Increased Bile Acid Biosynthesis Is Associated With Irritable Bowel Syndrome With Diarrhea

Banny S. Wong, Michael Camilleri, Paula Carlson, Sanna McKinzie, Irene Busciglio, Olga Bondar, Roy B. Dyer, Jesse Lamsam, Alan R. Zinsmeister

Research output: Contribution to journalArticle

111 Citations (Scopus)

Abstract

Background & Aims: Variations in genes that regulate bile acid (BA) synthesis are associated with colonic transit in patients with irritable bowel syndrome (IBS). We investigated features of BA synthesis and excretion and genetic features of patients with different types of IBS. Methods: In 26 healthy volunteers, 26 patients with IBS and constipation (IBS-C), and 26 with IBS and diarrhea (IBS-D), we measured serum levels of 7α-hydroxy-4-cholesten-3-one (C4; a surrogate for BA synthesis) and fibroblast growth factor (FGF) 19 (an ileal hormone that downregulates BA synthesis). For stool samples, we measured concentration of BA, weight, and amount of fat when participants were given high-fat diets. Spearman correlations were used to explore relationships among factors. We analyzed 1 polymorphism in Klotho-β (KLB) and 3 in fibroblast growth factor receptor-4 (FGFR4) for all members of each group using analysis of covariance. Results: The concentration of BA in stool was associated with group (for a comparison of 3 groups; P = .057); it was higher in patients with IBS-D than IBS-C (P = .017). The serum level of C4 was higher in patients with IBS-D than IBS-C (P = .02) or healthy volunteers (P = .01); 38% of patients with IBS-D had increased serum levels of C4, compared with healthy volunteers. Serum level of C4 correlated with stool concentration of BA (rs = 0.606; P < .001), serum FGF19 (rs = -0.324; P = .007), and stool weight (rs = 0.366; P = .003). Stool concentration of BA correlated with weight (rs = 0.737; P < .001) and level of fat (rs = 0.528; P < .001). Body mass index correlated with serum level of C4 (rs = 0.423, P < .001) and stool concentration of BA (rs = 0.507, P < .001), and was higher in patients with IBS-D compared with other groups (overall P = .036). FGFR4 rs1966265 was associated with stool level of BA (P = .032). Conclusions: Patients with IBS-D have greater body mass index and synthesize and excrete higher levels of BA than individuals with IBS-C or healthy volunteers. Serum levels of C4 might be used to identify patients with IBS-D who have BA malabsorption; studies are needed to determine if some patients have a genetic predisposition to this disorder.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
Volume10
Issue number9
DOIs
StatePublished - Sep 2012

Fingerprint

Irritable Bowel Syndrome
Bile Acids and Salts
Diarrhea
Serum
Receptor, Fibroblast Growth Factor, Type 4
Healthy Volunteers
Weights and Measures
Body Mass Index
Fats
Fibroblast Growth Factors
High Fat Diet
Constipation
Genetic Predisposition to Disease
Down-Regulation

Keywords

  • Colon
  • Liver
  • Malabsorption
  • Metabolism

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Increased Bile Acid Biosynthesis Is Associated With Irritable Bowel Syndrome With Diarrhea. / Wong, Banny S.; Camilleri, Michael; Carlson, Paula; McKinzie, Sanna; Busciglio, Irene; Bondar, Olga; Dyer, Roy B.; Lamsam, Jesse; Zinsmeister, Alan R.

In: Clinical Gastroenterology and Hepatology, Vol. 10, No. 9, 09.2012.

