Mechanisms linking bariatric surgery to adipose tissue, glucose metabolism, fatty liver disease and gut microbiota

Langenbecks Arch Surg. 2023 Feb 24;408(1):101. doi: 10.1007/s00423-023-02821-8.

Abstract

Purpose: In the last 20 years, bariatric surgery has achieved an important role in translational and clinical research because of obesity comorbidities. Initially, a tool to lose weight, bariatric surgery now has been shown to be involved in several metabolic pathways.

Methods: We conducted a narrative review discussing the underlying mechanisms that could explain the impact of bariatric surgery and the relationship between obesity and adipose tissue, T2D, gut microbiota, and NAFLD.

Results: Bariatric surgery has an impact in the relation between obesity and type 2 diabetes, but in addition it induces the white-to-brown adipocyte trans-differentiation, by enhancing thermogenesis. Another issue is the connection of bariatric surgery with the gut microbiota and its role in the complex mechanism underlying weight gain.

Conclusion: Bariatric surgery modifies gut microbiota, and these modifications influence lipid metabolism, leading to improvement of non-alcoholic fatty liver disease.

Keywords: Adipose tissue; Bariatric surgery; Diabetes; Gut microbiota; Non-alcoholic fatty liver disease.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / metabolism
  • Bariatric Surgery*
  • Diabetes Mellitus, Type 2*
  • Gastrointestinal Microbiome*
  • Glucose / metabolism
  • Humans
  • Liver
  • Non-alcoholic Fatty Liver Disease* / metabolism
  • Obesity / surgery

Substances

  • Glucose