Probiotics administration following sleeve gastrectomy surgery: A randomized double-blind trial

S. Sherf-Dagan; S. Zelber-Sagi; G. Zilberman-Schapira; M. Webb; A. Buch; A. Keidar; A. Raziel; N. Sakran; D. Goitein; N. Goldenberg; J. A. Mahdi; M. Pevsner-Fischer; N. Zmora; M. Dori-Bachash; E. Segal; E. Elinav; O. Shibolet

doi:10.1038/ijo.2017.210

Probiotics administration following sleeve gastrectomy surgery: A randomized double-blind trial

S. Sherf-Dagan, S. Zelber-Sagi, G. Zilberman-Schapira, M. Webb, A. Buch, A. Keidar, A. Raziel, N. Sakran, D. Goitein, N. Goldenberg, J. A. Mahdi, M. Pevsner-Fischer, N. Zmora, M. Dori-Bachash, E. Segal, E. Elinav, O. Shibolet

School of Public Health

Research output: Contribution to journal › Article › peer-review

Abstract

Background:Probiotics are commonly used after bariatric surgery; however, uncertainty remains regarding their efficacy. Our aim was to compare the effect of probiotics vs placebo on hepatic, inflammatory and clinical outcomes following laparoscopic sleeve gastrectomy (LSG).Methods:This randomized, double-blind, placebo-controlled, trial of 6-month treatment with probiotics (Bio-25; Supherb) vs placebo and 6 months of additional follow-up was conducted among 100 morbidly obese nonalcoholic fatty liver disease (NAFLD) patients who underwent LSG surgery. The primary outcome was a reduction in liver fat content, measured by abdominal ultrasound, and secondary outcomes were improvement of fibrosis, measured by shear-wave elastography, metabolic and inflammatory parameters, anthropometrics and quality of life (QOL). Fecal samples were collected and analyzed for microbial composition.Results:One hundred patients (60% women, mean age of 41.9±9.8 years and body mass index of 42.3±4.7 kg m '2) were randomized, 80% attended the 6-month visit and 77% completed the 12-month follow-up. Fat content and NAFLD remission rate were similarly reduced in the probiotics and placebo groups at 6 months postsurgery ('0.9±0.5 vs '0.7±0.4 score; P=0.059 and 52.5 vs 40%; P=0.262, respectively) and at 12 months postsurgery. Fibrosis, liver-enzymes, C-reactive protein (CRP), leptin and cytokeratin-18 levels were significantly reduced and QOL significantly improved within groups (P1/20.014 for all), but not between groups (P3/40.173 for all) at 6 and 12 months postsurgery. Within-sample microbiota diversity (alpha-diversity) increased at 6-month postsurgery compared with baseline in both study arms (P1/20.008) and decreased again at 12 months postsurgery compared with 6 months postsurgery (P1/20.004) but did not reach baseline values.Conclusions:Probiotics administration does not improve hepatic, inflammatory and clinical outcomes 6- and 12 months post-LSG.

Original language	English
Pages (from-to)	147-155
Number of pages	9
Journal	International Journal of Obesity
Volume	42
Issue number	2
DOIs	https://doi.org/10.1038/ijo.2017.210
State	Published - 1 Feb 2018

Bibliographical note

Funding Information:
This study was supported (in part) by grant no. 3-10470 from the Chief Scientist Office of the Ministry of Health, Israel. The funding source did not have a role in the design, conduct and analysis of the study or the decision to submit the manuscript for publication.

ASJC Scopus subject areas

Medicine (miscellaneous)
Endocrinology, Diabetes and Metabolism
Nutrition and Dietetics

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1038/ijo.2017.210

Cite this

Sherf-Dagan, S., Zelber-Sagi, S., Zilberman-Schapira, G., Webb, M., Buch, A., Keidar, A., Raziel, A., Sakran, N., Goitein, D., Goldenberg, N., Mahdi, J. A., Pevsner-Fischer, M., Zmora, N., Dori-Bachash, M., Segal, E., Elinav, E., & Shibolet, O. (2018). Probiotics administration following sleeve gastrectomy surgery: A randomized double-blind trial. International Journal of Obesity, 42(2), 147-155. https://doi.org/10.1038/ijo.2017.210

