Assessment of the content of short-chain fatty acids in ulcerative colitis as an indicator of the patient's metabolic health

Numerous studies show that in the pathogenesis of ulcerative colitis (UC), a significant role is played by a change in the diversity of the intestinal microflora, which is associated with fewer bacteria producing short-chain fatty acids (SCFAs). SCFCS affect the differentiation and activation of cells of the immune system, play a protective role in maintaining the integrity of the epithelial barrier, participate in the regulation of intestinal peristalsis and blood supply to its wall, muscle anabolism, bioavailability of amino acids.

The aim of the study. To evaluate the content of SCLC in the feces of UC patients with varying degrees of severity of the current attack, as well as to investigate the relationship between the content of SCLC with dietary characteristics, body mass index (BMI), and dyspenia.

Materials and methods. The study involved 80 UC patients, conducted a survey, objective examination, filling out medical history and outpatient records, blood and stool sampling. The content of SCLC was determined in feces. The study of nutritional characteristics in patients with UC was conducted using a standardized questionnaire of the WHO CINDI program. Statistical methods: median (Me), upper and lower quartiles (P₂₅, P₇₅) were calculated; Mann-Whitney criterion; Kolmogorov-Smirnov criterion; nonparametric correlation analysis was performed.

Results. The absolute content of SCFCS in the feces of patients with UC is lower than the reference values. The relative content of propionic acid in the subgroup with severe attack was significantly lower than in the remission subgroup, in the subgroup with mild and moderate attack of the disease. In patients with body weight deficiency, the relative content of propionic acid is lower than in UC patients with normal or overweight. A positive relationship was found between the total content of SCFCS in feces and the amount of dietary fiber consumed in the form of fruits and vegetables. In patients with dinapenia, the relative content of butyric acid in feces is significantly lower than in patients without dinapenia.

1. Shelygin Yu.A., Ivashkin V. T., Belousova E. A., Reshetov I. V., Maev I. V., Achkasov S. I., et al. Ulcerative colitis (K51), adults. Coloproctology. 2023;22(1):10–44. https://doi.org/10.33878/2073–7556–2023–22–1–10–44

2. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. Gastroenterol Hepatol. 2020;5(1):17–30. https://doi.org/10.1016/S2468–1253(19)30333–4

3. Borowitz S. M. The epidemiology of inflammatory bowel disease: Clues to pathogenesis? Front Ped. 2023;10:1103713. https://www.frontiersin.org/articles/10.3389/fped.2022.1103713/full

4. Bikbavova G. R., Livzan M. A., Sovalkin V. I., Turchaninov D. V., Lopatina O. E., Tretyakova T. V., et al. The influence of features of modern lifestyle on the occurrence of ulcerative colitis. Archive of Internal Medicine. 2019; 9(3):188–193. https://doi.org/10.20514/2226–6704–2019–9–3–188–193

5. Ardatskaya M.D. Clinical significance of short-chain fatty acids in pathology of the gastrointestinal tract: thesis. Dr. med. Sci. Moscow, 2003. 45 p.

6. Peng K., Xia S., Xiao S., Yu Q. Short-chain fatty acids affect the development of inflammatory bowel disease through intestinal barrier, immunology, and microbiota: A promising therapy? J Gastroenterol Hepatol. 2022;37(9):1710–1718. https://doi.org/10.1111/jgh.15970

7. Zhang D., Jian Y.-P, Zhang Y.-N., Li Y., Gu L.-T., Sun H.-H., et al. Short-chain fatty acids in diseases. Cell Commun Signal. 2023;21(1):212. https://doi.org/10.1186/s12964–023–01219–9

8. Markowiak-Kopeć P., Śliżewska K. The effect of probiotics on the production of short-chain fatty acids by human intestinal microbiome. Nutrients. 2020;12(4):1107. https://doi.org/10.3390/nu12041107

9. Liu P., Wang Y., Yang G., Zhang Q., Meng L., Xin Y., et al. The role of short-chain fatty acids in intestinal barrier function, inflammation, oxidative stress, and colonic carcinogenesis. Pharmacol Res. 2021;165:105420. https://doi.org/10.1016/j.phrs.2021.105420

10. Sun J., Shen X., Li Y., Guo Z., Zhu W., Zuo L., et al. Therapeutic potential to modify the mucus barrier in inflammatory bowel disease. Nutrients. 2016;8(1):44. https://doi.org/10.3390/nu8010044

11. Ney L. M., Wipplinger M., Grossmann M., Engert N., Wegner V.D, Mosig A. S. Short chain fatty acids: key regulators of the local and systemic immune response in inflammatory diseases and infections. Open Biol. 2023;13(3):230014. https://doi.org/10.1098/rsob.230014

12. Nardone O. M., de Sire R., Petito V., Testa A., Villani G., Scaldaferri F., et al. Inflammatory bowel diseases and sarcopenia: the role of inflammation and gut microbiota in the development of muscle failure. Front Immunol. 2021;12:694217. https://doi.org/10.3389/fimmu.2021.694217

13. Xu H. M., Zhao H.-L., Guo G.-J., Xu J., Zhou Y.-L., Huang H.-L., et al. Characterization of short-chain fatty acids in patients with ulcerative colitis: A meta-analysis. BMC Gastroenterol. 2022;22(1):1–9. https://doi.org/10.1186/s12876–022–02191–3

14. Ministry of Health of the Russian Federation. Ulcerative colitis. Clinical recommendations. 2022. Available at: https://cr.minzdrav.gov.ru/schema/193_1#doc_b (access date: 02/12/2024). Cruz-Jentoft A.J., Bahat G., Bauer J., Boirie Y., Bruyère O., Cederholm T., et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31. https:// doi.org/10.1093/ageing/afy169

15. Robertson A., Prättälä R., Zakotnik J. M., Brazdova Z., MacLean D., Ellul M., et al. CINDI dietary guide. (Document EUR/00/5018028). Copenhagen: WHO Regional Office for Europe, 2000. 42 p. Available at: https://www.researchgate.net/publication/265594306_CINDI_Dietary_Guide (access date: 12.02.2024).

16. Dominianni C., Sinha R., Goedert J. J., Pei Z., Yang L., Hayes R. B., et al. Sex, body mass index, and dietary fiber intake influence the human gut microbiome. PloS One. 2015;10(4): e0124599. https://doi.org/10.1371/journal.pone.0124599

17. De Filippis F., Pellegrini N., Vannini L., Jeffery I. B., La Storia A., Laghi L., et al. High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Gut. 2016;65(11):1812–1821. https://doi.org/10.1136/gutjnl-2015–309957

18. Kang L., Li P., Wang D., Wang T., Hao D., Qu X. Alterations in intestinal microbiota diversity, composition, and function in patients with sarcopenia. Sci Rep.2021; 11(1):4628. https://doi.org/10.1038/s41598–021–84031–0.

19. Volpi, E., Kobayashi H., Sheffield-Moore M., Mittendorfer B., Wolfe R. R. Essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. Am J Clin Nutr. 2003;78(2):250–258. https://doi.org/10.1093/ajcn/78.2.250