Obesity is one of the main worldwide public health concerns whose clinical management demands new therapeutic approaches. Bariatric surgery is the most efficient treatment when other therapies have previously failed. Due to the role of gut microbiota in obesity development, the knowledge of the link between bariatric surgery and gut microbiota could elucidate new mechanistic approaches. This study aims to evaluate the long-term effects of bariatric surgery in the faecal metagenome and metabolome of patients with severe obesity. Faecal and blood samples were collected before and four years after the intervention from patients with severe obesity. Biochemical, metagenomic and metabolomic analyses were performed and faecal short-chain fatty acids were measured. Bariatric surgery improved the obesity-related status of patients and significantly reshaped gut microbiota composition. Moreover, this procedure was associated with a specific metabolome profile characterized by a reduction in energetic and amino acid metabolism. Acetate, butyrate and propionate showed a significant reduction with bariatric surgery. Finally, correlation analysis suggested the existence of a long-term compositional and functional gut microbiota profile associated with the intervention. In conclusion, bariatric surgery triggered long-lasting effects on gut microbiota composition and faecal metabolome that could be associated with the remission of obesity.

Background: colorectal cancer (CRC) is one of the most frequent tumors in terms of incidence and mortality. Several elements, both inherited and environmental, have been related with its pathogenesis.Aims: to analyze the influence of age, gender and nutritional factors on the diagnosis of colonic polyps and CRC.Methods: a prospective, descriptive study over outpatients from the Health Area of Leon who took a colonoscopy between 09/09/2012 and 06/30/2013. Patients were asked to fill a semiquantitative food frequency questionnaire with data such a sociodemographic, toxic and dietetic facts. Differences in diagnosis according to sociodemographic and hygiene-dietetic data were analyzed with a multivariate analysis by forward stepwise logistic regression.Results: data were collected from 1390 patients. Mean age was 57.88 (15.17) years and 47.8 % were male. CRC was diagnosed in 5 % of colonoscopies, and polyps in 20.4 %, with 9.4 % of them being HRA. Risk of polyps and HRA was higher in males (26.9 % vs 14.5 %) and (12.6 % vs 6.3 %), respectively (p < 0.001). Mean age was significantly higher in patients who presented polyps (56.51 (15.45) vs 63.22 (12.69) years; p < 0.001). Among the group who reported intake of smoked and salted food, the risk of polyps doubled (2.9 % vs 6.7 %, p = 0.002). In relation to alcohol intake we found that subjects with daily alcohol consumption showed a higher incidence of polyps when compared to occasional drinkers and teetotallers (32 % vs 20 % vs 18.6 %, p = 0.002).Conclusions: age correlated with higher risk of polyps, HRA and CRC. Moreover, male gender also was associated with a high risk of polyps and HRA. Alcohol and red and processed meat intake increased polyp risk.

ResumenAntecedentesLa presencia de antecedentes familiares implica un riesgo aumentado de presentar colorrectal (CCR), lo que condiciona una estrategia de cribado diferente.El objetivo de este trabajo fue evaluar las lesiones halladas en las colonoscopias de pacientes que se sometieron a esta exploración y que tuvieron antecedentes familiares para CCR.Material y métodosSe realizó un estudio retrospectivo incluyendo las colonoscopias consecutivas realizadas en un centro de referencia desde abril del 2000 hasta enero del 2012 en pacientes con antecedentes familiares de CCR. Los hallazgos encontrados en la colonoscopia se analizaron en función del sexo, la edad y la presencia o ausencia de síntomas.ResultadosSe recogieron datos de 3,792 colonoscopias. La edad media ± desviación estándar de los pacientes fue de 53.14 ± 12.22 años, siendo el 57,4% mujeres. La colonoscopia fue normal en el 71.7% de los casos, se detectaron pólipos hiperplásicos en el 7.1% y pólipos adenomatosos en el 19.8% (39.4% de ellos, de alto riesgo). La presencia de adenocarcinomas se evidenció en el 1.5% de los sujetos. La presencia de pólipos y CCR predomina en varones (p=0.001 y p=0.027, respectivamente) y aumentan de forma lineal con la edad. En los pacientes sintomáticos hubo mayor tasa de detección de CCR (p<0.001), mientras que no se observaron diferencias para el diagnóstico de pólipos.ConclusionesEn el grupo de pacientes con antecedentes familiares de CCR, la edad y el sexo masculino aumentan el riesgo de presentar CCR o adenomas. La presencia de síntomas se asocia a mayor riesgo de presentar CCR.AbstractBackgroundThe presence of a family history implies an increased risk for developing colorectal cancer (CRC), and may require a different screening strategy.The aim of this study was to evaluate lesions found during colonoscopies of patients that had a family history of CRC.Material and methodsA retrospective study was conducted that included consecutive colonoscopies performed on patients with a family history of CRC at a referral center within the period from April 2000 to January 2012. The colonoscopic findings were analyzed in relation to sex, age, and the presence or absence of symptoms.ResultsData from 3,792 colonoscopies were collected. The mean age of the patients was 53.14 years (SD 12.22), and 57.4% were women. Colonoscopy was normal in 71.7% of the cases, with hyperplastic polyps being detected in 7.1%, and adenomatous polyps in 19.8% (39.4% of them were high risk). There was a 1.5% presence of adenocarcinomas in the subjects. Polyps and CRC were predominant in men (P=.001 and P=.027, respectively) and there was a linear increase with age. Symptomatic patients had a higher CRC detection rate (P<.001), but no differences were observed in relation to polyp diagnosis.ConclusionsAge and male sex increased the risk for presenting with CRC or adenomas in the group of patients with a family history of CRC, and the presence of symptoms was associated with a greater risk for presenting with CRC