@article{8db14936579e4942ac9a47c36ed75d72,

title = "Probiotics administration following sleeve gastrectomy surgery: A randomized double-blind trial",

abstract = "Background:Probiotics are commonly used after bariatric surgery; however, uncertainty remains regarding their efficacy. Our aim was to compare the effect of probiotics vs placebo on hepatic, inflammatory and clinical outcomes following laparoscopic sleeve gastrectomy (LSG).Methods:This randomized, double-blind, placebo-controlled, trial of 6-month treatment with probiotics (Bio-25; Supherb) vs placebo and 6 months of additional follow-up was conducted among 100 morbidly obese nonalcoholic fatty liver disease (NAFLD) patients who underwent LSG surgery. The primary outcome was a reduction in liver fat content, measured by abdominal ultrasound, and secondary outcomes were improvement of fibrosis, measured by shear-wave elastography, metabolic and inflammatory parameters, anthropometrics and quality of life (QOL). Fecal samples were collected and analyzed for microbial composition.Results:One hundred patients (60% women, mean age of 41.9±9.8 years and body mass index of 42.3±4.7 kg m '2) were randomized, 80% attended the 6-month visit and 77% completed the 12-month follow-up. Fat content and NAFLD remission rate were similarly reduced in the probiotics and placebo groups at 6 months postsurgery ('0.9±0.5 vs '0.7±0.4 score; P=0.059 and 52.5 vs 40%; P=0.262, respectively) and at 12 months postsurgery. Fibrosis, liver-enzymes, C-reactive protein (CRP), leptin and cytokeratin-18 levels were significantly reduced and QOL significantly improved within groups (P1/20.014 for all), but not between groups (P3/40.173 for all) at 6 and 12 months postsurgery. Within-sample microbiota diversity (alpha-diversity) increased at 6-month postsurgery compared with baseline in both study arms (P1/20.008) and decreased again at 12 months postsurgery compared with 6 months postsurgery (P1/20.004) but did not reach baseline values.Conclusions:Probiotics administration does not improve hepatic, inflammatory and clinical outcomes 6- and 12 months post-LSG.",

author = "S. Sherf-Dagan and S. Zelber-Sagi and G. Zilberman-Schapira and M. Webb and A. Buch and A. Keidar and A. Raziel and N. Sakran and D. Goitein and N. Goldenberg and Mahdi, {J. A.} and M. Pevsner-Fischer and N. Zmora and M. Dori-Bachash and E. Segal and E. Elinav and O. Shibolet",

note = "Funding Information: This study was supported (in part) by grant no. 3-10470 from the Chief Scientist Office of the Ministry of Health, Israel. The funding source did not have a role in the design, conduct and analysis of the study or the decision to submit the manuscript for publication.",

year = "2018",

month = feb,

day = "1",

doi = "10.1038/ijo.2017.210",

language = "English",

volume = "42",

pages = "147--155",

journal = "International Journal of Obesity",

issn = "0307-0565",

publisher = "Nature Publishing Group",

number = "2",

}

Sherf-Dagan, S, Zelber-Sagi, S, Zilberman-Schapira, G, Webb, M, Buch, A, Keidar, A, Raziel, A, Sakran, N, Goitein, D, Goldenberg, N, Mahdi, JA, Pevsner-Fischer, M, Zmora, N, Dori-Bachash, M, Segal, E, Elinav, E & Shibolet, O 2018, 'Probiotics administration following sleeve gastrectomy surgery: A randomized double-blind trial', International Journal of Obesity, vol. 42, no. 2, pp. 147-155. https://doi.org/10.1038/ijo.2017.210

TY - JOUR

T1 - Probiotics administration following sleeve gastrectomy surgery

T2 - A randomized double-blind trial

AU - Sherf-Dagan, S.

AU - Zelber-Sagi, S.

AU - Zilberman-Schapira, G.

AU - Webb, M.

AU - Buch, A.

AU - Keidar, A.

AU - Raziel, A.

AU - Sakran, N.

AU - Goitein, D.

AU - Goldenberg, N.

AU - Mahdi, J. A.

AU - Pevsner-Fischer, M.

AU - Zmora, N.

AU - Dori-Bachash, M.

AU - Segal, E.

AU - Elinav, E.

AU - Shibolet, O.

