Gastrointestinal manifestations after Roux-en-Y gastric bypass surgery in individuals with and without type 2 diabetes |
| |
| Authors: | Mari-Anne Härma Krishna Adeshara Natalie Istomin Markku Lehto Michael Blaut Markku J. Savolainen Sohvi Hörkkö Per-Henrik Groop Vesa Koivukangas Janne Hukkanen |
| |
| Affiliation: | 1. Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland;2. Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;3. Clinical and Molecular Metabolism, Faculty of Medicine Research Programs, University of Helsinki, Helsinki, Finland;4. Medical Microbiology and Immunology, Research Unit of Biomedicine, University of Oulu, Oulu, Finland;5. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland;6. Nordlab, Oulu University Hospital, Oulu, Finland;7. Department of Gastrointestinal Microbiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany;8. Research Unit of Internal Medicine and Biocenter Oulu, University of Oulu, Oulu, Finland;9. Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia;10. Department of Surgery, Oulu University Hospital and University of Oulu, Oulu, Finland |
| |
| Abstract: | BackgroundRoux-en-Y gastric bypass (RYGB) surgery is an effective treatment for obesity, which improves cardiovascular health and reduces the risk of premature mortality. However, some reports have suggested that RYGB may predispose patients to adverse health outcomes, such as inflammatory bowel disease (IBD) and colorectal cancer.ObjectivesThe present prospective study aimed to evaluate the impact of RYGB surgery on cardiovascular risk factors and gastrointestinal inflammation in individuals with and without type 2 diabetes (T2D).SettingUniversity hospital setting in Finland.MethodsBlood and fecal samples were collected at baseline and 6 months after surgery from 30 individuals, of which 16 had T2D and 14 were nondiabetics. There were also single study visits for 6 healthy reference patients. Changes in cardiovascular risk factors, serum cholesterol, and triglycerides were investigated before and after surgery. Fecal samples were analyzed for calprotectin, anti-Saccharomyces cerevisiae immunoglobulin A antibodies (ASCA), active lipopolysaccharide (LPS) concentration, short-chain fatty acids (SCFAs), intestinal alkaline phosphatase activity, and methylglyoxal-hydro-imidazolone (MG-H1) protein adducts formation.ResultsAfter RYGB, weight decreased on average ?21.6% (?27.2 ± 7.8 kg), excess weight loss averaged 51%, and there were improvements in cardiovascular risk factors. Fecal calprotectin levels (P < .001), active LPS concentration (P < .002), ASCA (P < .02), and MG-H1 (P < .02) values increased significantly, whereas fecal SCFAs, especially acetate (P < .002) and butyrate (P < .03) levels, were significantly lowered.ConclusionThe intestinal homeostasis is altered after RYGB, with several fecal markers suggesting increased inflammation; however, clinical significance of the detected changes is currently uncertain. As chronic inflammation may predispose patients to adverse health effects, our findings may have relevance for the suggested association between RYGB and increased risks of incident IBD and colorectal cancer. |
| |
| Keywords: | Calprotectin Intestinal inflammation Roux-en-Y gastric bypass surgery Short-chain fatty acids Type 2 diabetes |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
