IBS randomized study: FODMAPs alter bile acids, phenolic- and tryptophan metabolites, while gluten modifies lipids
Artikel i vetenskaplig tidskrift, 2023

Diet is considered a culprit for symptoms in irritable bowel syndrome (IBS), although the mechanistic understanding of underlying causes is lacking. Metabolomics, i.e., the analysis of metabolites in biological samples may offer a diet-responsive fingerprint for IBS. Our aim was to explore alterations in the plasma metabolome after interventions with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) or gluten versus control in IBS, and to relate such alterations to symptoms. People with IBS (n = 110) were included in a double-blind, randomized, crossover study with 1-wk provocations of FODMAPs, gluten, or placebo. Symptoms were evaluated with the IBS severity scoring system (IBS-SSS). Untargeted metabolomics was performed on plasma samples using LC-qTOF-MS. Discovery of metabolite alterations by treatment was performed using random forest followed by linear mixed modeling. Associations were studied using Spearman correlation. The metabolome was affected by FODMAP [classification rate (CR) 0.88, P < 0.0001], but less by gluten intake CR 0.72, P = 0.01). FODMAP lowered bile acids, whereas phenolic-derived metabolites and 3-indolepropionic acid (IPA) were higher compared with placebo. IPA and some unidentified metabolites correlated weakly to abdominal pain and quality of life. Gluten affected lipid metabolism weakly, but with no interpretable relationship to IBS. FODMAP affected gut microbial-derived metabolites relating to positive health outcomes. IPA and unknown metabolites correlated weakly to IBS severity. Minor symptom worsening by FODMAP intake must be weighed against general positive health aspects of FODMAP. The gluten intervention affected lipid metabolism weakly with no interpretable association to IBS severity. Registration: www.clinicaltrials.gov as NCT03653689.NEW & NOTEWORTHY In irritable bowel syndrome (IBS), fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs) affected microbial-derived metabolites relating to positive health outcomes such as reduced risk of colon cancer, inflammation, and type 2 diabetes, as shown in previous studies. The minor IBS symptom induction by FODMAP intake must be weighed against the positive health aspects of FODMAP consumption. Gluten affected lipids weakly with no association to IBS severity.

FODMAPs

gluten

irritable bowel syndrome

double-blind

metabolomics

Författare

Elise Nordin

Chalmers, Life sciences, Livsmedelsvetenskap

Per M. Hellstrom

Uppsala universitet

Eddie Vuong

Chalmers, Life sciences, Livsmedelsvetenskap

Anton Ribbenstedt

Chalmers, Life sciences, Systembiologi

Carl Brunius

Chalmers, Life sciences, Livsmedelsvetenskap

Rikard Landberg

Chalmers, Life sciences, Livsmedelsvetenskap

American Journal of Physiology - Regulatory Integrative and Comparative Physiology

0363-6119 (ISSN) 1522-1490 (eISSN)

Vol. 325 3 248-259

Ämneskategorier

Biologiska vetenskaper

Gastroenterologi

DOI

10.1152/ajpregu.00016.2023

PubMed

37399002

Mer information

Senast uppdaterat

2023-08-17