Differential Adaptation of Human Gut Microbiota to Bariatric Surgery–Induced Weight Loss

Links With Metabolic and Low-Grade Inflammation Markers

  1. Karine Clément2,3
  1. 1French National Institute for Agricultural Research, U910, Unité d'Ecologie et de Physiologie du Système Digestif, Jouy-en-Josas, France;
  2. 2Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Département de Nutrition et d'Endocrinologie, Paris, France, and the Centre de Recherche Nutrition Humaine, Ile de France, Paris, France;
  3. 3INSERM, U872, équipe 7 Nutriomique, Paris, France, and the Université Pierre et Marie Curie-Paris, Centre de Recherche des Cordeliers, UMR S 872, Paris, France; and the
  4. 4Assistance Publique Hôpitaux de Paris, Département de Chirurgie, Hôpital Hôtel-Dieu, Paris, France.
  1. Corresponding author: Karine Clément, karine.clement{at}psl.aphp.fr.
  1. J.-P.F. and L.-C.K. contributed equally to this work.


OBJECTIVE Obesity alters gut microbiota ecology and associates with low-grade inflammation in humans. Roux-en-Y gastric bypass (RYGB) surgery is one of the most efficient procedures for the treatment of morbid obesity resulting in drastic weight loss and improvement of metabolic and inflammatory status. We analyzed the impact of RYGB on the modifications of gut microbiota and examined links with adaptations associated with this procedure.

RESEARCH DESIGN AND METHODS Gut microbiota was profiled from fecal samples by real-time quantitative PCR in 13 lean control subjects and in 30 obese individuals (with seven type 2 diabetics) explored before (M0), 3 months (M3), and 6 months (M6) after RYGB.

RESULTS Four major findings are highlighted: 1) Bacteroides/Prevotella group was lower in obese subjects than in control subjects at M0 and increased at M3. It was negatively correlated with corpulence, but the correlation depended highly on caloric intake; 2) Escherichia coli species increased at M3 and inversely correlated with fat mass and leptin levels independently of changes in food intake; 3) lactic acid bacteria including Lactobacillus/Leuconostoc/Pediococcus group and Bifidobacterium genus decreased at M3; and 4) Faecalibacterium prausnitzii species was lower in subjects with diabetes and associated negatively with inflammatory markers at M0 and throughout the follow-up after surgery independently of changes in food intake.

CONCLUSIONS These results suggest that components of the dominant gut microbiota rapidly adapt in a starvation-like situation induced by RYGB while the F. prausnitzii species is directly linked to the reduction in low-grade inflammation state in obesity and diabetes independently of calorie intake.


  • Clinical trial reg. no. NCT0047658, www.clinicaltrials.gov.

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

  • Received February 22, 2010.
  • Accepted August 21, 2010.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

| Table of Contents

This Article

  1. Diabetes vol. 59 no. 12 3049-3057
  1. Online Appendix
  2. All Versions of this Article:
    1. db10-0253v1
    2. 59/12/3049 most recent