Gastrointestinal Hormones, Intestinal Microbiota and Metabolic Homeostasis in Obese Patients: Effect of Bariatric Surgery.
OBJECTIVE
Bariatric surgery has proven efficacy in the modulation of a number of gut peptides that can contribute to improvement of diabetes and its associated metabolic changes. In order to evaluate dietary intake, nutritional assessment and plasma levels of gastrointestinal peptides, we enrolled severely obese patients before and after bariatric surgery.


METHODS
We evaluated food intake, plasma levels of peptide YY (PYY), glucagon-like peptide-1/2 (GLP-1/2), ghrelin (GHR), orexin (ORE) and cholecystokinin (CCK), body composition and fecal microbiota in 28 severely obese patients and 28 healthy normal-weight controls. All parameters were evaluated at 0 time and 6 months after bariatric surgery.


RESULTS
In obese patients we found a higher intake of nutrients, a decrease of free fat mass and an increase of BMI (body mass index), a significant decrease of GLP-1 and an increase of GLP-2, GHR and PYY with respect to controls, further increase in GLP-2, GHR and PYY, as well as increase over control values of GLP-1 after bariatric surgery. Obese individuals were found to harbor a community dominated by members of the Clostridial clusters XIVa and IV, whereas prominent bands after surgery were identified as Lactobacillus crispatus and Megasphaera elsdenii-related phylotype.


CONCLUSIONS
The beneficial effects of bariatric surgery may at least in part be accounted for changes in circulating gastrointestinal (GI) peptides and fecal microbiota.
Division of Hepatogastroenterology, Second University of Naples, Naples, Italy alessandro.federico@unina2.it.
Alessandro
A
Federico
Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
Marcello
M
Dallio
Division of General and Bariatric Surgery, Second University of Naples, Naples, Italy.
Salvatore
S
Tolone
Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
Antonietta Gerarda
AG
Gravina
Institute of Microbiology, Catholic University, Piacenza, Italy.
Vania
V
Patrone
Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
Marco
M
Romano
Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
Concetta
C
Tuccillo
Division of General and Bariatric Surgery, Second University of Naples, Naples, Italy.
Anna Licia
AL
Mozzillo
Division of General and Bariatric Surgery, Second University of Naples, Naples, Italy.
Vincenzo
V
Amoroso
Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy.
Gabriella
G
Misso
Institute of Microbiology, Catholic University, Piacenza, Italy.
Lorenzo
L
Morelli
Division of General and Bariatric Surgery, Second University of Naples, Naples, Italy.
Ludovico
L
Docimo
Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
Carmelina
C
Loguercio
D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D002766:Cholecystokinin / Q000097:blood; D004734:Energy Metabolism; D005243:Feces / Q000382:microbiology; D005260:Female; D005768:Gastrointestinal Hormones / Q000097:blood*; D000069196:Gastrointestinal Microbiome; D054439:Ghrelin / Q000097:blood; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D053767:Glucagon-Like Peptide 2 / Q000097:blood; D006706:Homeostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009765:Obesity / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery; D000068797:Orexins / Q000097:blood; D019894:Peptide YY / Q000097:blood; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
D005768:Gastrointestinal Hormones; D054439:Ghrelin; D053767:Glucagon-Like Peptide 2; D000068797:Orexins; D019894:Peptide YY; D052216:Glucagon-Like Peptide 1; D002766:Cholecystokinin
Obesity; bariatric surgery; diabetes; gastrointestinal hormones; gut-microbiota