AbstractBackgroundObesity and diabetes mellitus (DM) have become public health concerns worldwide. Both conditions have severe consequences and are associated with significant medical costs and productivity loss. Additionally, Helicobacter pylori infection may be a risk factor for the development of these conditions.

摘要背景肥胖和糖尿病（DM）已成为全球公共卫生问题。这两种情况都会产生严重后果，并伴随着巨大的医疗费用和生产力损失。此外，幽门螺杆菌感染可能是这些疾病发展的危险因素。

However, whether eradicating H. pylori infection directly causes weight loss or improves insulin sensitivity is unknown.MethodsIn this study, we confirmed the effect of sleeve gastrectomy according to the state of the gastric microbiota in 40 patients with obesity, DM, and H. pylori infection. Patients with obesity were divided into four groups: non-DM without H.

然而，根除幽门螺杆菌感染是否直接导致体重减轻或改善胰岛素敏感性尚不清楚。方法在本研究中，我们根据40例肥胖，DM和幽门螺杆菌感染患者的胃微生物群状态证实了袖状胃切除术的效果。肥胖患者分为四组：无H的非DM。

pylori infection (ND), non-DM with H. pylori infection (ND-HP), DM, and DM with H. pylori infection (DM-HP) using 16S V3–V4 sequencing.ResultsIn the DM group, ALT, hemoglobin, HbA1c, blood glucose, and HSI significantly decreased, whereas high-density lipoprotein significantly increased. However, in the H.

使用16S V3-V4测序，幽门螺杆菌感染（ND），非DM伴幽门螺杆菌感染（ND-HP），DM和DM伴幽门螺杆菌感染（DM-HP）。结果DM组ALT、血红蛋白、HbA1c、血糖、HSI显著降低，高密度脂蛋白显著升高。然而，在H。

pylori-positive group, no significant difference was observed. The diversity of gastric microbiota decreased in the order of the ND > DM > ND-HP > DM-HP groups. We also conducted a correlation analysis between the preoperative microbes and clinical data. In the ND-HP group, most of the top 20 gastric microbiota were negatively correlated with glucose metabolism.

幽门螺杆菌阳性组，无显著性差异。胃微生物群的多样性按ND>，DM>，ND-HP>，DM-HP组的顺序下降。我们还对术前微生物与临床数据进行了相关性分析。在ND-HP组中，前20名胃微生物群中的大多数与葡萄糖代谢呈负相关。

However, H. pylori infection was positively correlated with pre-insulin levels.ConclusionTherefore, these findings indicate that patients with obesity and diabetes clearly benefit from surgery, but H. pylori infection may also affect clinical improvement..

然而，幽门螺杆菌感染与胰岛素前水平呈正相关。结论因此，这些发现表明肥胖和糖尿病患者明显受益于手术，但幽门螺杆菌感染也可能影响临床改善。。

IntroductionOver the past few decades, the prevalence of individuals with overweight and obesity has increased worldwide. Particularly, the incidence of obesity has doubled in over 70 countries since 1980, increasing the risk of several non-communicable diseases [1]. Although the exact causes of diabetes are not fully understood, several factors increase the risk of developing different types of diabetes mellitus (DM) [2].

引言在过去的几十年中，全球超重和肥胖人群的患病率有所增加。特别是，自1980年以来，70多个国家的肥胖发病率翻了一番，增加了几种非传染性疾病的风险（1）。虽然糖尿病的确切原因尚不完全清楚，但有几个因素会增加患不同类型糖尿病（DM）的风险。

For type 2 diabetes, these factors include being overweight or obese (having a body mass index [BMI] of ≥30). Obesity accounts for 80–85% of the risk of developing type 2 diabetes [3]. Both conditions have severe consequences and cause significant healthcare burdens and productivity losses [4]. Notably, obesity and DM have become global public health concerns.Helicobacter pylori (HP) infection can cause gastric and duodenal ulcers, chronic gastritis, gastric cancer, gastric lymphoma, nervous system diseases, and rheumatic diseases [5].

对于2型糖尿病，这些因素包括超重或肥胖（体重指数（BMI）≥30）。肥胖占患2型糖尿病风险的80-85%[3]。。值得注意的是，肥胖和糖尿病已成为全球公共卫生问题。幽门螺杆菌（HP）感染可引起胃和十二指肠溃疡、慢性胃炎、胃癌、胃淋巴瘤、神经系统疾病和风湿性疾病。

This infection is more common in individuals with obesity, suggesting that obesity may be a risk factor [6,7,8,9]. Additionally, HP increases the risk of developing diabetes [10, 11]. Eradicating the infection may improve insulin sensitivity, thereby reducing the risk of diabetes in affected individuals [12,13,14,15].

