Синдром повышенной эпителиальной проницаемости у больных синдромом раздраженного кишечника, ассоциированным с избыточной массой тела и ожирением

Abstract

Aim: to study the intestinal epithelial barrier state and conduct clinical comparisons in patients with IBS associated with overweight and obesity with the following parameters: irritable bowel syndrome (IBS) manifestations, life quality, eating habits, signs of anxiety and depression based on the special questionnaire results and leptin and adiponectin adipokines levels. Materials and Methods: an open cross-sectional study was conducted with the inclusion of 175 subjects (mean age — 29 y.o. [26; 35]). Group 1 included 100 patients with IBS: subgroup 1A consisted of 50 patients with IBS associated with overweight or obesity, subgroup 1B — 50 patients with IBS and normal BMI. Group 2 included 75 patients without IBS: subgroup 2A consisted of 50 subjects without IBS but with overweight or obesity, subgroup 2B — 25 conditionally healthy subjects. IBS symptoms were assessed using a 10-point numeric rating scale. Verified questionnaires were used to assess the severity of gastrointestinal symptoms, the presence of anxiety and depression, the specific anxiety level, life quality and eating habits. The levels of fecal zonulin, leptin and adiponectin adipokines in blood serum were determined in all subjects. Results: patients with IBS based on overweight and obesity were characterized by a more significant disorder in the intestinal barrier permeability versus patients with normal BMI. This significant disorder in the intestinal barrier permeability was associated with more severe IBS symptoms and disease course, as well as it was characteristic of patients experiencing cravings for fatty, starchy and salty foods. In subgroup 1A (IBS associated with overweight and obesity) there was a negative association of fecal zonulin concentration with life quality indicators. Patients with IBS who had signs of anxiety and depression according to the special questionnaire results were characterized by more significant epithelial permeability disorders (p<0.05). The association presence of fecal zonulin levels and adipokines was established in the subgroups 1A and 2A (overweight and obesity, with and without IBS). Conclusion: it is promising to assess the potential in using cytoprotectors in patients with overweight and obesity in order to pathogenetically influence the source mechanisms of IBS symptoms and reduce the risks of endothelial dysfunction. KEYWORDS: irritable bowel syndrome, zonulin, syndrome of increased epithelial permeability, obesity. FOR CITATION: Fedorin M.M., Livzan M.A., Gaus O.V. Syndrome of increased epithelial permeability in patients with irritable bowel syndrome associated with overweight and obesity. Russian Medical Inquiry. 2023;7(7):424–431 (in Russ.). DOI: 10.32364/2587-6821-2023-7-7-4.