Bariatric/Metabolic Surgery Induces Noticeable Changes of Microbiota and Their Secreting Extracellular Vesicle Composition in the Gut

  • Yeon-Ju Huh
  • Joo-Young Seo
  • Jieun Nam
  • Jinho Yang
  • Andrea McDowell
  • Yoon-Keun Kim
  • Joo-Ho LeeEmail author
Original Contributions



Microbial ecology is reported to be an important regulator of energy homeostasis and glucose metabolism. Microbes secrete extracellular vesicles (EVs) during their proliferation and death to communicate with other cells. To investigate the roles of gut microbiota in glucose metabolism, we analyzed serial changes of gut microbe and microbial EV composition before and after bariatric/metabolic surgery (BMS).


Twenty-eight Wistar rats were fed on high-fat diet (HFD) to induce obesity and diabetes. Five of them compared with 5 rats fed on regular chow diet (RCD). Among the remaining 23 rats, Roux-en-Y gastric bypass (RYGB) (n = 10), sleeve gastrectomy (SG) (n = 10), or sham operation (n = 3) was randomly performed. Gut microbiota and EVs from fecal samples were analyzed by 16S rDNA amplicon sequencing.


The present study showed that microbial diversity was decreased in HFD-fed rats versus RCD-fed rats. In addition, BMS reversed glucose intolerance and microbial richness which were induced by HFD. In terms of microbiota and microbial EV composition, both RYGB and SG enhance the composition of phyla Proteobacteria, Verrucomicrobia, and their secreting EVs, but decrease phylum Firmicutes and its EVs. We tried to demonstrate specific genera showed a significant compositional difference in obesity/diabetes-induced rats compared with normal rats and then restored similarly toward normal rats’ level after BMS. At the genus level, Lactococcus, Ruminococcus, Dorea in Firmicutes(p), Psychrobacter in Proteobacteria(p), and Akkermansia in Verrucomicrobia(p) fit these conditions after BMS.


We suggest that these genera are the candidates contributing to obesity and diabetes improvement mechanism after BMS.


Gut microbiota Extracellular vesicle Obesity Diabetes Bariatric/metabolic surgery 



This study was presented at the 22nd World Congress of international federation for the surgery of Obesity and Metabolic Disorders (IFSO 2017).


This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2016R1D1A1B03932360).

Compliance with Ethical Standards

The study protocol was reviewed and approved by the Institutional Animal Care and Use Committee of Ewha Womans University Mokdong Hospital (IACUC approval no. 15-0292).

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The research followed all applicable institutional and/or national guidelines for the care and use of animals.

Supplementary material

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Fig. S1

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High resolution image (TIFF 40.9 mb)
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Table S1 (DOCX 14.7 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.LHK Bariatric and Metabolic ClinicSeoulRepublic of Korea
  2. 2.Department of SurgeryEwha Womans University College of MedicineSeoulRepublic of Korea
  3. 3.Department of MicrobiologyEwha Womans University College of MedicineSeoulRepublic of Korea
  4. 4.Institute of MD Healthcare Inc.SeoulRepublic of Korea

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