这种感染在肥胖患者中更为常见，这表明肥胖可能是一个危险因素[6,7,8,9]。此外，HP增加了患糖尿病的风险[10，11]。根除感染可能会提高胰岛素敏感性，从而降低受影响个体患糖尿病的风险[12、13、14、15]。

However, it remains unclear whether eradication directly causes weight loss or improves insulin sensitivity. Treating obesity and DM often involves a combination of lifestyle changes, medication, and, in some cases, insulin therapy [16]. Bariatric surgery is the most effective treatment for severe obesity [17].

然而，目前尚不清楚根除是否直接导致体重减轻或改善胰岛素敏感性。。减肥手术是治疗严重肥胖最有效的方法（17）。

Bariatric surgery is generally recommended for people with a BMI of ≥40 or ≥35 with obesity-related health conditions, such as type 2 diabetes. Sleeve gastrectomy is widely used to treat obesity, es.

对于体重指数≥40或≥35且患有肥胖相关健康状况（如2型糖尿病）的人，通常建议进行减肥手术。袖状胃切除术被广泛用于治疗肥胖，es。

Figure 3 (Fig. S2 and Table S6) shows the results of the network analysis, involving BNC and CC. The plot indicates that in the ND group, Lachnospiraceae-NK4A136-group (0.056) and Lactobacillus (0.051) had high BNC values, whereas Porphyromonas (1), Prevotella (0.86), and Lachnoclostridium (0.809) had high CC values (Fig.

图3（图S2和表S6）显示了涉及BNC和CC的网络分析结果。该图表明，在ND组中，Lachnospiraceae-NK4A136组（0.056）和乳酸杆菌（0.051）具有高BNC值，而卟啉单胞菌（1），普雷沃氏菌（0.86）和Lachnoclostridium（0.809）具有高CC值（图）。

3A). In the ND-HP group, Helicobacter (0.011) and Streptococcus (0.011) showed high BNC values. Staphylococcus (0.90) had a high CC value, whereas Lactobacillus (0.80) had a low CC value (Fig. 3B). In the DM group, Cutibacterium (0.052) had the highest BNC value, and Lachnoanaerobaculum (0.73) had the highest CC value (Fig.

3A）。在ND-HP组中，螺杆菌（0.011）和链球菌（0.011）显示出高BNC值。葡萄球菌（0.90）具有高CC值，而乳酸杆菌（0.80）具有低CC值（图3B）。在DM组中，角质层（0.052）具有最高的BNC值，而Lachnoanaerobaculum（0.73）具有最高的CC值（图）。

3C). In the DM-HP group, Helicobacter (0.051) had the highest BNC value, and Romboutsia (0.001) had the lowest BNC value. Acinetobacter (0.73) had the highest CC value, and Leptotrichia (0.461) had the lowest (Fig. 3D). In the ND-HP group, the CC value was much higher than 0.40 (horizontal red dotted line: arbitrary boundary line) compared to that of other groups.

3C）。在DM-HP组中，螺杆菌（0.051）的BNC值最高，Romboutsia（0.001）的BNC值最低。不动杆菌（0.73）的CC值最高，而Leptotrichia（0.461）的CC值最低（图3D）。在ND-HP组中，与其他组相比，CC值远高于0.40（水平红色虚线：任意边界线）。

Therefore, the connectivity between nodes is higher in the ND-HP group than in other groups. These results suggest that the presence of Helicobacter is associated with a higher CC and greater co-occurrence among bacterial genera in gastric microbiota.Fig. 3: Co-occurrence analysis between the gastric microbiome before sleeve gastrectomy in each group.The y-axis indicates betweenness centrality (BNC), and the x-axis indicates the clustering coefficient (CC).

因此，ND-HP组中节点之间的连通性高于其他组。这些结果表明，螺杆菌的存在与胃微生物群中细菌属之间更高的CC和更大的共现有关。图3：每组袖状胃切除术前胃微生物组之间的共现分析。y轴表示中间性中心性（BNC），x轴表示聚类系数（CC）。

The genera located at the bottom right of the plots have the lowest rates of co-occurrence with other genera (low CC) and play a central role in the topology of the network (high BNC). The red dotted line is an arbitrary line for comparing the positions above the microbiota on the coordinates of the BNC and CC.

位于图右下角的属与其他属（低CC）的共现率最低，并且在网络拓扑中起着核心作用（高BNC）。红色虚线是用于比较BNC和CC坐标上微生物群上方位置的任意线。

The red .

红色。

Data availability

数据可用性

The 16S rRNA gene and metagenomic sequence data supporting the findings of this study are publicly available at the National Center for Biotechnology Information Sequence Read Archive (SRA) with BioProject ID PRJNA1059754.

