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| Pàgina inicial > Articles > Articles publicats > 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 |
| Data: | 2023 |
| Resum: | 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. |
| Ajuts: | Ministerio de Ciencia e Innovación PI11/01960 Ministerio de Economía y Competitividad PI14/01997 Instituto de Salud Carlos III PI17/01556 Instituto de Salud Carlos III PI22/01773 Instituto de Salud Carlos III PI17/01503 Ministerio de Economía y Competitividad SAF2015-65019-R Instituto de Salud Carlos III CB07708/0012 Ministerio de Ciencia e Innovación CP10/00438 |
| Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. |
| Llengua: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Matèria: | Incretin ; Microbiota ; Type 2 diabetes remission ; Severe obesity ; Bariatric surgery |
| Publicat a: | Frontiers in endocrinology, Vol. 14 (October 2023) , p. 1181744, ISSN 1664-2392 |
12 p, 5.1 MB |