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Liébana-Castillo AR, Redondo-Cuevas L, Nicolás Á, Martín-Carbonell V, Sanchis L, Olivares A, Grau F, Ynfante M, Colmenares M, Molina ML, Lorente JR, Tomás H, Moreno N, Garayoa A, Jaén M, Mora M, Gonzalvo J, Molés JR, Díaz S, Sancho N, Sánchez E, Ortiz J, Gil-Guillén V, Cortés-Castell E, Cortés-Rizo X. Should We Treat SIBO Patients? Impact on Quality of Life and Response to Comprehensive Treatment: A Real-World Clinical Practice Study. Nutrients 2025; 17:1251. [PMID: 40219008 PMCID: PMC11990593 DOI: 10.3390/nu17071251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2025] [Revised: 03/09/2025] [Accepted: 03/31/2025] [Indexed: 04/14/2025] Open
Abstract
Background: Small intestinal bacterial overgrowth (SIBO) is a dysbiosis marked by an excessive proliferation of bacteria in the small intestine, resulting in abdominal symptoms that significantly affect patients' quality of life. Objectives: This study aims to evaluate the impact of a comprehensive therapeutic approach in improving the quality of life of patients with SIBO. Methods: For this purpose, standardized questionnaires were used at baseline, 30 days and 90 days, including the IBS-QOL (Irritable Bowel Syndrome Quality of Life Questionnaire), the GSRS (Gastrointestinal Symptom Rating Scale), the EuroQOL-5D, and the Bristol Scale. Results: The results show that a comprehensive approach, combining pharmacological treatment, appropriate dietary intervention, and strategies aimed at improving gut microbiota and intestinal permeability, produces a sustained improvement in the quality of life of a significant proportion of patients who participated in the study. Furthermore, the results suggest that, although gas normalization is a relevant indicator, clinical improvement and quality of life depend considerably on patients' subjective perception of their health. Conclusions: This finding underscores the importance of recognizing SIBO as a prevalent condition that requires accurate diagnoses and individualized treatments to improve patients' well-being.
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Affiliation(s)
- Ana Reyes Liébana-Castillo
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Lucía Redondo-Cuevas
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Ángela Nicolás
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Vanessa Martín-Carbonell
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (A.G.); (J.G.)
| | - Laura Sanchis
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (A.G.); (J.G.)
| | - Aroa Olivares
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Francisco Grau
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Marina Ynfante
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Michel Colmenares
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - María Leonor Molina
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - José Ramón Lorente
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Héctor Tomás
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Nadia Moreno
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Ana Garayoa
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (A.G.); (J.G.)
| | - Mercedes Jaén
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (A.G.); (J.G.)
| | - María Mora
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (A.G.); (J.G.)
| | - José Gonzalvo
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (A.G.); (J.G.)
| | - José Ramón Molés
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (A.G.); (J.G.)
| | - Samuel Díaz
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Noelia Sancho
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Eva Sánchez
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (A.G.); (J.G.)
| | - Juan Ortiz
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
| | - Vicente Gil-Guillén
- Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, 03550 Elche, Spain; (V.G.-G.); (E.C.-C.)
| | - Ernesto Cortés-Castell
- Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, 03550 Elche, Spain; (V.G.-G.); (E.C.-C.)
| | - Xavier Cortés-Rizo
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (A.R.L.-C.); (Á.N.); (V.M.-C.); (L.S.); (A.O.); (M.Y.); (M.C.); (M.L.M.); (J.R.L.); (H.T.); (N.M.); (M.J.); (M.M.); (J.R.M.); (S.D.); (N.S.); (E.S.); (J.O.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (A.G.); (J.G.)
