| Project/Area Number |
17K16513
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
General surgery
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| Research Institution | Iwate Medical University |
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Principal Investigator |
Baba Shigeaki 岩手医科大学, 医学部, 助教 (90573064)
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| Project Period (FY) |
2017-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2018: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2017: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 肥満外科手術 / 高度肥満症 / 腸内・口腔内細菌叢 / 肥満関連健康障害 / 腹腔鏡下スリーブ状胃切除術 / 腸内細菌叢 / 口腔内細菌叢 / ヘパトカイン / 肥満関連健康障害の変化 / 腸内・口腔内細菌叢の変化 |
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| Outline of Final Research Achievements |
The aim of the present study was to evaluate changes in gut microbiota following laparoscopic sleeve gastrectomy (LSG) for the treatment of severe obesity in Japanese patients. Gut microbiota were analyzed in both the LSG group (12 cases; average BMI: 42.4 kg/m2) and the control group (14 cases; average BMI: 23.4 kg/m2). The mean postoperative excess body weight loss 1 year after LSG procedures were performed on the LSG group was 57%. Prior to the LSG operations, the gut microbiota of LSG patients contained a high proportion of Firmicutes and a low proportion of Bacteroidetes. After the LSG procedures, a decrease in the proportion of Firmicutes and an increase in the proportion of Bacteroidetes were observed in these patients, and their oral microbiota demonstrated the same tendency. Following the LSG procedures, a significant weight loss effect was observed, and the distribution of intestinal flora in LSG patients became the same as that of the control group.
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| Academic Significance and Societal Importance of the Research Achievements |
腹腔鏡下スリーブ状胃切除術(LSG)により、食事制限や運動療法以上の減量効果が得られた。高度肥満症LSG前の腸内細菌叢は、非肥満者とは異なる分布を示していた。LSG後には非肥満者と同様の分布に変化した。また、2型糖尿病を有した10例では、HbA1cとHOMA-IRが低下し、術後3か月で全例が寛解した。そして、腸管バリア機能回復とインスリン抵抗性改善の関与が報告されているAkkermansia muciniphilaが増加していることも確認した。これらの結果から、今後は低侵襲で低コストな治療の提供、国の医療費削減という社会的貢献を兼ね備えた新たな治療に発展させられる可能性がある。
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