Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
PLoS One. 2021 Oct 11;16(10):e0257331. doi: 10.1371/journal.pone.0257331. eCollection 2021.
Irritable bowel syndrome (IBS) is a multi-faceted gastrointestinal disorder where food intake often triggers symptoms. Metabolomics may provide mechanistical insights to why responses to dietary modifications are diverse.
This study aimed to identify metabolite patterns related to dietary intake in patients with IBS, and to identify metabolites driving the separation between responders and non-responders to treatment.
Participants were randomized to a low fermentable oligo-, di-, monosaccharide and polyol (FODMAP) diet (LFD) or traditional IBS diet (TID) for four weeks. Fasting serum and urine samples pre- and post-intervention were analyzed using 1H nuclear magnetic resonance (NMR) metabolomics. Response to treatment was defined as a reduction in IBS severity scoring system (IBS-SSS) ≥50.
Twenty-five individuals in the LFD (13 responders) and 28 in the TID (14 responders) were included in these post hoc analyses. In endpoint samples, significant decreases in polyols and glucose were seen in the LFD. Post-intervention samples revealed that LFD responders had significantly increased levels of 2-hydroxybuturate and decreased levels of glucose and pantothenic acid compared to non-responders. For the TID, only weak multivariate models were identified and a larger diversity in metabolite response compared to the LFD were noted.
In this study, metabolite patterns between individuals who responded well to an LFD compared to non-responders could be distinguished. This provides new hypotheses for mechanistic actions related to response to dietary modifications, but the results need to be validated in larger cohorts.
This trial was registered at www.clinicaltrials.gov, registry number NCT02107625.
肠易激综合征（IBS）是一种多方面的胃肠道疾病，其中食物摄入常引发症状。代谢组学可能为为什么对饮食改变的反应不同提供机制上的见解。
本研究旨在确定与 IBS 患者饮食摄入相关的代谢物模式，并确定导致治疗反应者和非反应者分离的代谢物。
参与者被随机分配到低发酵寡糖、二糖、单糖和多糖（FODMAP）饮食（LFD）或传统 IBS 饮食（TID）中，为期四周。在干预前后，使用 1H 核磁共振（NMR）代谢组学分析空腹血清和尿液样本。治疗反应定义为 IBS 严重程度评分系统（IBS-SSS）降低≥50。
25 名 LFD 组（13 名反应者）和 28 名 TID 组（14 名反应者）的患者纳入了这些事后分析。在终点样本中，LFD 中多元醇和葡萄糖的含量显著降低。干预后样本显示，与非反应者相比，LFD 反应者的 2-羟基丁酸盐水平显著升高，葡萄糖和泛酸水平降低。对于 TID，只确定了微弱的多变量模型，与 LFD 相比，代谢物反应的多样性更大。
在这项研究中，与非反应者相比，对 LFD 反应良好的个体之间的代谢物模式可以区分。这为与饮食改变反应相关的机制作用提供了新的假说，但需要在更大的队列中验证这些结果。
这项试验在 www.clinicaltrials.gov 上注册，注册号为 NCT02107625。
