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Bariatric Surgery

Effect of probiotic supplementation on plasma metabolite profile after Roux-Y gastric bypass: a prospective, randomized, double-blind, placebo-controlled clinical trial

International Journal of Obesity volume 46, pages 2006–2012 (2022)Cite this article

Subjects

Abstract

Background/objective

There is evidence that metabolic profile changes after Roux-Y gastric bypass (RYGB), especially due to modifications in the gastrointestinal tract. In addition, previous studies have suggested that probiotics can modify the microbiome and produce metabolites important for metabolic health maintenance. In this sense, the aim of this study was to verify the influence of probiotic supplementation on the plasma metabolite profile after RYGB.

Methods

This was a randomized, double-blind, placebo-controlled clinical trial conducted with 31 patients subjected to RYGB surgery, randomized in probiotic group that was supplemented with a probiotic supplement (FloraVantage®) for 3 months after surgery or a placebo group. Plasma metabonomics was performed using nuclear magnetic resonance (NMR) at the preoperative period (T0) and at 45–50 days (T1) and 90–95 days (T2) during the postoperative period/intervention.

Results

Reductions in trimethylamine-N-oxide (TMAO) and alanine were observed in both groups, however this reduction was greater in the probiotic group (TMAO 13.82%, p = 0.01 and alanine 14.03%, p = 0.03) at T2. Additionally, β-hydroxybutyrate (BHB) levels increased 10.77% in the probiotic group (p = 0.03) compared to the placebo group at T2.

Conclusion

Supplementation with Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 was able to associate with significant differences in relevant plasma metabolites associated with improved metabolic health.

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Fig. 1: First three scores factors from NPLS-DA model showing a clear cluster separation of the placebo (o-red) and probiotic (*-blue) group.
Fig. 2: A representative ¹H NMR spectra (bottom line, red) comparing with the first spectral loading from the NPLS-DA model (top line, black).
Fig. 3: Trajectories of the postprandial states, shown as fold-changes compared to the baseline levels.

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Funding

This research received financial support from the CAPES (Coordination for the Improvement of Higher Education Personnel). CAPES had no influence on the writing, submission, or any other part of research formulation.

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Authors and Affiliations

  1. Department of Clinical Surgery, Federal University of Parana, Curitiba, Brazil

    Marília Rizzon Zaparolli Ramos, Lígia de Oliveira Carlos, Nathalia Ramori Farinha Wagner & Antônio Carlos Ligocki Campos

  2. Department of General Biology, Center of Biological Sciences, State University of Londrina (UEL), Londrina, Brazil

    Ingrid Felicidade, Mário Sérgio Mantovani & Luan Vitor Alves de Lima

  3. School of Medicine, Department of Pathology, São Paulo State University (UNESP), São Paulo, Brazil

    Ingrid Felicidade & Lúcia Regina Ribeiro

  4. Department of Chemistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil

    Thiago Inácio Barros Lopes

  5. Department of Food Science and Technology, Center of Agrarian Sciences, State University of Londrina, Londrina, Brazil

    Fernanda Carla Henrique-Bana

  6. Department of Chemistry, Center of Exact Sciences, State University of Londrina, Londrina, Brazil

    João Vitor Zimmerman & Fernando Cesar Macedo Junior

  7. Department of Nutrition, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil

    Magda Rosa Ramos da Cruz

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Contributions

MRZR, LCO, NRFW, IF, MRRC, and ACLC contributed to the conception and design of the study. MRZR, LCO, NRFW were responsible for data collect. MRZR, IF, FCHB, TIBL, MSM, LRR, JVZ, FCMJ, and ACLC were responsible for the analysis, and/or interpretation and discussion of the data. LVAL was responsible for the graphical abstract. MRZR and FCHB submitted the manuscript. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Ingrid Felicidade.

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Competing interests

The authors declare that they have no conflict of interest. The probiotics were donated by Bariatric Advantage (Aliso Viejo, California, United States) and placebo and glucose by Dermatologica Pharmacy (Curitiba, Paraná, Brazil). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Ethics approval

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Research Ethics Committee of the Pontifical Catholic University of Paraná (PUCPR) (n° 4.252.808) and was registered in the Brazilian Clinical Trials Registry - REBEC (n°RBR-4x3gqp)

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Informed consent was obtained from all subjects involved in the study.

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Ramos, M.R.Z., Felicidade, I., de Oliveira Carlos, L. et al. Effect of probiotic supplementation on plasma metabolite profile after Roux-Y gastric bypass: a prospective, randomized, double-blind, placebo-controlled clinical trial. Int J Obes 46, 2006–2012 (2022). https://doi.org/10.1038/s41366-022-01213-0

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