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

Jean Debédat (1) , Chloé Amouyal (1) , Karine Clement (2, 3, 1) , Judith Aron-Wisnewsky (2, 3, 1)

1 Nutriomics - Nutrition et obésités: approches systémiques (UMR-S 1269)
2 CHU Pitié-Salpêtrière [AP-HP]
3 Centre de Recherche en Nutrition Humaine - Ile de France (CRNH - IDF)

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.

Mots clés: Microbiome; Inflammation; Gut microbiota; Type 2 diabetes; Obesity; Bariatric surgery

Domaines: Endocrinologie et métabolisme; Chirurgie

Jean Debédat, Chloé Amouyal, Karine Clement, Judith Aron-Wisnewsky. Impact of bariatric surgery on type 2 diabetes: contribution of inflammation and gut microbiome?. Seminars in Immunopathology, 2019, 41 (4), pp.461-475. ⟨10.1007/s00281-019-00738-3⟩. ⟨hal-02291846⟩