Background:
Obesity and diabetes mellitus (DM) are growing global health issues, leading to severe health complications, increased medical costs, and productivity loss. Helicobacter pylori infection has been suggested as a potential risk factor for these conditions, but it remains unclear whether eradicating H. pylori directly contributes to weight loss or improves insulin sensitivity.
Methods:
This study investigated the effects of sleeve gastrectomy based on the gastric microbiota in 40 patients with obesity, DM, and H. pylori infection. Patients were classified into four groups: non-diabetic without H. pylori (ND), non-diabetic with H. pylori (ND-HP), diabetic (DM), and diabetic with H. pylori (DM-HP). The composition of the gastric microbiome was analyzed using 16S V3–V4 sequencing.
Results:
In the DM group, there was a significant reduction in ALT, hemoglobin, HbA1c, blood glucose, and the hepatic steatosis index (HSI), along with a notable increase in high-density lipoprotein (HDL). However, these improvements were not observed in patients with H. pylori infection. Gastric microbiome diversity decreased across the groups in the following order: ND > DM > ND-HP > DM-HP. A correlation analysis revealed that in the ND-HP group, the majority of the top 20 gastric microbiota species were negatively associated with glucose metabolism. Additionally, H. pylori infection was positively correlated with preoperative insulin levels.
Conclusion:
These findings suggest that while sleeve gastrectomy provides significant benefits for patients with obesity and diabetes, the presence of H. pylori infection may hinder clinical improvements, potentially affecting metabolic outcomes post-surgery.
