Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
Institute of Systems Biomedicine, School of Basic Medical Sciences, Peking University, Beijing, China.
J Dig Dis. 2021 May;22(5):246-255. doi: 10.1111/1751-2980.12988.
To explore alterations in fecal short-chain fatty acids (SCFA) and gut microbiota in patients with diarrhea-predominant irritable bowel disease (IBS-D) and their relationships with clinical manifestations.
We recruited 162 patients with IBS-D and 66 healthy controls (HC). Their manifestations and psychological status were evaluated using the IBS severity scoring system and the Hospital Anxiety and Depression Scale (HADS). Colorectal visceral sensitivity was evaluated using a barostat. Systemic inflammation was evaluated using plasma cytokine levels. Fecal SCFA were quantified using ultra-performance liquid chromatography-tandem mass spectrometry, and fecal microbiota communities were analyzed using 16S rRNA sequencing.
More men presented with IBS-D than women in our patient cohort. Patients with IBS-D had more severe manifestations, higher HADS score, and a higher rate of previous infectious enteritis than HC. Notably, female patients had significantly higher HADS scores than male patients. Male patients had significantly higher levels of plasma interleukin (IL)-12, fecal propionate and colorectal visceral sensitivity than male HC, while no differences were observed between female patients and female HC. Fecal acetate, butyrate and valerate correlated with the initial visceral sensory threshold, stressors, and IL-10 and IL-12 levels. The propionate-producing Prevotella 9 genus was significantly increased in male patients and positively correlated with fecal propionate.
Distinct sex-based differences in clinical manifestations, fecal SCFA and microbiota richness are found in Chinese patients with IBS-D, which may be used to diagnose dysbiosis in these patients.
探讨腹泻型肠易激综合征（IBS-D）患者粪便短链脂肪酸（SCFA）和肠道微生物群的变化及其与临床表现的关系。
我们招募了 162 例 IBS-D 患者和 66 例健康对照（HC）。采用 IBS 严重程度评分系统和医院焦虑抑郁量表（HADS）评估其临床表现和心理状态。使用测压计评估结肠内脏敏感性。采用酶联免疫吸附试验检测血浆细胞因子水平评估全身炎症。采用超高效液相色谱-串联质谱法定量检测粪便 SCFA，采用 16S rRNA 测序分析粪便微生物群落。
与女性相比，我们的患者队列中更多的男性患有 IBS-D。IBS-D 患者的临床表现更严重，HADS 评分更高，既往感染性肠炎发生率更高。值得注意的是，女性患者的 HADS 评分明显高于男性患者。与男性 HC 相比，男性患者的血浆白细胞介素（IL）-12、粪便丙酸和结肠内脏敏感性明显更高，而女性患者与女性 HC 之间无差异。粪便乙酸盐、丁酸盐和戊酸盐与初始内脏感觉阈值、应激源以及 IL-10 和 IL-12 水平相关。丙酸产生菌普雷沃氏菌属 9 种在男性患者中显著增加，与粪便丙酸呈正相关。
中国 IBS-D 患者存在以性别为基础的临床表现、粪便 SCFA 和微生物丰富度的显著差异，这可能用于诊断这些患者的菌群失调。