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Wang H, Xi Y, Gu F, Peng L, Li J. Protective Effects of a Polyherbal Mixture on Intestinal Injury via the NF-κB Signaling Pathway and Gut Microbiota Modulation in Hyperuricemic Mice. Foods 2025; 14:1118. [PMID: 40238278 PMCID: PMC11988963 DOI: 10.3390/foods14071118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2025] [Revised: 03/10/2025] [Accepted: 03/22/2025] [Indexed: 04/18/2025] Open
Abstract
This study investigated the protective effects of a polyherbal tea (PHT) on intestinal injury in hyperuricemia (HUA) mice and the underlying mechanisms. PHT was orally administered to mice for 49 days, while potassium oxonate and hypoxanthine were administered 7 days after PHT administration and continued for 42 days to cause HUA. Treatment with PHT significantly reduced serum uric acid and blood urea nitrogen levels in HUA mice. It also inhibited liver xanthine oxidase activity and promoted intestinal uric acid excretion through the upregulation of transporters GLUT9 and ABCG2. Intestinal barrier integrity was reinforced, as evidenced by the restoration of the villous structure, reduction in edema, and upregulation of tight junction proteins (occludin, ZO-1) and mucin (MUC2). Moreover, PHT suppressed serum LPS levels and inhibited the NF-κB pathway, leading to a reduction in TNF-α and IL-6 levels in the gut. Gut microbiota analysis revealed PHT reversed dysbiosis, enriching beneficial bacteria like Duncaniella sp. and Heminiphilus faecis. By UPLC-MS analysis, 154 compounds of PHT persisted in the gut, suggesting that these compounds are likely to modulate both intestinal barrier function and gut microbiota. These findings suggest that this PHT may have potential as a functional food for the prevention of hyperuricemia.
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Affiliation(s)
- Haoluan Wang
- Key Laboratory of Geriatric Nutrition and Health, Ministry of Education, Beijing Technology and Business University, Beijing 100048, China; (H.W.); (F.G.); (L.P.)
- Key Laboratory of Green and Low-Carbon Processing Technology for Plant-Based Food of China National Light Industry Council, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
| | - Yu Xi
- Key Laboratory of Geriatric Nutrition and Health, Ministry of Education, Beijing Technology and Business University, Beijing 100048, China; (H.W.); (F.G.); (L.P.)
- Key Laboratory of Green and Low-Carbon Processing Technology for Plant-Based Food of China National Light Industry Council, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
| | - Fengju Gu
- Key Laboratory of Geriatric Nutrition and Health, Ministry of Education, Beijing Technology and Business University, Beijing 100048, China; (H.W.); (F.G.); (L.P.)
- Key Laboratory of Green and Low-Carbon Processing Technology for Plant-Based Food of China National Light Industry Council, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
| | - Linlin Peng
- Key Laboratory of Geriatric Nutrition and Health, Ministry of Education, Beijing Technology and Business University, Beijing 100048, China; (H.W.); (F.G.); (L.P.)
- Key Laboratory of Green and Low-Carbon Processing Technology for Plant-Based Food of China National Light Industry Council, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
| | - Jian Li
- Key Laboratory of Geriatric Nutrition and Health, Ministry of Education, Beijing Technology and Business University, Beijing 100048, China; (H.W.); (F.G.); (L.P.)
- Key Laboratory of Green and Low-Carbon Processing Technology for Plant-Based Food of China National Light Industry Council, School of Food and Health, Beijing Technology and Business University, Beijing 100048, China
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Sharabi E, Rezaie A. Small Intestinal Bacterial Overgrowth. Curr Infect Dis Rep 2024; 26:227-233. [DOI: 10.1007/s11908-024-00847-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 01/04/2025]
Abstract
Abstract
Purpose of review
Small intestinal bacterial overgrowth (SIBO) is a chronic gastrointestinal disorder wherein excessive and abnormal growth of bacteria in the small bowel generally causes abdominal pain, bloating, and change in bowel habits. Our understanding of the underlying pathology and microbiome changes in SIBO has advanced greatly in the last 20 years in parallel with advances in treatment methods and diagnostics. Here, we review many of the latest findings that describe the pathophysiology of SIBO as well as its risk factors, clinical behavior, diagnosis, and management.