N1 - Funding Information: This study was supported (in part) by grant no. 3-10470 from the Chief Scientist Office of the Ministry of Health, Israel. The funding source did not have a role in the design, conduct and analysis of the study or the decision to submit the manuscript for publication.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background:Probiotics are commonly used after bariatric surgery; however, uncertainty remains regarding their efficacy. Our aim was to compare the effect of probiotics vs placebo on hepatic, inflammatory and clinical outcomes following laparoscopic sleeve gastrectomy (LSG).Methods:This randomized, double-blind, placebo-controlled, trial of 6-month treatment with probiotics (Bio-25; Supherb) vs placebo and 6 months of additional follow-up was conducted among 100 morbidly obese nonalcoholic fatty liver disease (NAFLD) patients who underwent LSG surgery. The primary outcome was a reduction in liver fat content, measured by abdominal ultrasound, and secondary outcomes were improvement of fibrosis, measured by shear-wave elastography, metabolic and inflammatory parameters, anthropometrics and quality of life (QOL). Fecal samples were collected and analyzed for microbial composition.Results:One hundred patients (60% women, mean age of 41.9±9.8 years and body mass index of 42.3±4.7 kg m '2) were randomized, 80% attended the 6-month visit and 77% completed the 12-month follow-up. Fat content and NAFLD remission rate were similarly reduced in the probiotics and placebo groups at 6 months postsurgery ('0.9±0.5 vs '0.7±0.4 score; P=0.059 and 52.5 vs 40%; P=0.262, respectively) and at 12 months postsurgery. Fibrosis, liver-enzymes, C-reactive protein (CRP), leptin and cytokeratin-18 levels were significantly reduced and QOL significantly improved within groups (P1/20.014 for all), but not between groups (P3/40.173 for all) at 6 and 12 months postsurgery. Within-sample microbiota diversity (alpha-diversity) increased at 6-month postsurgery compared with baseline in both study arms (P1/20.008) and decreased again at 12 months postsurgery compared with 6 months postsurgery (P1/20.004) but did not reach baseline values.Conclusions:Probiotics administration does not improve hepatic, inflammatory and clinical outcomes 6- and 12 months post-LSG.

AB - Background:Probiotics are commonly used after bariatric surgery; however, uncertainty remains regarding their efficacy. Our aim was to compare the effect of probiotics vs placebo on hepatic, inflammatory and clinical outcomes following laparoscopic sleeve gastrectomy (LSG).Methods:This randomized, double-blind, placebo-controlled, trial of 6-month treatment with probiotics (Bio-25; Supherb) vs placebo and 6 months of additional follow-up was conducted among 100 morbidly obese nonalcoholic fatty liver disease (NAFLD) patients who underwent LSG surgery. The primary outcome was a reduction in liver fat content, measured by abdominal ultrasound, and secondary outcomes were improvement of fibrosis, measured by shear-wave elastography, metabolic and inflammatory parameters, anthropometrics and quality of life (QOL). Fecal samples were collected and analyzed for microbial composition.Results:One hundred patients (60% women, mean age of 41.9±9.8 years and body mass index of 42.3±4.7 kg m '2) were randomized, 80% attended the 6-month visit and 77% completed the 12-month follow-up. Fat content and NAFLD remission rate were similarly reduced in the probiotics and placebo groups at 6 months postsurgery ('0.9±0.5 vs '0.7±0.4 score; P=0.059 and 52.5 vs 40%; P=0.262, respectively) and at 12 months postsurgery. Fibrosis, liver-enzymes, C-reactive protein (CRP), leptin and cytokeratin-18 levels were significantly reduced and QOL significantly improved within groups (P1/20.014 for all), but not between groups (P3/40.173 for all) at 6 and 12 months postsurgery. Within-sample microbiota diversity (alpha-diversity) increased at 6-month postsurgery compared with baseline in both study arms (P1/20.008) and decreased again at 12 months postsurgery compared with 6 months postsurgery (P1/20.004) but did not reach baseline values.Conclusions:Probiotics administration does not improve hepatic, inflammatory and clinical outcomes 6- and 12 months post-LSG.

UR - http://www.scopus.com/inward/record.url?scp=85041652186&partnerID=8YFLogxK

U2 - 10.1038/ijo.2017.210

DO - 10.1038/ijo.2017.210

M3 - Article

C2 - 28852205

AN - SCOPUS:85041652186

SN - 0307-0565

VL - 42

SP - 147

EP - 155

JO - International Journal of Obesity

JF - International Journal of Obesity

IS - 2

ER -

Probiotics administration following sleeve gastrectomy surgery: A randomized double-blind trial

Abstract

Bibliographical note

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this