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Huang HH, Lin TL, Lee WJ, Chen SC, Lai WF, Lu CC, Lai HC, Chen CY. Impact of Metabolic Surgery on Gut Microbiota and Sera Metabolomic Patterns among Patients with Diabetes. Int J Mol Sci 2022; 23:ijms23147797. [PMID: 35887145 PMCID: PMC9320451 DOI: 10.3390/ijms23147797] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023] Open
Abstract
Metabolic surgery is a promising treatment for obese individuals with type 2 diabetes mellitus (T2DM), but the mechanism is not completely understood. Current understanding of the underlying ameliorative mechanisms relies on alterations in parameters related to the gastrointestinal hormones, biochemistry, energy absorption, the relative composition of the gut microbiota, and sera metabolites. A total of 13 patients with obesity and T2DM undergoing metabolic surgery treatments were recruited. Systematic changes of critical parameters and the effects and markers after metabolic surgery, in a longitudinal manner (before surgery and three, twelve, and twenty-four months after surgery) were measured. The metabolomics pattern, gut microbiota composition, together with the hormonal and biochemical characterizations, were analyzed. Body weight, body mass index, total cholesterol, triglyceride, fasting glucose level, C-peptide, HbA1c, HOMA-IR, gamma-glutamyltransferase, and des-acyl ghrelin were significantly reduced two years after metabolic surgery. These were closely associated with the changes of sera metabolomics and gut microbiota. Significant negative associations were found between the Eubacterium eligens group and lacosamide glucuronide, UDP-L-arabinose, lanceotoxin A, pipercyclobutanamide B, and hordatine B. Negative associations were identified between Ruminococcaceae UCG-003 and orotidine, and glucose. A positive correlation was found between Enterococcus and glutamic acid, and vindoline. Metabolic surgery showed positive effects on the amelioration of diabetes and metabolic syndromes, which were closely associated with the change of sera metabolomics, the gut microbiota, and other disease-related parameters.
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Affiliation(s)
- Hsien-Hao Huang
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Institute of Emergency and Critical Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei 11221, Taiwan
| | - Tzu-Lung Lin
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Microbiota Research Center and Emerging Viral Infections Research Center, Chang Gung University, Taoyuan 33302, Taiwan
| | - Wei-Jei Lee
- Department of Surgery, Min-Sheng General Hospital, Taoyuan 33044, Taiwan;
- Taiwan Society for Metabolic and Bariatric Surgery, Taipei 11031, Taiwan;
| | - Shu-Chun Chen
- Taiwan Society for Metabolic and Bariatric Surgery, Taipei 11031, Taiwan;
- Department of Nursing, Chang-Gung Institute of Technology, Taoyuan 33303, Taiwan
| | - Wei-Fan Lai
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
| | - Chia-Chen Lu
- Department of Chest Medicine, Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan;
- Department of Respiratory Therapy, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Hsin-Chih Lai
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Microbiota Research Center and Emerging Viral Infections Research Center, Chang Gung University, Taoyuan 33302, Taiwan
- Research Center for Chinese Herbal Medicine and Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan 33303, Taiwan
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
- Central Research Laboratory, Xiamen Chang Gung Allergology Consortium, Xiamen Chang Gung Hospital, Xiamen 361028, China
- Correspondence: (H.-C.L.); (C.-Y.C.); Tel.: +886-2-28712121 (ext. 2050) (C.-Y.C.)
| | - Chih-Yen Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Faculty of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Bariatric and Metabolic Surgery Center, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Chinese Taipei Society for the Study of Obesity, Taipei 11031, Taiwan
- Taiwan Association for the Study of Small Intestinal Diseases, Taoyuan 333423, Taiwan
- Correspondence: (H.-C.L.); (C.-Y.C.); Tel.: +886-2-28712121 (ext. 2050) (C.-Y.C.)
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Spurny M, Jiang Y, Sowah SA, Schübel R, Nonnenmacher T, Bertheau R, Kirsten R, Johnson T, Hillengass J, Schlett CL, von Stackelberg O, Ulrich CM, Kaaks R, Kauczor HU, Kühn T, Nattenmüller J. Changes in Bone Marrow Fat upon Dietary-Induced Weight Loss. Nutrients 2020; 12:nu12051509. [PMID: 32455947 PMCID: PMC7284630 DOI: 10.3390/nu12051509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/09/2020] [Accepted: 05/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Bone marrow fat is implicated in metabolism, bone health and haematological diseases. Thus, this study aims to analyse the impact of moderate weight loss on bone marrow fat content (BMFC) in obese, healthy individuals. Methods: Data of the HELENA-Trial (Healthy nutrition and energy restriction as cancer prevention strategies: a randomized controlled intervention trial), a randomized controlled trial (RCT) among 137 non-smoking, overweight or obese participants, were analysed to quantify the Magnetic Resonance Imaging (MRI)-derived BMFC at baseline, after a 12-week dietary intervention phase, and after a 50-week follow-up. The study cohort was classified into quartiles based on changes in body weight between baseline and week 12. Changes in BMFC in respect of weight loss were analysed by linear mixed models. Spearman’s coefficients were used to assess correlations between anthropometric parameters, blood biochemical markers, blood cells and BMFC. Results: Relative changes in BMFC from baseline to week 12 were 0.0 ± 0.2%, −3.2 ± 0.1%, −6.1 ± 0.2% and −11.5 ± 0.6% for Q1 to Q4. Across all four quartiles and for the two-group comparison, Q1 versus Q4, there was a significant difference (p < 0.05) for changes in BMFC. BMFC was not associated with blood cell counts and showed only weaker correlations (<0.3) with metabolic biomarkers. Conclusion: Weight loss is associated with a decrease of BMFC. However, BMFC showed no stronger associations with inflammatory and metabolic biomarkers.
