Intestinal Energy Harvest Mediates Gut Microbiota-Associated Weight Loss Following Bariatric Surgery

Yunzhi Qian; Alicia A Sorgen; Kristine J Steffen; Leslie J Heinberg; Kylie Reed; Ian M Carroll

doi:10.1007/s11695-024-07467-z

Intestinal Energy Harvest Mediates Gut Microbiota-Associated Weight Loss Following Bariatric Surgery

Obes Surg. 2024 Oct;34(10):3771-3780. doi: 10.1007/s11695-024-07467-z. Epub 2024 Aug 28.

Authors

Yunzhi Qian¹, Alicia A Sorgen², Kristine J Steffen^{3

4}, Leslie J Heinberg⁵, Kylie Reed^{1

6

7}, Ian M Carroll^{8

9}

Affiliations

¹ Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
² Department of Bioinformatics and Genomics, University of North Carolina, Charlotte, NC, 28262, USA.
³ Department of Pharmaceutical Sciences, College of Health Professions, North Dakota State University, Fargo, ND, 58103, USA.
⁴ Sanford Center for Biobehavioral Research, Fargo, ND, 58103, USA.
⁵ Department of Psychiatry and Psychology, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, 44195, USA.
⁶ Department of Molecular Genetics and Microbiology, Duke University, Durham, NC, 27708, USA.
⁷ Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
⁸ Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. ian_carroll@med.unc.edu.
⁹ Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. ian_carroll@med.unc.edu.

PMID: 39196507
DOI: 10.1007/s11695-024-07467-z

Abstract

Purpose: Metabolic and bariatric surgery (MBS) is the most effective treatment for class III obesity. The capacity to efficiently extract intestinal energy is potentially a determinant of varying weight loss outcomes post-MBS. Prior research indicated that intestinal energy harvest is correlated with post-MBS weight loss. Studies have also demonstrated that the gut microbiota is associated with weight loss post-MBS. We aim to investigate whether gut microbiota-associated weight loss is mediated by intestinal energy harvest in patients post-MBS.

Materials and methods: We examined the relationship between specific gut microbiota, intestinal energy harvest, diet, and weight loss using fecal metagenomic sequence data, bomb calorimetry (fecal energy content as a proxy for calorie absorption), and a validated dietary questionnaire on 67 individuals before and after MBS. Mediation analysis and a machine learning algorithm were conducted.

Results: Intestinal energy harvest was a mediator in the relationship between the intestinal microbiota (Bacteroides caccae) and weight loss outcomes in patients post-MBS at 18 months (M). The association between the abundance of B. caccae and post-MBS weight loss rate at 18 M was partly mediated by 1 M intestinal energy harvest (β = 0.001 ± 0.001, P = 0.020). This mediation represents 2.83% of the total effect (β = 0.050 ± 0.047; P = 0.028). Intestinal microbiota and energy harvest improved random forest model's accuracy in predicting weight loss results.

Conclusion: Energy harvest partly mediates the relationship between the intestinal microbiota and weight loss outcomes among patients post-MBS. This study elucidates a potential mechanism regarding how intestinal energy absorption facilitates the effect of intestinal microbiota on energy metabolism and weight loss outcomes.

Keywords: Bariatric surgery; Gut microbiota; Intestinal energy harvest; Mediation analysis; Weight loss.

MeSH terms

Adult
Bariatric Surgery*
Energy Metabolism
Feces / microbiology
Female
Gastrointestinal Microbiome* / physiology
Humans
Male
Middle Aged
Obesity, Morbid* / microbiology
Obesity, Morbid* / surgery
Weight Loss* / physiology

Grants and funding

1R01DK112585-01/National Institute of Health