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. 2019 Jul 29;9(1):10979.
doi: 10.1038/s41598-019-47332-z.

Roux-Y Gastric Bypass and Sleeve Gastrectomy directly change gut microbiota composition independent of surgery type

Fernanda L Paganelli  1 , Misha Luyer  2 , C Marijn Hazelbag  3 , Hae-Won Uh  3 , Malbert R C Rogers  1 , Danielle Adriaans  2 , Roos-Marijn Berbers  1   4 , Antoni P A Hendrickx  1 , Marco C Viveen  1 , James A Groot  1 , Marc J M Bonten  1 , Ad C Fluit  1 , Rob J L Willems  1 , Helen L Leavis  5
Affiliations

Roux-Y Gastric Bypass and Sleeve Gastrectomy directly change gut microbiota composition independent of surgery type

Fernanda L Paganelli et al. Sci Rep. .

Abstract

Bariatric surgery in morbid obesity, either through sleeve gastrectomy (SG) or Roux-Y gastric bypass (RYGB), leads to sustainable weight loss, improvement of metabolic disorders and changes in intestinal microbiota. Yet, the relationship between changes in gut microbiota, weight loss and surgical procedure remains incompletely understood. We determined temporal changes in microbiota composition in 45 obese patients undergoing crash diet followed by SG (n = 22) or RYGB (n = 23). Intestinal microbiota composition was determined before intervention (baseline, S1), 2 weeks after crash diet (S2), and 1 week (S3), 3 months (S4) and 6 months (S5) after surgery. Relative to S1, the microbial diversity index declined at S2 and S3 (p < 0.05), and gradually returned to baseline levels at S5. Rikenellaceae relative abundance increased and Ruminococcaceae and Streptococcaceae abundance decreased at S2 (p < 0.05). At S3, Bifidobacteriaceae abundance decreased, whereas those of Streptococcaceae and Enterobacteriaceae increased (p < 0.05). Increased weight loss between S3-S5 was not associated with major changes in microbiota composition. No significant differences appeared between both surgical procedures. In conclusion, undergoing a crash diet and bariatric surgery were associated with an immediate but temporary decline in microbial diversity, with immediate and permanent changes in microbiota composition, independent of surgery type.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Observed and estimated richness of gut microbiota at different time points during the bariatric surgery procedure. (A) Shannon diversity index estimated a decrease in bacterial richness at S2 and S3. (B) Rarefaction curves showed a reduction in bacterial richness at S2 and S3. (C) Principal component analysis (PCA) plot of similarity between the samples; each dot represents 1 sample, each color a different time point. S1. before surgery (red); S2. after 2 weeks of crash diet (orange); S3. 1 week after surgery (yellow); S4. 3 months after surgery (light blue); S5. 6 months after surgery (dark blue).
Figure 2
Figure 2
Relative abundance of bacterial families in the gut microbiota at the five time points analyzed. (A–G) Boxplots show the average relative abundance of 7 families that significantly changed between 2 different time points. (A) Streptococcaceae. (B) Enterobacteriaceae. (C) Bifidobacteriaceae. (D) Ruminococcaceae. (E) Rikenellaceae. (F) Veillonellaceae. (G) O_Clostridiales_f_others. H. Relative abundance of all families identified at the different time points. Significant families are represented in the same color. Asterisk (in red) indicates significant fold change differences (p < 0,05) analyzed by ANCOM.
Figure 3
Figure 3
(A–C). Principal coordinate analysis (PCoA) plots comparing beta diversity of Sleeve Gastrectomy (SG) versus Roux-Y Gastric bypass (RYGB) surgery at baseline (S1) (A) 1 week after surgery (S3) (B) and 6 months after surgery (S5). (C) SG is indicated in red, RYGB is indicated in blue. (D) Relative abundance of bacterial families in the gut microbiota at the five time points analyzed in SG versus RYGB surgery.
Figure 4
Figure 4
Association between clinical parameters and family taxa calculated based on the difference between 6 months after surgery (S6) and baseline (S1). Significant associations (false discovery rate (FDR) adjusted p-value < 0.05) are indicated with an “x”. The red color indicates a positive association and the blue color a negative association. HbA1c, glycated hemoglobin; VitD, vitamin D; VitB6, vitamin B6.
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