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Role of Gut Microbiome and Microbial Metabolites in Alleviating Insulin Resistance After Bariatric Surgery

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Abstract

Insulin resistance (IR) is the most common pathophysiological change in patients with type 2 diabetes mellitus (T2DM). Several recent studies have suggested that the gut microbiome and microbial metabolites are involved in the pathogenesis of IR. Bariatric surgery, as an effective treatment for T2DM, can markedly alleviate IR through mechanisms that have not been elucidated. In this review, we summarize the current evidence on the changes in the gut microbiome and microbial metabolites (including lipopolysaccharide, short-chain fatty acids, branched-chain amino acids, aromatic amino acids, bile acids, methylamines, and indole derivatives) after bariatric surgery. Additionally, we discuss the mechanisms that correlate the changes in microbial metabolites with the postoperative alleviation of IR. Furthermore, we discuss the prospect of bariatric surgery as a treatment for T2DM.

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Abbreviations

IR:

Insulin resistance

T2DM:

Type 2 diabetes mellitus

GB:

Gastric banding

RYGB:

Roux-en-Y gastric bypass

SG:

Sleeve gastrectomy

LPS:

Lipopolysaccharide

SCFAs:

Short-chain fatty acids

BCAAs:

Branched-chain amino acids

AAAs:

Aromatic amino acids

TMAO:

Trimethylamine N-oxide

IPA:

Indole propionic acid

BAs:

Bile acids

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Funding

The work was supported by the National Natural Science Foundation of China (grant number 81970524 and 81702363); the Natural Science Foundation of Shandong Province (grant number ZR2019BH010); the Key Research and Development Program of Shandong Province (grant number 2019GSF108243 and 2019GSF108161); the Science and Technology Development Program of Jinan (grant number 201907068); and the China Postdoctoral Science Foundation (grant number 2020M672102).

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  1. Mingfei Wang, Leping Li and Yuezhi Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China

    Mingfei Wang, Leping Li, Yuezhi Chen, Guodong Lian, Jinshen Wang, Jizhun Zhang, Keshu Shan, Liang Shang, Feng Tian & Changqing Jing

  2. Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China

    Leping Li, Yuezhi Chen, Guodong Lian, Jinshen Wang, Jizhun Zhang, Keshu Shan, Liang Shang, Feng Tian & Changqing Jing

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  1. Mingfei Wang
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Wang, M., Li, L., Chen, Y. et al. Role of Gut Microbiome and Microbial Metabolites in Alleviating Insulin Resistance After Bariatric Surgery. OBES SURG 31, 327–336 (2021). https://doi.org/10.1007/s11695-020-04974-7

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