支持本研究结果的16S rRNA基因和宏基因组序列数据可在国家生物技术信息中心序列读取档案（SRA）公开获得，生物项目ID为PRJNA1059754。

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Download referencesAcknowledgementsThis study was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2021R1F1A1062147) and the Basic Science Research Capacity Enhancement Project (Bio-Medical Engineering Core Facility and Support for Activating Joint Research) through a Korea Basic Science Institute (National Research Facilities and Equipment Center) grant funded by the Ministry of Education (grant nos.

。

2019R1A6C1010033 and 2021R1A6C103B392).Author informationAuthor notesThese authors contributed equally: Young Suk Park, Kung Ahn.Authors and AffiliationsDepartment of Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South KoreaYoung Suk Park & Do Joong ParkDepartment of Surgery, Seoul National University College of Medicine, Seoul, South KoreaYoung Suk ParkHuNbiome Co., Ltd, R&D Center, Gasan Digital 1-ro, Geumcheon-gu, Seoul, KoreaKung Ahn, Kyeongeui Yun & Yong Ju AhnDepartment of Microbiology, College of Science & Technology, Dankook University, Cheonan, 31116, KoreaJinuk Jeong & Kyudong HanResearch Institute of Pharmaceutical Sciences, Gyeongsang National University, Jinju, KoreaKyung-Wan BaekDepartment of Surgery, Seoul National University Hospital, Seoul, South KoreaDo Joong ParkCenter for Bio-Medical Engineering Core Facility, Dankook University, Cheonan, 31116, KoreaKyudong HanDepartment of Bioconvergence Engineering, Dankook University, Yongin, 1491, Republic of KoreaKyudong HanAuthorsYoung Suk ParkView author publicationsYou can also search for this author in.

2019R1A6C1010033和2021R1A6C103B392）。作者信息作者注意到这些作者做出了同样的贡献：Young Suk Park，Kung Ahn。作者和附属机构首尔国立大学盆唐医院外科，首尔国立大学医学院外科，首尔，韩国首尔，首尔，首尔，首尔，韩国，首尔，韩国，韩国，韩国，韩国金州，KoreaKyung-Wan-Baek首尔国立大学医院外科，首尔，南韩，丹国大学生物医学工程核心设施公园中心，天安，31116，KoreaKyudong HanDepartment of Bioconvergence Engineering，丹国大学，Yongin，1491，KoreaKyudong HanAuthorsYoung Suk ParkView author Publications你也可以在中搜索这位作者。

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PubMed Google ScholarContributionsYSP, KA, and YJA contributed to the conception and design of this study. YSP conducted the experiments. KY, KA, and KWB organized the data. KY and KA performed statistical analyses. KA wrote the first draft of the manuscript. JJ and KA wrote sections of the manuscript.

PubMed Google ScholarContributionsYSP，KA和YJA为本研究的概念和设计做出了贡献。YSP进行了实验。KY，KA和KWB组织了数据。KY和KA进行了统计分析。KA写了手稿的初稿。JJ和KA写了手稿的部分。

KH, YJA, and DJP revised the manuscript. All authors contributed to the manuscript revision and have read and approved the submitted version.Corresponding authorsCorrespondence to.

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Kyudong Han or Yong Ju Ahn.Ethics declarations

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The authors declare no competing interests.

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Ethical approval

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The collection of clinical data and patient-derived tissues was approved by the Institutional Review Board of SNUBH (IRB No: B-1812-513-302). All patients provided written informed consent before participation. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards..

SNUBH机构审查委员会（IRB编号：B-1812-513-302）批准了临床数据和患者来源组织的收集。所有患者在参与之前都提供了书面知情同意书。在涉及人类参与者的研究中进行的所有程序均符合机构和/或国家研究委员会的道德标准以及1964年《赫尔辛基宣言》及其后来的修正案或类似的道德标准。。

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Reprints and permissionsAbout this articleCite this articlePark, Y.S., Ahn, K., Yun, K. et al. Effect of Helicobacter pylori on sleeve gastrectomy and gastric microbiome differences in patients with obesity and diabetes.

转载和许可本文引用本文Park，Y.S.，Ahn，K.，Yun，K。等人。幽门螺杆菌对肥胖和糖尿病患者袖状胃切除术和胃微生物组差异的影响。

Int J Obes (2024). https://doi.org/10.1038/s41366-024-01611-6Download citationReceived: 25 March 2024Revised: 29 July 2024Accepted: 08 August 2024Published: 24 August 2024DOI: https://doi.org/10.1038/s41366-024-01611-6Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

Int J Obes（2024年）。https://doi.org/10.1038/s41366-024-01611-6Download引文收到日期：2024年3月25日修订日期：2024年7月29日接受日期：2024年8月8日发布日期：2024年8月24日OI：https://doi.org/10.1038/s41366-024-01611-6Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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