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

Objective: To 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 methods: Prospective single-center...

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Detalles Bibliográficos
Autores: Hernández-Montoliu, Laura, Rodríguez-Peña, M.Mar, Puig, Rocío, Astiarraga, Brenno|||0000-0003-2216-8974, Guerrero-Pérez, Fernando, Virgili, Nuria, López-Urdiales, Rafael|||0000-0002-2355-3041, Osorio, Javier|||0000-0002-0889-4585, Monseny, Rosa, Lazzara, Claudia, Sobrino, Lucía, Pérez-Maraver, Manuel|||0000-0003-4427-7581, Pérez-Prieto, María, Pellitero, Silvia|||0000-0002-9510-7251, Fernández-Veledo, Sonia|||0000-0003-2906-3788, Vendrell, Joan|||0000-0002-6994-6115, Vilarrasa, Nuria|||0000-0003-3188-1990
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:320056
Acceso en línea:https://ddd.uab.cat/record/320056
https://dx.doi.org/urn:doi:10.3389/fendo.2023.1181744
Access Level:acceso abierto
Palabra clave:Incretin
Microbiota
Type 2 diabetes remission
Severe obesity
Bariatric surgery
Descripción
Sumario:Objective: To 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 methods: Prospective 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. Results: Thirteen patients aged 52.6 ± 6.5 years, BMI 39.3 ± 1.4 kg/m, HbA 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, HbA, 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. Conclusions: Patients 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.

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