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Impact of bariatric surgery on type 2 diabetes: contribution of inflammation and gut microbiome?

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Abstract

Obesity is a chronic low-grade inflammatory disease (both at the systemic and adipose tissue level) that continues to rise worldwide. It is associated with an abundance of comorbidities, including type 2 diabetes (T2D). Bariatric surgery, which induces modifications of the intestinal tract, is to date the most successful treatment for obesity. Its use has dramatically increased in number as it enables both weight reduction and metabolic improvements, with 60% of patients even achieving diabetes remission. Several mechanisms are actually demonstrated to be involved in those clinical improvements. Importantly, both obesity and T2D share many phenotypic characteristics, including increased systemic and adipose tissue inflammation, as well as gut microbiota dysbiosis. These characteristics are deeply modulated after bariatric surgery. This review will address the host metabolic changes observed after bariatric surgery, focusing on the induced gut architectural changes, as well as on the modifications of the inflammatory tone and the gut microbiota.

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Acknowledgments

The authors would like to thank Dr Tim Swartz for the careful English-language review of the manuscript, as well as Les Laboratoires Servier for the use of icons provided through the SMART (Servier Medical ART) image collection (https://smart.servier.com/). JAW received grant from Institut Benjamin Delessert and Société Francophone du Diabète (SFD) and KC received an award from the Fondation de France.

Funding

Funding to support NutriOmics research Unit activity on this reviewed topic were obtained from European Union’s Seventh Framework Program (FP7) for research, technological development and demonstration under grant agreement HEALTH-F4-2012-305312 (Metacardis) and from the French national program “Investissement d’Avenir” FORCE, the Metagenopolis grant ANR-11-DPBS-0001 and the ANR-10-IAHU-05, (Institute of Cardiometabolism and Nutrition), from the National Agency of Research ANR-OB MAIT, CAPTOR, and from INSERM (to CA as program “Accueil Jeune Chercheur”).

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  1. Jean Debédat and Chloé Amouyal contributed equally to this work.

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  1. Sorbonne Université, INSERM UMRS, Nutrition and Obesities; Systemic Approaches (NutriOmics), 47-83 Bd de l’hôpital, 75013, Paris, France

    Jean Debédat, Chloé Amouyal, Judith Aron-Wisnewsky & Karine Clément

  2. Assistance Publique Hôpitaux de Paris, Nutrition Departement, CRNH Île-de-France, Pitié-Salpêtrière Hospital, Sorbonne Université, Faculty of Medicine, 47-83 Bd de l’hôpital, 75013, Paris, France

    Judith Aron-Wisnewsky & Karine Clément

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JD and CA contributed to the research, discussion of content, and writing of this manuscript; J.A.W contributed to the research, discussion of content, writing, and editing of this manuscript; and K.C. contributed to the discussion of content, writing, and reviewing/editing of the manuscript before submission. All authors reviewed the manuscript.

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This article is a contribution to the special issue on Inflammation and Type 2 Diabetes - Guest Editor: Marc Y. Donath

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Debédat, J., Amouyal, C., Aron-Wisnewsky, J. et al. Impact of bariatric surgery on type 2 diabetes: contribution of inflammation and gut microbiome?. Semin Immunopathol 41, 461–475 (2019). https://doi.org/10.1007/s00281-019-00738-3

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  • DOI: https://doi.org/10.1007/s00281-019-00738-3

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