We aimed to assess the effect of sleeve gastrectomy (SG) on the metabolic and gut microbiota profiles in non-diabetic obese patients with different grade of insulin resistance (IR).
Methods: Prospective study of 22 morbid non-diabetic obese patients (77.2% women, age 47.13±9.51 years, basal BMI 45.59±4.99 kg/m2, 11 IR and 11 non-IR) undergoing SG. A fasting blood sample was collected at baseline and at 6 months post-SG for the determination of glycaemia, HbA1c, insulin, C-peptide, complete lipid profile. Gut microbiota study and body composition analysis by dual-energy X-ray absorptiometry (DEXA) were performed at the same time-points.
Results: At baseline insulin and C-peptide were higher in IR group (19.10±4.47 vs 11.83±4.80 m.u.int/l, P=0.001 and 3.59±0.98 vs 2.33±0.49 ng/ml, P=0.016, respectively) with no differences in lipid profile. At 6 months after SG, a significant decrease in BMI, waist circumference, blood pressure was observed, as well as a fat mass similar decrease in both groups, although fat free mass only decreased in non-IR group (52.17±7.47 vs 46.86±6.73 kg, P=0.04). After SG, in IR-group: Phylum and family diversity increased (0.7±0.10 vs 0.79±0.11 and 1.58±0.39 vs 2.1±0.18, P<0.005, respectively); bacteroidetes decreased (71.16±9.43 vs 51.48±17.4, P>005) and firmicutes increased (25.07±10.3 vs 43.96±19.09, P>0.005). Prevotellaceae diminished and odoribacteraceae rose (P<0.05). In non IR-group: family and genus richness decreased (186±43.71 vs 159.4±43.75, P<0.005 and 592±187.03 vs 487±171.01, P<005, respectively), Prevotellaceae diminished but not significantly (20.92±30.09 vs 13.02±21.69), and odoribacteraceae increased (0.63±0.41 vs 2.32±2.53, P<0.005) but there were no changes in bacteroidetes or firmicutes.
Conclusions: SG produces different effects on gut microbiota composition in non-diabetic patients with different grade of insulin resistance despite similar changes in BMI, waist circumference and fat mass. The decrease in Prevotellaceae and the increase in Odoribacteraceae after SG could be related with the enhancement of inflammation and metabolic dysfunction observed in patients undergoing bariatric surgery.
19 - 22 May 2018
European Society of Endocrinology