Markers of Bile Acid Metabolism in Pediatric Diarrhea Predominant Irritable Bowel Syndrome and Healthy Controls.
J Pediatr Gastroenterol Nutr
; 72(6): 859-865, 2021 06 01.
Article
en En
| MEDLINE
| ID: mdl-33976086
ABSTRACT
OBJECTIVES:
Excessive fecal bile acids in adults have been associated with diarrhea-predominant irritable bowel syndrome (IBS-D), but their role in pediatric IBS-D is unknown. Serum markers including 7α-hydroxy-4-cholesten-3-one (C4) and fibroblast growth factor-19 (FGF-19) were validated in adults to detect bile acid diarrhea (BAD) compared to 48-hour fecal bile acid collection (48FBA). Our aims were to assess fasting serum C4 and FGF-19 and 48FBA in a pediatric population, to compare measurements in IBS-D patients and healthy controls (HC), and to determine the prevalence of BAD among children with IBS-D.METHODS:
Using a cross-sectional design, 26 patients with IBS-D and 56 HC were recruited in two pediatric tertiary care centers. Fasting serum C4 and FGF-19 and 48FBA were obtained. Participants completed a 7-day bowel diary coinciding with stool collection. Associations were analyzed using Spearman correlations.RESULTS:
Mean age was 14.7â±â2.5âyears (42.3% female) in IBS-D and 12.6â±â2.4âyears (39.3% female) in HC. There was a significant correlation of C4 with 48FBA (râ=â0.48, Pâ<â0.05) and an inverse association with FGF-19 (râ=â-0.43, Pâ<â0.05). No significant differences were noted in C4 (Pâ=â0.32), FGF-19 (Pâ=â0.1), or 48FBA (Pâ=â0.5) between IBS-D and HC groups; however, 20% of IBS-D patients had elevated C4 and 28% had low FGF-19 values.Fecal primary BA was significantly correlated with stool frequency (râ=â0.45, Pâ<â0.002).CONCLUSIONS:
Correlations of C4 with 48FBA and FGF-19 are confirmed in a pediatric population. Twenty percent of pediatric patients with IBS-D had abnormal fasting serum C4. This serum test could be applied to identify BAD in pediatric IBS-D.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Síndrome del Colon Irritable
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Año:
2021
Tipo del documento:
Article
País de afiliación:
Marruecos