Recent findings
Studies have begun to employ advanced molecular assays to sequence the small bowel microbiome to reveal the changes evident in SIBO. An increase in the abundance of members of the Enterobacteriaceae is the main alteration to the gut microbiome that correlates with SIBO diagnosis and symptom severity, and enhancement of specific gas-producing pathways has been demonstrated in SIBO. Diagnostic methods continue to evolve with novel methods of small bowel aspiration and changes to interpretation of hydrogen breath tests. Elemental diets are the newest treatment modality that offer an exciting alternative to antibiotic therapy.
Summary
The study of SIBO provides valuable insights into the small bowel microbiome, particularly using molecular testing. Exciting changes to our understanding and treatment of SIBO are already in progress. Future work will be able to better elucidate not only the altered microbiology, but also its gold standard of diagnosis, treatment modalities, and secondary prevention.
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Van Hul M, Cani PD, Petitfils C, De Vos WM, Tilg H, El-Omar EM. What defines a healthy gut microbiome? Gut 2024; 73:1893-1908. [PMID: 39322314 PMCID: PMC11503168 DOI: 10.1136/gutjnl-2024-333378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 08/16/2024] [Indexed: 09/27/2024]
Abstract
The understanding that changes in microbiome composition can influence chronic human diseases and the efficiency of therapies has driven efforts to develop microbiota-centred therapies such as first and next generation probiotics, prebiotics and postbiotics, microbiota editing and faecal microbiota transplantation. Central to microbiome research is understanding how disease impacts microbiome composition and vice versa, yet there is a problematic issue with the term 'dysbiosis', which broadly links microbial imbalances to various chronic illnesses without precision or definition. Another significant issue in microbiome discussions is defining 'healthy individuals' to ascertain what characterises a healthy microbiome. This involves questioning who represents the healthiest segment of our population-whether it is those free from illnesses, athletes at peak performance, individuals living healthily through regular exercise and good nutrition or even elderly adults or centenarians who have been tested by time and achieved remarkable healthy longevity.This review advocates for delineating 'what defines a healthy microbiome?' by considering a broader range of factors related to human health and environmental influences on the microbiota. A healthy microbiome is undoubtedly linked to gut health. Nevertheless, it is very difficult to pinpoint a universally accepted definition of 'gut health' due to the complexities of measuring gut functionality besides the microbiota composition. We must take into account individual variabilities, the influence of diet, lifestyle, host and environmental factors. Moreover, the challenge in distinguishing causation from correlation between gut microbiome and overall health is presented.The review also highlights the resource-heavy nature of comprehensive gut health assessments, which hinders their practicality and broad application. Finally, we call for continued research and a nuanced approach to better understand the intricate and evolving concept of gut health, emphasising the need for more precise and inclusive definitions and methodologies in studying the microbiome.
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Affiliation(s)
- Matthias Van Hul
- Louvain Drug Research Institute (LDRI), Metabolism and Nutrition research group (MNUT), UCLouvain, Université catholique de Louvain, Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO) department, WEL Research Institute, Wavre, Belgium
| | - Patrice D Cani
- Louvain Drug Research Institute (LDRI), Metabolism and Nutrition research group (MNUT), UCLouvain, Université catholique de Louvain, Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO) department, WEL Research Institute, Wavre, Belgium
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Université catholique de Louvain, Brussels, Belgium
| | - Camille Petitfils
- Louvain Drug Research Institute (LDRI), Metabolism and Nutrition research group (MNUT), UCLouvain, Université catholique de Louvain, Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO) department, WEL Research Institute, Wavre, Belgium
| | - Willem M De Vos
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medizinische Universitat Innsbruck, Innsbruck, Austria
| | - Emad M El-Omar
- Microbiome Research Centre, St George and Sutherland Clinical Campuses, University of New South Wales, Sydney, NSW, Australia
