Reversal of Functional Brain Activity Related to Gut Microbiome and Hormones After VSG Surgery in Patients With Obesity.
Reversal of Functional Brain Activity Related to Gut Microbiome and Hormones After VSG Surgery in Patients With Obesity.
复制标题
肥胖患者 VSG 手术后与肠道微生物组和激素相关的大脑功能活动的逆转
DOI：
10.1210/clinem/dgab297
复制
发表时间：
2021-08-18
期刊：
影响因子：
--
通讯作者：
Ning G
中科院分区：
文献类型：
--
作者：
Hong J;Bo T;Xi L;Xu X;He N;Zhan Y;Li W;Liang P;Chen Y;Shi J;Li D;Yan F;Gu W;Wang W;Liu R;Wang J;Wang Z;Ning G
垂直袖状胃切除术（VSG）正在成为肥胖个体的优先手术干预;然而，介导其有效控制食物摄入和预测手术结果的脑回路在很大程度上仍不清楚。目的探讨血管平滑肌细胞（VSG）相关的肠-脑轴改变。方法对80例肥胖患者进行观察性队列研究。共36例患者和26例正常体重受试者入选，并使用21项三因素饮食问卷（TFEQ）、MRI扫描、血浆肠激素分析和粪便样本测序进行评估。32例患者接受了VSG治疗，19例受试者完成了平均4个月的随访评价。数据驱动的区域同质性（ReHo）加上基于种子的连接分析被用来量化VSG相关的大脑活动。检测体重、进食行为、大脑活动、胃肠激素和肠道菌群的纵向变化，并进行重复测量相关性分析。结果VSG可引起右侧壳核（PUT.R）和左侧辅助运动区的功能改变，且与体重减轻和TFEQ评分相关。此外，餐后活性胰高血糖素样肽-1（aGLP-1）和Ghrelin水平与PUT.R的ReHo相关;同时，VSG增加的梭菌相对丰度与aGLP-1分泌、PUT.R活性和体重减轻的改善相关。重要的是，VSG使与PUT.R的过度功能连接正常化，其中PUT.R与右眶额皮质之间的基线连接与术后体重减轻相关。结论VSG可引起肠-脑轴相关改变，包括梭菌、餐后aGLP-1、PUT.R活性及饮食习惯的改变。术前PUT.R的连接可能是肥胖患者手术结果的潜在预测指标。
Abstract Context Vertical sleeve gastrectomy (VSG) is becoming a prioritized surgical intervention for obese individuals; however, the brain circuits that mediate its effective control of food intake and predict surgical outcome remain largely unclear. Objective We investigated VSG-correlated alterations of the gut-brain axis. Methods In this observational cohort study, 80 patients with obesity were screened. A total of 36 patients together with 26 normal-weight subjects were enrolled and evaluated using the 21-item Three-Factor Eating Questionnaire (TFEQ), MRI scanning, plasma intestinal hormone analysis, and fecal sample sequencing. Thirty-two patients underwent VSG treatment and 19 subjects completed an average of 4-month follow-up evaluation. Data-driven regional homogeneity (ReHo) coupled with seed-based connectivity analysis were used to quantify VSG-related brain activity. Longitudinal alterations of body weight, eating behavior, brain activity, gastrointestinal hormones, and gut microbiota were detected and subjected to repeated measures correlation analysis. Results VSG induced significant functional changes in the right putamen (PUT.R) and left supplementary motor area, both of which correlated with weight loss and TFEQ scores. Moreover, postprandial levels of active glucagon-like peptide-1 (aGLP-1) and Ghrelin were associated with ReHo of PUT.R; meanwhile, relative abundance of Clostridia increased by VSG was associated with improvements in aGLP-1 secretion, PUT.R activity, and weight loss. Importantly, VSG normalized excessive functional connectivities with PUT.R, among which baseline connectivity between PUT.R and right orbitofrontal cortex was related to postoperative weight loss. Conclusion VSG causes correlated alterations of gut-brain axis, including Clostridia, postprandial aGLP-1, PUT.R activity, and eating habits. Preoperative connectivity of PUT.R may represent a potential predictive marker of surgical outcome in patients with obesity.
登录
查看更多内容
DOI：
10.1002/oby.21464
发表时间：
2016-05
期刊：
Obesity (Silver Spring, Md.)
影响因子：
--
作者：
Faulconbridge LF;Ruparel K;Loughead J;Allison KC;Hesson LA;Fabricatore AN;Rochette A;Ritter S;Hopson RD;Sarwer DB;Williams NN;Geliebter A;Gur RC;Wadden TA
通讯作者：
Wadden TA
影响因子：
7
作者：
Blaut, Michael
通讯作者：
Blaut, Michael
影响因子：
64.5
作者：
Gautron L;Elmquist JK;Williams KW
通讯作者：
Williams KW
影响因子：
3.8
作者：
Bakdash JZ;Marusich LR
通讯作者：
Marusich LR
影响因子：
7.1
作者：
Kong, Ling-Chun;Tap, Julien;Clement, Karine
通讯作者：
Clement, Karine