A specific gut microbiota signature is associated with an enhanced GLP-1 and GLP-2 secretion and improved metabolic control in patients with type 2 diabetes after metabolic Roux-en-Y gastric bypass

Frontiers in Endocrinology

Endocrinology

Rosa Monseny¹  Rocío Puig²  Silvia Pellitero³  María Pérez-Prieto⁴  Manuel Pérez-Maraver⁴  Rafael López-Urdiales⁴  Laura Hernández-Montoliu⁴  Fernando Guerrero-Pérez⁴  Nuria Virgili⁴  Nuria Vilarrasa⁵  Javier Osorio⁶  Lucía Sobrino⁶  Claudio Lazzara⁶  Sonia Fernández-Veledo⁷  Brenno Astiarraga⁷  M-Mar Rodríguez-Peña⁷  Joan Vendrell⁸ 

[1] Clinical Nutrition Unit. Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain;Department of Endocrinology and Nutrition Hospital de la Santa Creu i Sant Pau, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;Department of Endocrinology and Nutrition and Health Sciences Research Institute and University Hospital Germans Trias i Pujol, Badalona, Spain;Department of Endocrinology and Nutrition, Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain;Department of Endocrinology and Nutrition, Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain;CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III (ISCIII), Madrid, Spain;Department of General and Gastrointestinal Surgery. Bellvitge University Hospital-Institut d'Investigació Biomédica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain;Hospital Universitari Joan XXIII de Tarragona, Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain;CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III (ISCIII), Madrid, Spain;Hospital Universitari Joan XXIII de Tarragona, Institut d’Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain;CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III (ISCIII), Madrid, Spain;Department of Medicine and Surgery, Universitat Rovira i Virgili (URV), Reus, Spain;

关键词: incretin;    microbiota;    type 2 diabetes remission;    severe obesity;    bariatric surgery;   

DOI  :  10.3389/fendo.2023.1181744

 received in 2023-03-07, accepted in 2023-09-22,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveTo determine changes in incretins, systemic inflammation, intestinal permeability and microbiome modifications 12 months after metabolic RYGB (mRYGB) in patients with type 2 diabetes (T2D) and their relationship with metabolic improvement.Materials and methodsProspective single-center non-randomized controlled study, including patients with class II-III obesity and T2D undergoing mRYGB. At baseline and one year after surgery we performed body composition measurements, biochemical analysis, a meal tolerance test (MTT) and lipid test (LT) with determination of the area under the curve (AUC) for insulin, C-peptide, GLP-1, GLP-2, and fasting determinations of succinate, zonulin, IL-6 and study of gut microbiota.ResultsThirteen patients aged 52.6 ± 6.5 years, BMI 39.3 ± 1.4 kg/m2, HbA1c 7.62 ± 1.5% were evaluated. After mRYGB, zonulin decreased and an increase in AUC after MTT was observed for GLP-1 (pre 9371 ± 5973 vs post 15788 ± 8021 pM, P<0.05), GLP-2 (pre 732 ± 182 vs post 1190 ± 447 ng/ml, P<0.001) and C- peptide, as well as after LT. Species belonging to Streptococaceae, Akkermansiacea, Rickenellaceae, Sutterellaceae, Enterobacteriaceae, Oscillospiraceae, Veillonellaceae, Enterobacterales_uc, and Fusobacteriaceae families increased after intervention and correlated positively with AUC of GLP-1 and GLP-2, and negatively with glucose, HbA1c, triglycerides and adiposity markers. Clostridium perfringens and Roseburia sp. 40_7 behaved similarly. In contrast, some species belonging to Lachnospiraceae, Erysipelotricaceae, and Rumnicocaceae families decreased and showed opposite correlations. Higher initial C-peptide was the only predictor for T2D remission, which was achieved in 69% of patients.ConclusionsPatients with obesity and T2D submitted to mRYGB show an enhanced incretin response, a reduced gut permeability and a metabolic improvement, associated with a specific microbiota signature.

【 授权许可】

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Copyright © 2023 Hernández-Montoliu, Rodríguez-Peña, Puig, Astiarraga, Guerrero-Pérez, Virgili, López-Urdiales, Osorio, Monseny, Lazzara, Sobrino, Pérez-Maraver, Pérez-Prieto, Pellitero, Fernández-Veledo, Vendrell and Vilarrasa