Khushbu Agarwal1,2, Katherine A Maki3, Carlotta Vizioli1,2, Susan Carnell4, Ethan Goodman4, Matthew Hurley4, Civonnia Harris5, Rita Colwell6,7,8, Kimberley Steele5,9, Paule V Joseph1,2. 1. National Institute on Alcohol Abuse and Alcoholism, 2511National Institutes of Health, Bethesda, MD, USA. 2. National Institute of Nursing Research, 2511National Institutes of Health, Bethesda, MD, USA. 3. Translational Biobehavioral and Health Disparities Branch, Clinical Center, 2511National Institutes of Health, Bethesda, MD, USA. 4. Department of Psychiatry and Behavioral Sciences, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. Department of Surgery, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA. 6. CosmosID Inc., Rockville, MD, USA. 7. Center for Bioinformatics and Computational Biology, 271755University of Maryland Institute for Advanced Computer Studies, University of Maryland, College Park, MD, USA. 8. Bloomberg School of Public Health, 1466Johns Hopkins University, Baltimore, MD, USA. 9. Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
BACKGROUND: Plausible phenotype mechanisms following bariatric surgery include changes in neural and gastrointestinal physiology. This pilot study aims to investigate individual and combined neurologic, gut microbiome, and plasma hormone changes pre- versus post-vertical sleeve gastrectomy (VSG), Roux-en-Y gastric bypass (RYGB), and medical weight loss (MWL). We hypothesized post-weight loss phenotype would be associated with changes in central reward system brain connectivity, differences in postprandial gut hormone responses, and increased gut microbiome diversity. METHODS: Subjects included participants undergoing VSG, n = 7; RYGB, n = 9; and MWL, n = 6. Ghrelin, glucagon-like peptide-1, peptide-YY, gut microbiome, and resting state functional magnetic resonance imaging (rsfMRI; using fractional amplitude of low-frequency fluctuations [fALFF]) were measured pre- and post-intervention in fasting and fed states. We explored phenotype characterization using clustering on gut hormone, microbiome, and rsfMRI datasets and a combined analysis. RESULTS: We observed more widespread fALFF differences post-bariatric surgery versus post-MWL. Decreased post-prandial fALFF was seen in food reward regions post-RYGB. The highest number of microbial taxa that increased post-intervention occurred in the RYGB group, followed by VSG and MWL. The combined hormone, microbiome, and MRI dataset most accurately clustered samples into pre- versus post-VSG phenotypes followed by RYGB subjects. CONCLUSION: The data suggest surgical weight loss (VSG and RYGB) has a bigger impact on brain and gut function versus MWL and leads to lesser post-prandial activation of food-related neural circuits. VSG subjects had the greatest phenotype differences in interactions of microbiome, rsfMRI, and gut hormone features, followed by RYGB and MWL. These results will inform future prospective research studying gut-brain changes post-bariatric surgery.
BACKGROUND: Plausible phenotype mechanisms following bariatric surgery include changes in neural and gastrointestinal physiology. This pilot study aims to investigate individual and combined neurologic, gut microbiome, and plasma hormone changes pre- versus post-vertical sleeve gastrectomy (VSG), Roux-en-Y gastric bypass (RYGB), and medical weight loss (MWL). We hypothesized post-weight loss phenotype would be associated with changes in central reward system brain connectivity, differences in postprandial gut hormone responses, and increased gut microbiome diversity. METHODS: Subjects included participants undergoing VSG, n = 7; RYGB, n = 9; and MWL, n = 6. Ghrelin, glucagon-like peptide-1, peptide-YY, gut microbiome, and resting state functional magnetic resonance imaging (rsfMRI; using fractional amplitude of low-frequency fluctuations [fALFF]) were measured pre- and post-intervention in fasting and fed states. We explored phenotype characterization using clustering on gut hormone, microbiome, and rsfMRI datasets and a combined analysis. RESULTS: We observed more widespread fALFF differences post-bariatric surgery versus post-MWL. Decreased post-prandial fALFF was seen in food reward regions post-RYGB. The highest number of microbial taxa that increased post-intervention occurred in the RYGB group, followed by VSG and MWL. The combined hormone, microbiome, and MRI dataset most accurately clustered samples into pre- versus post-VSG phenotypes followed by RYGB subjects. CONCLUSION: The data suggest surgical weight loss (VSG and RYGB) has a bigger impact on brain and gut function versus MWL and leads to lesser post-prandial activation of food-related neural circuits. VSG subjects had the greatest phenotype differences in interactions of microbiome, rsfMRI, and gut hormone features, followed by RYGB and MWL. These results will inform future prospective research studying gut-brain changes post-bariatric surgery.
Entities:
Keywords:
Roux-en-Y gastric bypass; bariatric surgery; cognition; gut hormones; gut microbiome; obesity; resting state functional magnetic resonance imaging; vertical sleeve gastrectomy
Authors: C Glicksman; D J Pournaras; M Wright; R Roberts; D Mahon; R Welbourn; R Sherwood; J Alaghband-Zadeh; C W le Roux Journal: Ann Clin Biochem Date: 2010-07-01 Impact factor: 2.057
Authors: Minke H C Nota; Debby Vreeken; Maximilian Wiesmann; Edo O Aarts; Eric J Hazebroek; Amanda J Kiliaan Journal: Neurosci Biobehav Rev Date: 2019-11-30 Impact factor: 8.989
Authors: Genevieve B Melton; Kimberley E Steele; Michael A Schweitzer; Anne O Lidor; Thomas H Magnuson Journal: J Gastrointest Surg Date: 2007-12-11 Impact factor: 3.452
Authors: Volodymyr B Bogdanov; Olena V Bogdanova; Sandra Dexpert; Ines Delgado; Helen Beyer; Agnès Aubert; Bixente Dilharreguy; Cédric Beau; Damien Forestier; Patrick Ledaguenel; Eric Magne; Bruno Aouizerate; Sophie Layé; Guillaume Ferreira; Jennifer Felger; Giuseppe Pagnoni; Lucile Capuron Journal: Psychoneuroendocrinology Date: 2019-11-20 Impact factor: 4.905
Authors: Rebecca J Lepping; Amanda S Bruce; Alex Francisco; Hung-Wen Yeh; Laura E Martin; Joshua N Powell; Laura Hancock; Trisha M Patrician; Florence J Breslin; Niazy Selim; Joseph E Donnelly; William M Brooks; Cary R Savage; W Kyle Simmons; Jared M Bruce Journal: Obesity (Silver Spring) Date: 2015-06-05 Impact factor: 5.002