Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
Aliment Pharmacol Ther. 2014 Aug;40(3):288-97. doi: 10.1111/apt.12829. Epub 2014 Jun 18.
Intestinal permeability has been studied in small groups of IBS patients with contrasting findings.
To assess intestinal permeability at different sites of the GI tract in different subtypes of well-characterised IBS patients and healthy controls (HC), and to assess potential confounding factors.
IBS patients and HC underwent a multi-sugar test to assess site-specific intestinal permeability. Sucrose excretion and lactulose/rhamnose ratio in 0-5 h urine indicated gastroduodenal and small intestinal permeability, respectively. Sucralose/erythritol ratio in 0-24 h and 5-24 h urine indicated whole gut and colonic permeability, respectively. Linear regression analysis was used to assess the association between IBS groups and intestinal permeability and to adjust for age, sex, BMI, anxiety or depression, smoking, alcohol intake and use of medication.
Ninety-one IBS patients, i.e. 37% IBS-D, 23% IBS-C, 33% IBS-M and 7% IBS-U and 94 HC were enrolled. Urinary sucrose excretion was significantly increased in the total IBS group [μmol, median (Q1;Q3): 5.26 (1.82;11.03) vs. 2.44 (0.91;5.85), P < 0.05], as well as in IBS-C and IBS-D vs. HC. However, differences attenuated when adjusting for confounders. The lactulose/rhamnose ratio was increased in IBS-D vs. HC [0.023 (0.013;0.038) vs. 0.014 (0.008;0.025), P < 0.05], which remained significant after adjustment for confounders. No difference was found in 0-24 and 5-24 h sucralose/erythritol ratio between groups.
Small intestinal permeability is increased in patients with IBS-D compared to healthy controls, irrespective of confounding factors. Adjustment for confounders is necessary when studying intestinal permeability, especially in a heterogeneous disorder such as IBS.
肠道通透性已在具有不同发现的小群 IBS 患者中进行了研究。
评估不同亚型的 IBS 患者和健康对照者（HC）不同胃肠道部位的肠道通透性，并评估潜在的混杂因素。
IBS 患者和 HC 接受了多糖测试以评估特定部位的肠道通透性。0-5 小时尿中蔗糖排泄和乳果糖/鼠李糖比值分别表示胃十二指肠和小肠通透性。0-24 小时和 5-24 小时尿中的蔗糖/赤藓糖醇比值分别表示全肠道和结肠通透性。线性回归分析用于评估 IBS 组与肠道通透性之间的关联，并调整年龄、性别、BMI、焦虑或抑郁、吸烟、饮酒和药物使用。
共纳入 91 例 IBS 患者，即 37%的 IBS-D、23%的 IBS-C、33%的 IBS-M 和 7%的 IBS-U，以及 94 例 HC。总 IBS 组的尿中蔗糖排泄明显增加[μmol，中位数（Q1；Q3）：5.26（1.82；11.03）比 2.44（0.91；5.85），P <0.05]，IBS-C 和 IBS-D 组也如此。然而，在调整混杂因素后，差异减弱。IBS-D 组的乳果糖/鼠李糖比值高于 HC[0.023（0.013；0.038）比 0.014（0.008；0.025），P <0.05]，调整混杂因素后仍有统计学意义。各组间 0-24 小时和 5-24 小时的蔗糖/赤藓糖醇比值无差异。
与健康对照者相比，IBS-D 患者的小肠通透性增加，无论混杂因素如何。在研究肠道通透性时，特别是在像 IBS 这样的异质性疾病中，需要调整混杂因素。
