Gut Microbial Predictors of Type 2 Diabetes Remission Following Bariatric Surgery
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ORIGINAL CONTRIBUTIONS
Gut Microbial Predictors of Type 2 Diabetes Remission Following Bariatric Surgery Naomi Davies 1,2 & Justin M. O’Sullivan 2,3 & Lindsay D. Plank 4 & Rinki Murphy 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Distinct anatomical rearrangements of the gastrointestinal tract achieved by various types of bariatric surgery cause changes in nutrient intake and gut microbiota. The contribution of such gut microbiota changes to remission of type 2 diabetes (T2D) remains unclear. Aim We examined gut microbiota changes following banded Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) in a randomised study, in relation to T2D remission. Materials and Methods Whole-metagenome shotgun sequencing was carried out on paired stool samples at pre- and 1-year postsurgery collected from 44 participants with T2D randomised to banded Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Taxonomic composition and predicted functional potential of the gut bacteria were identified using HUMANn2, and annotated using MetaCyc. Five-day dietary records (analysed using FoodWorks v8.0), body weight and diabetes status were recorded at both time points. Results RYGB participants had higher percentage excess weight loss than SG (p = 0.01), even though dietary intake was similar at 1year post-surgery. Similar proportions achieved diabetes remission (HbA1c < 48 mmol/mol without medications) after either RYGB (68%) or SG (59%). RYGB resulted in increased abundances of Firmicutes and Proteobacteria, while SG resulted in increased Bacteroidetes. Pre-surgery, an increased abundance of Eubacteriaceae (p = 0.01) and Alistipes putredinis (p = 0.01) was observed in those who went on to remit from T2D post-surgery. Following surgery, Lachnospiraceae (p = 0.04) and Roseburia (p = 0.01) species were more abundant in those who had achieved T2D remission. Conclusions Specific stool bacterial taxa may signal likelihood of T2D remission after bariatric surgery which is potentially mediated by increases in Lachnospiraceae and Roseburia. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04684-0) contains supplementary material, which is available to authorized users. * Rinki Murphy [email protected] Naomi Davies [email protected] Justin M. O’Sullivan [email protected] Lindsay D. Plank [email protected] 1
Department of Medicine, Faculty of medical and health sciences, University of Auckland, Auckland, New Zealand
2
Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
3
Liggins Institute, The University of Auckland, Auckland, New Zealand
4
Department of Surgery, The University of Auckland, Auckland, New Zealand
Keywords Bariatric surgery . Fecal microbiota . Bacteria . Bypass . Diabetes . Obesity
Abbreviations ANOVA BMI GI LDA LEfSe PERMANOVA RCT RYGB SCFA SG T2D VLCD
Analysis of variance Body mass index Gastrointestinal Linear discriminant analysis Linear discrimi
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