Endocrinol Metab.  2022 Jun;37(3):475-486. 10.3803/EnM.2022.1481.

Association between the Blautia/Bacteroides Ratio and Altered Body Mass Index after Bariatric Surgery

• Kim Y
• Son D
• Kim BK
• Kim KH
• Seo KW
• Jung K
• Park SJ
• Lim S
• Kim JH

• KMID: 2531391
• DOI: http://doi.org/10.3803/EnM.2022.1481

Abstract

Background
Current evidence support that the gut microbiota plays a potential role in obesity. Bariatric surgery can reduce excess weight and decrease the risk of life-threatening weight-related health problems and may also influence gut microbiota. In this study, we aimed to investigate the changes in gut microbiota before and after bariatric surgery and evaluate the association of the gut microbial shift and altered body mass index (BMI) after bariatric surgery.
Methods
Between January 2019 and July 2020, stools from 58 patients scheduled for bariatric surgery were collected. Six months after bariatric surgery, stools from 22 of these patients were re-collected, and the changes in gut microbiota before and after bariatric surgery were evaluated. In addition, the differences in gut microbiota between patients with severe obesity (BMI >35 kg/m², n=42) and healthy volunteers with normal BMI (18.8 to 22.8 kg/m², n=41) were investigated.
Results
The gut microbiota of patients who underwent bariatric surgery showed increased α-diversity and differed β-diversity compared with those before surgery. Interestingly, Blautia was decreased and Bacteriodes was increased at the genus level after bariatric surgery. Further, the Blautia/Bacteroides ratio showed a positive correlation with BMI. To validate these results, we compared the gut microbiota from severely obese patients with high BMI with those from healthy volunteers and demonstrated that the Blautia/Bacteroides ratio correlated positively with BMI.
Conclusion
In the gut microbial analysis of patients who underwent bariatric surgery, we presented that the Blautia/Bacteroides ratio had changed after bariatric surgery and showed a positive correlation with BMI.

Keyword

Obesity; Bariatric surgery; Gastrointestinal microbiome

Figure

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  Fig. 1. Changes of body profiles and gut microbiota after bariatric surgery. (A) Individual changes of body weight and (left panel) body mass index (BMI; right panel) after bariatric surgery. (B) Comparison of alpha diversity (left panel) and beta diversity (right panel) before and after bariatric surgery. (C) Alteration of taxonomy composition after bariatric surgery at the phylum level (left panel) and genus level (right panel). OTU, operational taxonomic unit; PCoA, principal coordinates analysis. aP<0.05.

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  Fig. 2. Prominent gut microbiota at the genus level before and after bariatric surgery and correlation with body mass index (BMI). (A) Linear discriminant analysis (LDA) effect size before and after bariatric surgery (threshold 2.4). (B) Correlation between Blautia and BMI. (C) Correlation between Bacteroides and BMI. (D) Correlation between the log value of Blautia/Bacteroides and BMI.

• 

  Fig. 3. Comparison of altered gut microbiota after bariatric surgery according to the surgery type. (A) Comparison of alpha diversity (left panel) and beta diversity (right panel) according to surgery type before and after bariatric surgery. (B) Linear discriminant analysis (LDA) effect size before and after laparoscopic sleeve gastrectomy (LSG; left panel). LDA effect size before and after laparoscopic Roux-en-Y gastric bypass (LRYGB; right panel). (C) Correlation between the log value of Blautia/Bacteroides and body mass index (BMI) in both two surgery types. OTU, operational taxonomic unit; PCoA, principal coordinates analysis. aP<0.5.

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  Fig. 4. Comparison of gut microbiota between severely obese patients and healthy controls. (A) Comparison of alpha diversity (left panel) and beta diversity (right panel) between severely obese patients and healthy controls. (B) Comparison of taxonomy composition at the phylum level (left panel) and genus level (right panel) between severely obese patients and healthy controls. OTU, operational taxonomic unit; PCoA, principal coordinates analysis.

• 

  Fig. 5. Prominent gut microbiota between severe obese patients and healthy controls and correlation with body mass index (BMI). (A) Linear discriminant analysis (LDA) effect size between severely obese patients and healthy controls (left panel). Cladogram analysis between severely obese patients and healthy controls (right panel). (B) Correlation between Blautia and BMI. (C) Correlation between Bacteroides and BMI. (D) Correlation between the log value of Blautia/Bacteroides and BMI.

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