Associations of chronic diarrhoea with non-alcoholic fatty liver disease and obesity-related disorders among US adults

Shin, Andrea; Xu, Huiping; Imperiale, Thomas F.

doi:10.1136/bmjgast-2019-000322

Cited by 9 publications

(3 citation statements)

References 43 publications

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“…Similar result was reported in a National Health and Nutrition Examination Survey among US adults, found positive association between obesity and chronic diarrhoea. 34 A birth cohort study conducted among 980 young adults in Dunedin, New Zealand, also found positive association between increased BMI and diarrhoea. 35 Literature also suggests that up to 8.5 per cent of obese and 11.5 per cent of severely obese individuals had chronic diarrhoea, compared with 4.5 per cent of normal-weight individuals.…”

Section: Discussionmentioning

confidence: 96%

Changing trends in nutritional status of adolescent females: a cross-sectional study from urban and rural Bangladesh

et al. 2021

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ObjectivesMalnutrition remains a major problem among adolescents worldwide, but the types of nutritional problem impacting this group are changing significantly. This study aims to describe and analyse the trends in nutritional status and related epidemiological characteristics of 10 to 19 years old adolescent girls over time (2001 to 2018) in Bangladesh.MethodsWe extracted data from the Diarrhoeal Disease- Surveillance System of the International Centre for Diarrhoeal Disease Research Bangladesh. We performed χ2 test for trend to test for statistical significance of the changing trends of undernutrition and overnutrition among the study participants. Multivariable logistic regression model was fit to measure the strength of association, reported as adjusted OR (aOR) and corresponding 95% CIs.ResultsA total of 1224 and 628 adolescent females attended urban and rural treatment facilities, respectively, between 2001 and 2018. The proportion of stunting and thinness decreased substantially, whereas overweight has been observed to increase (1.7% to 7.4%, p<0.001) over the study period. Factors independently associated with stunting were illiteracy (aOR 2.39, 95% CI (1.68 to 3.39), p<0.001), monthly family income of less than US$100 (aOR 1.54, 95% CI (1.25 to 1.9), p<0.001) and family belonging to poorest wealth quintile (aOR 1.45, 95% CI (1.13 to 1.87), p=0.004). Younger participants (aOR 2.69, 95% CI (2.10 to 3.45), p<0.001), rural participants (aOR 1.71 95% CI (1.23 to 2.38), p<0.001), longer hospital stay (aOR 1.52, 95% CI (1.16 to 1.98), p=0.002) and monthly family income less than US$100 (aOR 1.44, 95% CI (1.09 to 1.89), p=0.009) were significantly associated with thinness. Conversely, overweight/obesity was associated with monthly family income more than US$100, duration of diarrhoea and rural participants.ConclusionUndernutrition in adolescent girls has decreased with time, but the burden of overweight has increased. Higher literacy and better wealth status were found to be associated with the improved nutritional status of the participants.

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Section: Discussionmentioning

confidence: 96%

Changing trends in nutritional status of adolescent females: a cross-sectional study from urban and rural Bangladesh

et al. 2021

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“…55 Interestingly, the relationship between R. gnavus and IBS lost its significant in adjusted analyses due to a positive association between R. gnavus and BMI which may suggest a role R. gnavus in explaining the connection between IBS-D or chronic diarrhea with metabolic syndrome and obesity-related disorders. 56, 57 Associations of IBS-D with other taxa including Dorea sp. CAG:317, Blautia sp.…”

Section: Discussionmentioning

confidence: 99%

Microbiota-Short Chain Fatty Acid Relationships Underlie Clinical Heterogeneity and Identify Key Microbial Targets in Irritable Bowel Syndrome (IBS)

