Division Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Nutrients. 2022 May 6;14(9):1945. doi: 10.3390/nu14091945.
Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) share common culprit foods and potential pathophysiological factors. However, how diet may contribute to disease course and whether this differs between both entities is unclear. We therefore investigated the association of dietary indices with intestinal inflammation and gastrointestinal symptoms in both IBD and IBS patients. Food frequency questionnaires from 238 IBD, 261 IBS and 195 healthy controls (HC) were available to calculate the overall diet quality by the Dutch Healthy Diet-Index 2015 (DHD-2015) and its inflammatory potential by the Adapted Dietary Inflammatory Index (ADII). Intestinal inflammation and symptoms were evaluated by faecal calprotectin and the Gastrointestinal Symptom Rating Scale, respectively. The DHD-2015 was lower in IBD and IBS versus HC (p < 0.001), being associated with calprotectin levels in IBD (b = −4.009, p = 0.006), and with abdominal pain (b = −0.012, p = 0.023) and reflux syndrome (b = −0.016, p = 0.004) in IBS. ADII scores were comparable between groups and were only associated with abdominal pain in IBD (b = 0.194, p = 0.004). In this side-by-side comparison, we found a lower diet quality that was differentially associated with disease characteristics in IBD versus IBS patients. Longitudinal studies are needed to further investigate the role of dietary factors in the development of flares and predominant symptoms.
炎症性肠病 (IBD) 和肠易激综合征 (IBS) 有共同的致病食物和潜在的病理生理因素。然而，饮食如何影响疾病进程，以及这在两种疾病中是否存在差异尚不清楚。因此，我们研究了饮食指数与 IBD 和 IBS 患者肠道炎症和胃肠道症状之间的关系。我们有 238 名 IBD 患者、261 名 IBS 患者和 195 名健康对照者的食物频率问卷，可据此使用 2015 年荷兰健康饮食指数 (DHD-2015) 计算整体饮食质量，并用改良饮食炎症指数 (ADII) 计算其炎症潜能。通过粪便钙卫蛋白和胃肠道症状评分量表分别评估肠道炎症和症状。DHD-2015 在 IBD 和 IBS 患者中均低于健康对照组 (p < 0.001)，与 IBD 患者的钙卫蛋白水平相关 (b = -4.009，p = 0.006)，与 IBS 患者的腹痛 (b = -0.012，p = 0.023) 和反流综合征 (b = -0.016，p = 0.004) 相关。各组之间的 ADII 评分无差异，仅与 IBD 患者的腹痛相关 (b = 0.194，p = 0.004)。在这项平行比较中，我们发现饮食质量较低，且在 IBD 患者中与疾病特征的相关性存在差异，而在 IBS 患者中则无差异。需要进行纵向研究来进一步探讨饮食因素在疾病发作和主要症状中的作用。