Research output: Contribution to journalArticle

Wong, BS, Camilleri, M, Carlson, P, McKinzie, S, Busciglio, I, Bondar, O, Dyer, RB, Lamsam, J & Zinsmeister, AR 2012, 'Increased Bile Acid Biosynthesis Is Associated With Irritable Bowel Syndrome With Diarrhea', Clinical Gastroenterology and Hepatology, vol. 10, no. 9. https://doi.org/10.1016/j.cgh.2012.05.006
Wong, Banny S. ; Camilleri, Michael ; Carlson, Paula ; McKinzie, Sanna ; Busciglio, Irene ; Bondar, Olga ; Dyer, Roy B. ; Lamsam, Jesse ; Zinsmeister, Alan R. / Increased Bile Acid Biosynthesis Is Associated With Irritable Bowel Syndrome With Diarrhea. In: Clinical Gastroenterology and Hepatology. 2012 ; Vol. 10, No. 9.
@article{59a4d940ad3741ce8b27694c26cb53ee,
title = "Increased Bile Acid Biosynthesis Is Associated With Irritable Bowel Syndrome With Diarrhea",
abstract = "Background & Aims: Variations in genes that regulate bile acid (BA) synthesis are associated with colonic transit in patients with irritable bowel syndrome (IBS). We investigated features of BA synthesis and excretion and genetic features of patients with different types of IBS. Methods: In 26 healthy volunteers, 26 patients with IBS and constipation (IBS-C), and 26 with IBS and diarrhea (IBS-D), we measured serum levels of 7α-hydroxy-4-cholesten-3-one (C4; a surrogate for BA synthesis) and fibroblast growth factor (FGF) 19 (an ileal hormone that downregulates BA synthesis). For stool samples, we measured concentration of BA, weight, and amount of fat when participants were given high-fat diets. Spearman correlations were used to explore relationships among factors. We analyzed 1 polymorphism in Klotho-β (KLB) and 3 in fibroblast growth factor receptor-4 (FGFR4) for all members of each group using analysis of covariance. Results: The concentration of BA in stool was associated with group (for a comparison of 3 groups; P = .057); it was higher in patients with IBS-D than IBS-C (P = .017). The serum level of C4 was higher in patients with IBS-D than IBS-C (P = .02) or healthy volunteers (P = .01); 38{\%} of patients with IBS-D had increased serum levels of C4, compared with healthy volunteers. Serum level of C4 correlated with stool concentration of BA (rs = 0.606; P < .001), serum FGF19 (rs = -0.324; P = .007), and stool weight (rs = 0.366; P = .003). Stool concentration of BA correlated with weight (rs = 0.737; P < .001) and level of fat (rs = 0.528; P < .001). Body mass index correlated with serum level of C4 (rs = 0.423, P < .001) and stool concentration of BA (rs = 0.507, P < .001), and was higher in patients with IBS-D compared with other groups (overall P = .036). FGFR4 rs1966265 was associated with stool level of BA (P = .032). Conclusions: Patients with IBS-D have greater body mass index and synthesize and excrete higher levels of BA than individuals with IBS-C or healthy volunteers. Serum levels of C4 might be used to identify patients with IBS-D who have BA malabsorption; studies are needed to determine if some patients have a genetic predisposition to this disorder.",
keywords = "Colon, Liver, Malabsorption, Metabolism",
author = "Wong, {Banny S.} and Michael Camilleri and Paula Carlson and Sanna McKinzie and Irene Busciglio and Olga Bondar and Dyer, {Roy B.} and Jesse Lamsam and Zinsmeister, {Alan R.}",
year = "2012",
month = "9",
doi = "10.1016/j.cgh.2012.05.006",
language = "English (US)",
volume = "10",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "9",

}

TY - JOUR

T1 - Increased Bile Acid Biosynthesis Is Associated With Irritable Bowel Syndrome With Diarrhea

AU - Wong, Banny S.

AU - Camilleri, Michael

AU - Carlson, Paula

AU - McKinzie, Sanna

AU - Busciglio, Irene

AU - Bondar, Olga

AU - Dyer, Roy B.

AU - Lamsam, Jesse

AU - Zinsmeister, Alan R.