Shin,

Xing,

Waseem

et al. 2024

Preprint

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ObjectiveIdentifying microbial targets in irritable bowel syndrome (IBS) is challenged by dynamic microbiota-metabolite-host interactions. We aimed to assess microbial features associated with short chain fatty acids (SCFA) and determine if features were related to IBS symptoms, subtypes, and endophenotypes.DesignWe performed an observational study of stool microbial metagenomes, stool SCFA, and IBS traits (stool form, stool bile acids, and colonic transit) in patients with IBS (IBS with constipation [IBS-C] IBS with diarrhea [IBS-D]) and healthy controls. We analyzed associations of microbiome composition with stool SCFA to identify microbe-SCFA relationships that were shared and distinct across groups. We compared gut microbiome-encoded potential for substrate utilization across groups and within a subset of participants selected by stool characteristics. In IBS-D, we compared stool microbiomes of patients with and without bile acid malabsorption (BAM).ResultsOverall stool microbiome composition and abundances of individual taxa differed between groups. Increased abundances of several bacterial species were observed in IBS-D includingDoreasp. CAG:317.. Microbes-SCFA relationships varied across groups after accounting for transit and bile acids. Significant microbe-SCFA were common in IBS-D and several SCFA-producing species were inversely correlated with SCFA. Among participants selected by stool form characteristics, functional profiling demonstrated differential abundances of microbial genes/pathways for SCFA metabolism and degradation of carbohydrates and mucin across groups. SCFA-producing taxa were reduced in IBS-D with BAM.ConclusionMicrobe-SCFA associations differ across IBS subtypes and traits. Altered substrate preferences offer insights into functional microbiome traits and could be used as novel microbial IBS biomarkers.KEY MESSAGESWhat is already known on this topic:The intestinal microbiota and its metabolites (e.g., short chain fatty acids [SCFA]) modulate irritable bowel syndrome (IBS) pathophysiology.What this study adds:We studied microbe-SCFA associations across IBS subtypes and endophenotypes to demonstrate (1) the intestinal microbiome plays distinct roles across IBS subtypes, (2) microbial substrate preferences vary between IBS subtypes and influences stool form, and (3) microbe-SCFA patterns may reveal key taxa that underlie shared and distinct microbial mechanisms across the IBS spectrum.How this study might affect research, practice or policy:Findings demonstrate that structural and functional features of the intestinal microbiome may represent unbiased microbial biomarkers for clinical and mechanistic IBS subtypes. Further study of these putative microbial targets as well as their interactions with diet- and host-specific traits should be pursued to develop individualized microbiome-based approached to IBS management.

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“…Shin et al [ 16 ] found that the prevalence of presumed NAFLD was 12.9% in patients with diarrhoea predominant IBS (IBS-D) compared to 9.0% in patients with constipation predominant IBS (IBS-C), although the reasons for this apparent difference are unclear and merit further investigation. In an interesting study by Lee et al [ 19 ], rather than evaluating patients with a formal diagnosis of NAFLD, the authors assessed the incidence of elevated liver transaminases and the metabolic syndrome in patients with IBS, compared to an age and sex matched control group.…”

Section: The Prevalence Of Co-existing Ibs and Nafldmentioning

confidence: 99%

Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?

Purssell¹,

Whorwell²,

Athwal³

et al. 2021

WJH

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Irritable bowel syndrome (IBS) and non-alcoholic fatty liver disease (NAFLD) are amongst the most common gastrointestinal and liver conditions encountered in primary and secondary care. Recently, there has been interest in the apparent co-incidence of NAFLD in patients with IBS mainly driven by improved understanding of their shared risk factors and pathophysiology. In this paper we summarize the shared risk factors which include; overlapping nutritional and dietary factors as well as shared putative mechanisms of pathophysiology. These include changes in the gut microbiome, gut permeability, immunity, small bowel bacterial overgrowth and bile acid metabolism. This paper describes how these shared risk factors and etiological factors may have practical clinical implications for these highly prevalent conditions. It also highlights some of the limitations of current epidemiological data relating to estimates of the overlapping prevalence of the two conditions which have resulted in inconsistent results and, therefore the need for further research. Early recognition and management of the overlap could potentially have impacts on treatment outcomes, compliance and morbidity of both conditions. Patients with known IBS who have abnormal liver function tests or significant risk factors for NAFLD should be investigated appropriately for this possibility. Similarly, IBS should be considered in patients with NAFLD and symptoms of abdominal pain associated with defecation, an altered bowel habit and bloating.

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Associations of chronic diarrhoea with non-alcoholic fatty liver disease and obesity-related disorders among US adults

Cited by 9 publications

References 43 publications

Changing trends in nutritional status of adolescent females: a cross-sectional study from urban and rural Bangladesh

Changing trends in nutritional status of adolescent females: a cross-sectional study from urban and rural Bangladesh

Microbiota-Short Chain Fatty Acid Relationships Underlie Clinical Heterogeneity and Identify Key Microbial Targets in Irritable Bowel Syndrome (IBS)

Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?

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