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Talamantes S, Steiner F, Spencer S, Neshatian L, Sonu I. Intestinal Methanogen Overgrowth (IMO) Is Associated with Delayed Small Bowel and Colonic Transit Time (TT) on the Wireless Motility Capsule (WMC). Dig Dis Sci 2024; 69:3361-3368. [PMID: 39068378 PMCID: PMC11835418 DOI: 10.1007/s10620-024-08563-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 07/08/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Methanogens are associated with gut dysmotility in animal models but have not been robustly studied in humans. The WMC assesses regional transit time (TT) and pH in the GI tract. AIMS To study the segmental TT and pH among patients with SIBO or IMO utilizing WMC. METHODS We conducted a retrospective study of 207 patients who underwent a glucose or lactulose breath test (BT) and WMC from 2010 to 2022. Diagnosis of SIBO and IMO were based on the 2017 North American consensus criteria. TT and pH were extracted from WMC recordings. We tested for differences in means of continuous variables and frequencies of categorical variables using two-sample t tests, Wilcoxon Rank Sum test, Chi-square, and Fisher exact tests. We used R version 3.3.1 (2016-06-21) for all statistical analyses. RESULTS A total of 196 patients met criteria, mean age 47.4 years and 155 (79.1%) females. Of the 86 (43.9%) patients with a positive BT, 42 (58.3%) had IMO only (meeting only CH4 criteria) and 30 (34.9%) met both H2 and CH4 criteria. Colonic TT was longer in patients with a positive BT compared to negative patients (40 h:29 min vs 28 h:51 min, p = 0.028). Small bowel TT and colonic TT were longer in patients with IMO compared to negative patients (SBTT: 5 h:15 min vs 4 h:32 min, p = 0.021; CTT: 44 h:23 min vs 28 h:51 min, p = 0.030). There were no significant differences in segmental pH compared to negative patients. CONCLUSION To our knowledge, this is the largest study of patients who have undergone both BT and WMC. A positive BT was associated with delayed CTT, while having IMO only was associated with both delayed CTT and SBTT, but neither with pH. Future investigation is needed to elucidate whether changes in intestinal microbiota affect gut transit.
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Affiliation(s)
- Sarah Talamantes
- Division of Gastroenterology & Hepatology, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Faye Steiner
- Division of Gastroenterology & Hepatology, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Sean Spencer
- Division of Gastroenterology & Hepatology, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Leila Neshatian
- Division of Gastroenterology & Hepatology, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Irene Sonu
- Division of Gastroenterology & Hepatology, Department of Medicine, Stanford University, Palo Alto, CA, USA.
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 430 Broadway Pavilion C 3rd Floor, Redwood City, CA, 94063, USA.
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Roszkowska P, Klimczak E, Ostrycharz E, Rączka A, Wojciechowska-Koszko I, Dybus A, Cheng YH, Yu YH, Mazgaj S, Hukowska-Szematowicz B. Small Intestinal Bacterial Overgrowth (SIBO) and Twelve Groups of Related Diseases-Current State of Knowledge. Biomedicines 2024; 12:1030. [PMID: 38790992 PMCID: PMC11117733 DOI: 10.3390/biomedicines12051030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
The human gut microbiota creates a complex microbial ecosystem, characterized by its high population density, wide diversity, and complex interactions. Any imbalance of the intestinal microbiome, whether qualitative or quantitative, may have serious consequences for human health, including small intestinal bacterial overgrowth (SIBO). SIBO is defined as an increase in the number of bacteria (103-105 CFU/mL), an alteration in the bacterial composition, or both in the small intestine. The PubMed, Science Direct, Web of Science, EMBASE, and Medline databases were searched for studies on SIBO and related diseases. These diseases were divided into 12 groups: (1) gastrointestinal disorders; (2) autoimmune disease; (3) cardiovascular system disease; (4) metabolic disease; (5) endocrine disorders; (6) nephrological disorders; (7) dermatological diseases; (8) neurological diseases (9); developmental disorders; (10) mental disorders; (11) genetic diseases; and (12) gastrointestinal cancer. The purpose of this comprehensive review is to present the current state of knowledge on the relationships between SIBO and these 12 disease groups, taking into account risk factors and the causal context. This review fills the evidence gap on SIBO and presents a biological-medical approach to the problem, clearly showing the groups and diseases having a proven relationship with SIBO, as well as indicating groups within which research should continue to be expanded.
