva-Datchary P, Olbers T, Fändriks L, le Roux CW, Nielsen J, Bäckhed F - Cell Metab. (2015)

Postprandial Bile Acid and FGF19 Responses in RYGB, VBG, and OBS Women(A) Circulating concentrations of total bile acids (Total BA), total conjugated primary (G+T primary), total conjugated secondary (G+T secondary), glycine-conjugated primary (G-primary), glycine-conjugated secondary (G-secondary), taurine-conjugated primary (T-primary), taurine-conjugated secondary (T-secondary), unconjugated primary, and unconjugated secondary bile acids.(B) Tukey box plots showing the area under the curve (AUC) as a measure of the bile acid postprandial responses.(C) Circulating concentrations of FGF19 and AUC showing FGF19 postprandial response in RYGB, VBG, and OBS women.Plasma samples were collected during fasting and every 30 min for 2.5 hr after a standard meal. Samples from colecystectomized patients (one in the RYGB and one in the VBG group) were excluded from the analysis, and plasma from one VBG woman could not be obtained, so the results represent the mean ± SEM for six RYGB, five VBG, and seven OBS women. a p < 0.05 according to one-way ANOVA with Tukey’s correction for multiple comparisons for RYGB compared to OBS. See also Figure S3.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4537510&req=5

fig3: Postprandial Bile Acid and FGF19 Responses in RYGB, VBG, and OBS Women(A) Circulating concentrations of total bile acids (Total BA), total conjugated primary (G+T primary), total conjugated secondary (G+T secondary), glycine-conjugated primary (G-primary), glycine-conjugated secondary (G-secondary), taurine-conjugated primary (T-primary), taurine-conjugated secondary (T-secondary), unconjugated primary, and unconjugated secondary bile acids.(B) Tukey box plots showing the area under the curve (AUC) as a measure of the bile acid postprandial responses.(C) Circulating concentrations of FGF19 and AUC showing FGF19 postprandial response in RYGB, VBG, and OBS women.Plasma samples were collected during fasting and every 30 min for 2.5 hr after a standard meal. Samples from colecystectomized patients (one in the RYGB and one in the VBG group) were excluded from the analysis, and plasma from one VBG woman could not be obtained, so the results represent the mean ± SEM for six RYGB, five VBG, and seven OBS women. a p < 0.05 according to one-way ANOVA with Tukey’s correction for multiple comparisons for RYGB compared to OBS. See also Figure S3.
Mentions: Because the composition of the bile acid pool is regulated by the gut microbiota (Sayin et al., 2013), we examined the relationship between the altered gut microbiota and bile acid pool composition after bariatric surgery. We quantified putative microbial genes for bile acid metabolism and showed that levels of bsh genes (for bile salt hydrolases) did not differ, while baiB, baiCD, baiE, baiF, and baiG (genes for the 7α-dehydroxylation of primary bile acids) increased in RYGB compared to OBS, although not significantly (Figure S3A). Fasting bile acid concentrations did not differ between RYGB, VBG, and OBS patients, but we confirmed a blunted postprandial bile acid response for OBS women and observed a slight increase in postprandial bile acid levels for VBG patients (Figures 3A and 3B), which was significant only for the secondary bile acid glycine-conjugated lithocholic acid (Figure S3B). However, we observed a pronounced postprandial bile acid response in RYGB compared to OBS patients, with a significant increase in total and glycine- and taurine-conjugated bile acids, but not unconjugated bile acids (Figures 3A and 3B). The increased bile acid levels in RYGB women were attributable to increases in both primary and secondary conjugated bile acids (Figure S3B, ANOVA p < 0.05). Finally, we measured the circulating levels of FGF19, an intestinal factor that regulates bile acid, carbohydrate, lipid, and energy metabolism through bile acid-mediated activation of FXR (Beenken and Mohammadi, 2009). We observed an increased FGF19 response in RYGB women compared to OBS (Figure 3C), indicating increased FXR signaling.

Bottom Line: The two surgical procedures induced similar and durable changes on the gut microbiome that were not dependent on body mass index and resulted in altered levels of fecal and circulating metabolites compared with obese controls.By colonizing germ-free mice with stools from the patients, we demonstrated that the surgically altered microbiota promoted reduced fat deposition in recipient mice.These mice also had a lower respiratory quotient, indicating decreased utilization of carbohydrates as fuel.

View Article: PubMed Central - PubMed

Affiliation: The Wallenberg Laboratory and Sahlgrenska Center for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, SE-413 45 Gothenburg, Sweden.

No MeSH data available.


Related in: MedlinePlus