Bile Acid Deficiency in a Subgroup of Patients With Irritable Bowel Syndrome With Constipation Based on Biomarkers in Serum and Fecal Samples.
Bile Acid Deficiency in a Subgroup of Patients With Irritable Bowel Syndrome With Constipation Based on Biomarkers in Serum and Fecal Samples.
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DOI：
10.1016/j.cgh.2017.06.039
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Camilleri M
中科院分区：
文献类型：
--
作者：
Vijayvargiya P;Busciglio I;Burton D;Donato L;Lueke A;Camilleri M
肠易激综合征伴便秘（IBS-C）患者短期给予缓释鹅去氧胆酸可加速结肠传输并减轻症状。初步研究表明，IBS-C患者粪便中胆汁酸（BA）水平降低，BA合成减少。我们比较了在48小时内从每天含有100 g脂肪的饮食的IBS-C患者收集的粪便样本中的初级和次级BA水平，并比较了健康志愿者（对照）样本中的初级和次级BA水平。我们还研究了IBS-C患者的整体结肠运输和BA生物标志物之间的关系。我们对45例IBS-C患者和184例对照进行了回顾性研究。对于对照组，我们估计了C4（n=184）和48小时粪便BA（n=46）的空腹血清水平的第10百分位数，以及成纤维细胞生长因子19（FGF 19，n=50）的空腹血清水平的第90百分位数。使用经验证的结肠造影方法测量患者的结肠传输。采用斯皮尔曼相关性分析IBS-C患者的数据，以确定C4、FGF 19、粪便BA和结肠运输水平之间的关系。在IBS-C患者中，2/45例血清C4水平较低，4/43例血清FGF 19水平升高，6/39例48小时以上粪便中BA水平较低。与对照组相比，IBS-C患者的粪便石胆酸比例显著增加（P= 0.04），与对照组相比，脱氧胆酸减少（P= 0.03）。在IBS-C患者中，C4和FGF 19的血清水平之间存在负相关关系，48小时粪便BAs、结肠运输和血清C4和FGF 19的水平之间存在相关性。大约15%的IBS-C患者在100 g脂肪饮食下48小时内收集的粪便样本中总BA和脱氧胆酸水平降低。在这些患者中，较低水平的BAs排泄到粪便中与较慢的结肠传输相关。
Short-term administration of delayed-release chenodeoxycholic acid to patients with irritable bowel syndrome with constipation (IBS-C) accelerates colonic transit and reduces symptoms. A preliminary study has shown that patients with IBS-C have reduced levels of bile acids (BAs) in feces and reduced synthesis of BA. We compared levels of primary and secondary BAs in fecal samples collected over a 48-hr period from patients with IBS-C on a diet that contained 100 g fat per day, and compared them will levels in samples from healthy volunteers (controls). We also examined the relationship between overall colonic transit and biomarkers of BAs in patients with IBS-C. We performed a retrospective study of 45 patients with IBS-C and 184 controls. For controls, we estimated the 10th percentile of fasting serum levels of C4 (n=184) and 48-hr fecal BAs (n=46), and the 90th percentile of fasting serum level of fibroblast growth factor 19 (FGF19, n=50). Colonic transit was measured in patients using a validated scintigraphic method. Data from patients with IBS-C were analyzed using Spearman correlations to determine relationships among levels of C4, FGF19, fecal BAs, and colonic transit. Among the patients with IBS-C, 2/45 had low serum levels of C4, 4/43 had increased serum levels of FGF19, and 6/39 had low levels of BAs in feces collected over 48-hrs. Patients with IBS-C had a significant increase in proportions of fecal lithocholic acid compared with controls (P=.04) and decrease in deoxycholic acid compared to controls (P=.03). In patients with IBS-C, there were inverse relationships between serum levels of C4 and FGF19 and correlations among levels of 48-hr fecal BAs, colonic transit, and serum C4 and FGF19. Approximately 15% of patients with IBS-C have reduced total BAs and level of deoxycholic acid in fecal samples collected over 48 hrs on a 100 g fat diet. In these patients, lower levels of excretion of BAs into feces correlated with slower colonic transit.
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影响因子：
29.4
作者：
Rao AS;Wong BS;Camilleri M;Odunsi-Shiyanbade ST;McKinzie S;Ryks M;Burton D;Carlson P;Lamsam J;Singh R;Zinsmeister AR
通讯作者：
Zinsmeister AR
影响因子：
12.6
作者：
Wong, Banny S.;Camilleri, Michael;Carlson, Paula;McKinzie, Sanna;Busciglio, Irene;Bondar, Olga;Dyer, Roy B.;Lamsam, Jesse;Zinsmeister, Alan R.
通讯作者：
Zinsmeister, Alan R.
影响因子：
1.9
作者：
Abrahamsson, Hasse;Ostlund-Lindqvist, Ann-Margret;Gillberg, Per-Goran
通讯作者：
Gillberg, Per-Goran
影响因子：
3.5
作者：
Camilleri, M.;Shin, A.;Zinsmeister, A. R.
通讯作者：
Zinsmeister, A. R.
影响因子：
24.5
作者：
MARCUS, SN;HEATON, KW
通讯作者：
HEATON, KW