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Affiliation(s)
- Manuela Spurny
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (M.S.); (Y.J.); (R.S.); (T.N.); (R.B.); (O.v.S.); (H.-U.K.)
| | - Yixin Jiang
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (M.S.); (Y.J.); (R.S.); (T.N.); (R.B.); (O.v.S.); (H.-U.K.)
| | - Solomon A. Sowah
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (S.A.S.); (R.K.); (T.J.); (R.K.); (T.K.)
| | - Ruth Schübel
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (M.S.); (Y.J.); (R.S.); (T.N.); (R.B.); (O.v.S.); (H.-U.K.)
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (S.A.S.); (R.K.); (T.J.); (R.K.); (T.K.)
| | - Tobias Nonnenmacher
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (M.S.); (Y.J.); (R.S.); (T.N.); (R.B.); (O.v.S.); (H.-U.K.)
| | - Robert Bertheau
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (M.S.); (Y.J.); (R.S.); (T.N.); (R.B.); (O.v.S.); (H.-U.K.)
| | - Romy Kirsten
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (S.A.S.); (R.K.); (T.J.); (R.K.); (T.K.)
| | - Theron Johnson
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (S.A.S.); (R.K.); (T.J.); (R.K.); (T.K.)
| | - Jens Hillengass
- Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, New York 14263, USA;
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, D-79106 Freiburg, Germany;
| | - Oyunbileg von Stackelberg
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (M.S.); (Y.J.); (R.S.); (T.N.); (R.B.); (O.v.S.); (H.-U.K.)
| | - Cornelia M. Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112-5550, USA;
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (S.A.S.); (R.K.); (T.J.); (R.K.); (T.K.)
| | - Hans-Ulrich Kauczor
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (M.S.); (Y.J.); (R.S.); (T.N.); (R.B.); (O.v.S.); (H.-U.K.)
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (S.A.S.); (R.K.); (T.J.); (R.K.); (T.K.)
| | - Johanna Nattenmüller
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; (M.S.); (Y.J.); (R.S.); (T.N.); (R.B.); (O.v.S.); (H.-U.K.)
- Correspondence: ; Tel.: +49-6221-5636462
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Aron-Wisnewsky J, Clément K. A place for vitamin supplementation and functional food in bariatric surgery? Curr Opin Clin Nutr Metab Care 2019; 22:442-448. [PMID: 31589176 DOI: 10.1097/mco.0000000000000602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW This article summarizes recent literature concerning vitamin deficiency and required supplementation post-bariatric surgery, focusing on vitamin D (and associated clinical adverse effect on bone loss) and on the potential implication of the gut microbiota. RECENT FINDINGS Bariatric surgery induces weight loss and metabolic improvements yet with major inter-individual variability. If it is efficient in most patients, some display poor response (i.e. patients with the lowest weight loss at 1 year or weight regain afterwards, or patients without metabolic disease remission). Despite systematic vitamin supplementation, some patients develop vitamin deficiencies leading to poor clinical outcomes, among which vitamin D deficiency associated with observed bone mass loss and fractures. Recent mechanistic studies led to understand better the involved physiopathology. Furthermore, different intervention studies tested on top of bariatric surgery (using vitamin, diet, or nutrients acting as functional food) have evaluated whether nutritional adverse outcomes could be improved. Importantly, gut microbiota involved in food digestion and metabolization and vitamin synthesis is largely perturbed during severe obesity and is partially restored post-surgery, yet again with large interindividual variability. Whether differential gut microbiota modification could be associated with vitamin deficiencies is an open question. SUMMARY Future clinical research studies will need to evaluate whether add-on intervention to bariatric surgery using vitamin, diet, or specific food items could help prevent nutritional deficiencies and improve clinical response observed post-surgery. Importantly, personalizing the add-on intervention post-surgery upon gut microbiota composition should be tested in predicted poor-responders to surgery as already performed during diet intervention to further improve metabolic health.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and Obesities, Systemic Approaches (NutriOmics)
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition Department, Paris, France
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and Obesities, Systemic Approaches (NutriOmics)
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition Department, Paris, France
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