Jejunal Luminal and Colonic Mucosa-Associated Microbiota in Metabolic Diseases: Methods, Identification and Causalities

Inclusion Criteria

• •* Aged between 18 and 60 years;
• •* Ability to understand and provide informed consent (in French);
• •* Ability and willingness to meet the required schedule and study procedures;
• •Control Group
• •Presence of Gastroesophageal Reflux Disease symptoms or gastric discomfort.
• •BMI \[19kg/m² \< BMI \<25 kg/m²\]
• •Match age and sex to the patients from the Ob and ObD groups.
• •Only patients with normal glucose tolerance (NGT), glucose tolerance (IGT) and/or fasting glucose (IFG) and an HbA1c \< 6.5 % will be included in this group.
• •* Ob Group
• •● Candidate for bariatric surgery and meet the HAS criteria (Haute Autorité de Santé, 2009) :
• •IMC ≥ 40 kg/m² without comorbidities Or IMC≥ 35 kg/m² with at least one obesity-related comorbidity (i.e.: Hypertension, Dyslipidemia, Obstructive Sleep Apnea, Joints Disease, non-alcoholic steatohepatitis, excluding T2D)
• •Weight stable for at least 2 months
• •No treatment for metabolic health complications, no previous obesity surgery, no obesity treatment drug.
• •No monogenic form of obesity (Hebebrand et al., 2017)
• •* ObD Group
• •Candidate for bariatric surgery with T2D
• •At least one obesity-related comorbidity including T2D
• •Fasting plasma glucose (FPG) ≥7 mM (=1.26g/l) or
• •Participants with HbA1c ≥ 6.5% (48 mmol/mol)
• •All stages of albuminuria
• •* Treatment for the previous 12 week that could
• •* alter gastrointestinal motor function (e.g. opioids, prokinetics, anticholinergics, laxatives),
• •* acidity (PPI, H2RA)
• •* microbial population (e.g.: antibiotics, probiotics)
• •* immunosuppressants (eg: calcineurin inhibitors, corticosteroids, biological agents, etc.).
• •* use of weight-loss drug or dietary intervention aiming to lose weight;
• •* Altered anatomy of the esophagus, stomach, small or large intestine due to prior gastrointestinal surgery (exceptions include appendectomy or cholecystectomy more than 3 months prior to enrollment) or other reasons;
• •* Any abdominal or pelvic surgery within the past 3 months;
• •* Diverticulitis, diverticular stricture, or other intestinal strictures.
• •* Intestinal resection of the gastrointestinal tract
• •* Previous history of gastric bezoar or gastroparesis
• •* Acute or chronic inflammatory bowel disease or infections diseases (i.e.: VHC, VHB, VIH, etc.)
• •* Abdominal or pelvic radiotherapy or abdominal cancer
• •* Colorectal cancer, either known or not
• •* Dysphagia, eosinophilic esophagitis, esophageal stricture, or other swallowing disorder
• •* Organ Transplantation and patients on Immunosuppressive Therapy
• •* Severe kidney failure and/or patients on dialysis therapy (serum creatinine \> 150 μmol/l or eGFR \< 60 ml/min per 1.73 m2 body surface area)
• •* CVD, endocrine, renal or other chronic disease likely to affect motility.
• •* Colon cleansing preparation during the last 1 month
• •* No \< 3 bowel movements per week
• •* Females of childbearing age who do not practice birth control and/or are pregnant or lactating
• •* Participants non-affiliated to the French national health scheme
• •* Participants who are already included in a clinical study which implies testing any pharmaceutical drug.
• •* Participants who do not understand the research procedures those who are institutionalized, or who unable to give informed consent
• •* Participants placed under legal protection
• •* Patients with drug addiction
• •* Antibiotherapy 3 months preceding the endoscopy
• •* Weight variation (diminution or increase) \> 5kg in the last 3 months
• •Ob and ObT2D Group
• •* Usual contraindication for bariatric surgery;