Impact of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy on gut microbiota: a metagenomic comparative analysis

William Farin; Florian Plaza Oñate; Jonathan Plassais; Christophe Bonny; Christoph Beglinger; Bettina Woelnerhanssen; David Nocca; Frederic Magoules; Emmanuelle Le Chatelier; Nicolas Pons; Alessandra C L Cervino; S Dusko Ehrlich

doi:10.1016/j.soard.2020.03.014

Impact of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy on gut microbiota: a metagenomic comparative analysis

Surg Obes Relat Dis. 2020 Jul;16(7):852-862. doi: 10.1016/j.soard.2020.03.014. Epub 2020 Mar 20.

Affiliations

¹ Data Science, Enterome, Paris, France. Electronic address: wfarin@enterome.com.
² Data Science, Enterome, Paris, France; Université Paris-Saclay, Jouy en Josas, France.
³ Data Science, Enterome, Paris, France.
⁴ Department of Biomedicine, University of Basel and Department of Research, St. Claraspital, Basel, Switzerland.
⁵ Digestive Surgery, Saint-Eloi University Hospital of Montpellier, Montpellier, France.
⁶ Centrale Supélec, Université Paris Saclay, Gif-sur-Yvette, France.
⁷ Université Paris-Saclay, Jouy en Josas, France.
⁸ Université Paris-Saclay, Jouy en Josas, France; Centre for Host Microbiome Interaction, Dental Institute, King's College London, London, United Kingdom.

PMID: 32360114
DOI: 10.1016/j.soard.2020.03.014

Abstract

Background: Bariatric surgery is an effective therapeutic procedure for morbidly obese patients. The 2 most common interventions are sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (LRYGB).

Objectives: The aim of this study was to compare microbiome long-term microbiome after SG and LRYGB surgery in obese patients.

Setting: University Hospital, France; University Hospital, United States; and University Hospital, Switzerland.

Methods: Eighty-nine and 108 patients who underwent SG and LRYGB, respectively, were recruited. Stools were collected before and 6 months after surgery. Microbial DNA was analyzed with shotgun metagenomic sequencing (SOLiD 5500 xl Wildfire). MSPminer, a novel innovative tool to characterize new in silico biological entities, was used to identify 715 Metagenomic Species Pan-genome. One hundred forty-eight functional modules were analyzed using GOmixer and KEGG database.

Results: Both interventions resulted in a similar increase of Shannon's diversity index and gene richness of gut microbiota, in parallel with weight loss, but the changes of microbial composition were different. LRYGB led to higher relative abundance of aero-tolerant bacteria, such as Escherichia coli and buccal species, such as Streptococcus and Veillonella spp. In contrast, anaerobes, such as Clostridium, were more abundant after SG, suggesting better conservation of anaerobic conditions in the gut. Enrichment of Akkermansia muciniphila was also observed after both surgeries. Function-level changes included higher potential for bacterial use of supplements, such as vitamin B12, B1, and iron upon LRYGB.

Conclusion: Microbiota changes after bariatric surgery depend on the nature of the intervention. LRYGB induces greater taxonomic and functional changes in gut microbiota than SG. Possible long-term health consequences of these alterations remain to be established.

Keywords: Bariatric surgery; Laparoscopic Roux-en-Y gastric bypass; Metagenomics; Microbiome; Sleeve gastrectomy.

MeSH terms

France
Gastrectomy
Gastric Bypass*
Gastrointestinal Microbiome*
Humans
Laparoscopy*
Obesity, Morbid* / surgery
Switzerland