@article{fdi:010081460,
  title = {{G}ut microbiota changes after metabolic surgery in adult diabetic patients with mild obesity : a randomised controlled trial},
  author = {{L}au, {E}. and {B}elda, {E}. and {P}icq, {P}. and {C}arvalho, {D}. and {F}erreira-{M}agalhaes, {M}. and {S}ilva, {M}. {M}. and {B}arroso, {I}. and {C}orreia, {F}. and {V}az, {C}. {P}. and {M}iranda, {I}. and {B}arbosa, {A}. and {C}lement, {K}. and {D}ore, {J}. and {F}reitas, {P}. and {P}rifti, {E}di},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {R}oux-en-{Y} gastric bypass ({RYGB}) surgery is one of the most efficient procedures for the treatment of obesity, also improving metabolic and inflammatory status, in patients with mild obesity. {T}he underlying mechanisms have not been fully understood, but gut microbiota is hypothesized to play a key role. {O}ur aim was to evaluate the association between gut microbiota changes and anthropometric, metabolic and inflammatory profiles after metabolic surgery compared with medical therapy, in type 2 diabetic ({T}2{DM}) adults with mild obesity ({BMI} 30-35 kg/m(2)). {M}ethods {DM}2 was an open-label, randomised controlled clinical trial ({RCT}: {ISRCTN}53984585) with 2 arms: (i) surgical, and (ii) medical. {T}he main outcome was gut microbiota changes after: metabolic surgery ({R}oux-en-{Y} gastric bypass-{RYGB}) versus standard medical therapy. {S}econdary outcomes included anthropometric, metabolic and inflammatory profiles. {C}linical visits, blood workup, and stool samples were collected at baseline and months ({M})1, 3, 6, 12. {G}ut microbiota was profiled using 16{S} r{RNA} targeted sequencing. {R}esults {T}wenty patients were included: 10 in surgical and 10 in medical arm. {A}nthropometric and metabolic comparative analysis favoured {RYGB} over medical arm. {A}t {M}12, the percentage of weight loss was 25.5 vs. 4.9% (p < 0.001) and {H}b{A}1c was 6.2 vs. 7.7% (p < 0.001) respectively. {W}e observed a continuous increase of genus richness after {RYGB} up until {M}12. {I}n the medical arm, genus richness ended-up being significantly lower at {M}12. {C}omposition analysis indicated significant changes of the overall microbial ecosystem (permanova p = 0.004, [{R}-2 = 0.17]) during the follow-up period after {RYGB}. {T}here was a strong association between improvement of anthropometric/metabolic/inflammatory biomarkers and increase in microbial richness and {P}roteobacterial lineages. {C}onclusions {T}his was the first {RCT} studying composite clinical, analytic, and microbiome changes in {T}2{DM} patients with class 1 obesity after {RYGB} versus standard medical therapy. {T}he remarkable phenotypic improvement after surgery occurred concomitantly with changes in the gut microbiome, but at a lower level. {T}rial registration: {ISRCTN}53984585},
  keywords = {{D}iabetes mellitus ; {I}nsulin resistance ; {M}icrobiome ; {R}oux-en-{Y} gastric bypass ; {W}eight loss},
  booktitle = {},
  journal = {{D}iabetology and {M}etabolic {S}yndrome},
  volume = {13},
  numero = {1},
  pages = {56 [15 p.]},
  year = {2021},
  DOI = {10.1186/s13098-021-00672-1},
  URL = {https://www.documentation.ird.fr/hor/fdi:010081460},
}