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Shifts in gut microbiota and their metabolites induced by bariatric surgery. Impact of factors shaping gut microbiota on bariatric surgery outcomes

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Abstract

Evidence suggests that bariatric surgery alters gut microbiota, although its impact at compositional and functional level is not well described. In this review, the most relevant findings, mainly described in Roux-en-Y gastric bypass and sleeve gastrectomy, are outlined. Although the number of studies has increased in the last years, conclusive assertions cannot be elaborated. An issue to address is to know the influence of these alterations on host metabolism and the contribution of gut microbiota derived metabolites. New lines of research have been focusing on analysing gut microbiota functionality rather than evaluating changes at compositional level, and the functions of gut microbiota metabolites in host metabolism, what will bring more relevant information about the influence of gut microbiota in bariatric surgery outcomes. Personalized medicine, because of the predictive value of gut microbiota, is another promising field. The possibility of a specific gut microbiota pattern that could predict type 2 diabetes remission or weight loss failure after bariatric surgery is a matter of great interest. However, little is known about how gut microbiota manipulation could contribute to the beneficial effects of bariatric surgery. Peri-operative antibiotics prophylaxis or probiotic supplementation early after surgery, are strategies barely studied so far, and could constitute a novel tool in the management of weight loss and metabolic profile improvement after surgery.

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Abbreviations

ABC:

ATP-binding cassette

ACE:

Abundance-based coverage estimator

BCAAs:

Branched-chain amino acids

BCFAs:

Branched-chain fatty acids

BMI:

Body mass index

BSH:

Bile salt hydrolase

CA7S:

Cholic acid-7-sulfate

FMT:

Faecal microbiota transplantation

FXR:

Farnesoid X receptor

HbA1c:

Haemoglobin a1c

HOMA-IR:

Homeostasis model assessment of insulin resistance

LDL-cholesterol:

Low density lipoprotein cholesterol

MS:

Metabolic syndrome

PTS:

Phosphotransferase system

RYGB:

Roux-en-Y gastric bypass

SCFAs:

Short chain fatty acids

SG:

Sleeve gastrectomy

T2DM:

Type 2 diabetes mellitus

TGR5:

Takeda G protein-receptor 5

TMA:

Trimethylamine

TMAO:

Trimethylamine N-oxide

VBG:

Vertical banded gastroplasty

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The research group belongs to the “Centro de Investigación en Red de la Fisiopatología de la Obesidad y la Nutrición” (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. CGR and IMI are supported by a grant from Instituto de Salud Carlos III (“Miguel Servet programme” (CP20/00066 and CP16/00163, respectively), This work was supported in part by grants from ISCIII cofounded by Fondo Europeo de Desarrollo Regional – FEDER, PI18/01160, CP16/00163; as well as UMA18-FEDERJA-116 founded by Junta de Andalucía (Fondo Europeo de Desarrollo Regional-FEDER).

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  1. Unidad de Gestión Clínica de Endocrinología Y Nutrición del Hospital Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA) Málaga. Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y La Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain

    Carolina Gutiérrez-Repiso, Isabel Moreno-Indias & Francisco J. Tinahones

  2. Departamento de Medicina Y Dermatología, Universidad de Málaga, Málaga, Spain

    Francisco J. Tinahones

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  1. Carolina Gutiérrez-Repiso
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Gutiérrez-Repiso, C., Moreno-Indias, I. & Tinahones, F.J. Shifts in gut microbiota and their metabolites induced by bariatric surgery. Impact of factors shaping gut microbiota on bariatric surgery outcomes. Rev Endocr Metab Disord 22, 1137–1156 (2021). https://doi.org/10.1007/s11154-021-09676-8

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