PY - 2012/9

Y1 - 2012/9

N2 - Background & Aims: Variations in genes that regulate bile acid (BA) synthesis are associated with colonic transit in patients with irritable bowel syndrome (IBS). We investigated features of BA synthesis and excretion and genetic features of patients with different types of IBS. Methods: In 26 healthy volunteers, 26 patients with IBS and constipation (IBS-C), and 26 with IBS and diarrhea (IBS-D), we measured serum levels of 7α-hydroxy-4-cholesten-3-one (C4; a surrogate for BA synthesis) and fibroblast growth factor (FGF) 19 (an ileal hormone that downregulates BA synthesis). For stool samples, we measured concentration of BA, weight, and amount of fat when participants were given high-fat diets. Spearman correlations were used to explore relationships among factors. We analyzed 1 polymorphism in Klotho-β (KLB) and 3 in fibroblast growth factor receptor-4 (FGFR4) for all members of each group using analysis of covariance. Results: The concentration of BA in stool was associated with group (for a comparison of 3 groups; P = .057); it was higher in patients with IBS-D than IBS-C (P = .017). The serum level of C4 was higher in patients with IBS-D than IBS-C (P = .02) or healthy volunteers (P = .01); 38% of patients with IBS-D had increased serum levels of C4, compared with healthy volunteers. Serum level of C4 correlated with stool concentration of BA (rs = 0.606; P < .001), serum FGF19 (rs = -0.324; P = .007), and stool weight (rs = 0.366; P = .003). Stool concentration of BA correlated with weight (rs = 0.737; P < .001) and level of fat (rs = 0.528; P < .001). Body mass index correlated with serum level of C4 (rs = 0.423, P < .001) and stool concentration of BA (rs = 0.507, P < .001), and was higher in patients with IBS-D compared with other groups (overall P = .036). FGFR4 rs1966265 was associated with stool level of BA (P = .032). Conclusions: Patients with IBS-D have greater body mass index and synthesize and excrete higher levels of BA than individuals with IBS-C or healthy volunteers. Serum levels of C4 might be used to identify patients with IBS-D who have BA malabsorption; studies are needed to determine if some patients have a genetic predisposition to this disorder.

AB - Background & Aims: Variations in genes that regulate bile acid (BA) synthesis are associated with colonic transit in patients with irritable bowel syndrome (IBS). We investigated features of BA synthesis and excretion and genetic features of patients with different types of IBS. Methods: In 26 healthy volunteers, 26 patients with IBS and constipation (IBS-C), and 26 with IBS and diarrhea (IBS-D), we measured serum levels of 7α-hydroxy-4-cholesten-3-one (C4; a surrogate for BA synthesis) and fibroblast growth factor (FGF) 19 (an ileal hormone that downregulates BA synthesis). For stool samples, we measured concentration of BA, weight, and amount of fat when participants were given high-fat diets. Spearman correlations were used to explore relationships among factors. We analyzed 1 polymorphism in Klotho-β (KLB) and 3 in fibroblast growth factor receptor-4 (FGFR4) for all members of each group using analysis of covariance. Results: The concentration of BA in stool was associated with group (for a comparison of 3 groups; P = .057); it was higher in patients with IBS-D than IBS-C (P = .017). The serum level of C4 was higher in patients with IBS-D than IBS-C (P = .02) or healthy volunteers (P = .01); 38% of patients with IBS-D had increased serum levels of C4, compared with healthy volunteers. Serum level of C4 correlated with stool concentration of BA (rs = 0.606; P < .001), serum FGF19 (rs = -0.324; P = .007), and stool weight (rs = 0.366; P = .003). Stool concentration of BA correlated with weight (rs = 0.737; P < .001) and level of fat (rs = 0.528; P < .001). Body mass index correlated with serum level of C4 (rs = 0.423, P < .001) and stool concentration of BA (rs = 0.507, P < .001), and was higher in patients with IBS-D compared with other groups (overall P = .036). FGFR4 rs1966265 was associated with stool level of BA (P = .032). Conclusions: Patients with IBS-D have greater body mass index and synthesize and excrete higher levels of BA than individuals with IBS-C or healthy volunteers. Serum levels of C4 might be used to identify patients with IBS-D who have BA malabsorption; studies are needed to determine if some patients have a genetic predisposition to this disorder.

KW - Colon

KW - Liver

KW - Malabsorption

KW - Metabolism

UR - http://www.scopus.com/inward/record.url?scp=84865313567&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865313567&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2012.05.006

DO - 10.1016/j.cgh.2012.05.006

M3 - Article

C2 - 22610000

AN - SCOPUS:84865313567

VL - 10

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 9

ER -