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Affiliation(s)
- Paulina Roszkowska
- Department of Diagnostic Immunology, Pomeranian Medical University, st. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (P.R.); (I.W.-K.)
| | - Emilia Klimczak
- Institute of Biology, University of Szczecin, st. Z. Felczaka 3c, 71-412 Szczecin, Poland; (E.K.); (E.O.); (S.M.)
| | - Ewa Ostrycharz
- Institute of Biology, University of Szczecin, st. Z. Felczaka 3c, 71-412 Szczecin, Poland; (E.K.); (E.O.); (S.M.)
- Doctoral School, University of Szczecin, st. A. Mickiewicz 16, 71-412 Szczecin, Poland
- Molecular Biology and Biotechnology Center, University of Szczecin, st. Wąska 13, 71-412 Szczecin, Poland
| | - Aleksandra Rączka
- Department of Genetics, West Pomeranian University of Technology, st. Aleja Piastów 45, 70-311 Szczecin, Poland; (A.R.); (A.D.)
| | - Iwona Wojciechowska-Koszko
- Department of Diagnostic Immunology, Pomeranian Medical University, st. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (P.R.); (I.W.-K.)
| | - Andrzej Dybus
- Department of Genetics, West Pomeranian University of Technology, st. Aleja Piastów 45, 70-311 Szczecin, Poland; (A.R.); (A.D.)
| | - Yeong-Hsiang Cheng
- Department of Biotechnology and Animal Science, National Ilan University, Yilan 26047, Taiwan; (Y.-H.C.); (Y.-H.Y.)
| | - Yu-Hsiang Yu
- Department of Biotechnology and Animal Science, National Ilan University, Yilan 26047, Taiwan; (Y.-H.C.); (Y.-H.Y.)
| | - Szymon Mazgaj
- Institute of Biology, University of Szczecin, st. Z. Felczaka 3c, 71-412 Szczecin, Poland; (E.K.); (E.O.); (S.M.)
| | - Beata Hukowska-Szematowicz
- Institute of Biology, University of Szczecin, st. Z. Felczaka 3c, 71-412 Szczecin, Poland; (E.K.); (E.O.); (S.M.)
- Molecular Biology and Biotechnology Center, University of Szczecin, st. Wąska 13, 71-412 Szczecin, Poland
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Redondo-Cuevas L, Belloch L, Martín-Carbonell V, Nicolás A, Alexandra I, Sanchis L, Ynfante M, Colmenares M, Mora M, Liebana AR, Antequera B, Grau F, Molés JR, Cuesta R, Díaz S, Sancho N, Tomás H, Gonzalvo J, Jaén M, Sánchez E, Garayoa A, Moreno N, Gallén A, Cortés-Castell E, Cortés-Rizo X. Do Herbal Supplements and Probiotics Complement Antibiotics and Diet in the Management of SIBO? A Randomized Clinical Trial. Nutrients 2024; 16:1083. [PMID: 38613116 PMCID: PMC11013329 DOI: 10.3390/nu16071083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
Small intestinal bacterial overgrowth (SIBO) arises from dysbiosis in the small intestine, manifesting with abdominal symptoms. This study aims to assess the efficacy of combined antibiotic therapy, herbal supplements, probiotics, and dietary modifications in SIBO management. A total of 179 SIBO-diagnosed patients underwent clinical evaluation and breath testing. Patients were categorized into hydrogen (H2-SIBO) and methane (CH4-SIBO) groups. The control group received standard antibiotic therapy and a low-FODMAP diet, while the intervention group received additional herbal antibiotics, probiotics, and prebiotics. After treatment, both groups exhibited reduced gas levels, particularly in CH4-SIBO. Clinical remission rates were higher in the intervention group, especially in CH4-SIBO cases. Logistic regression analysis showed gas concentrations at diagnosis as significant predictors of treatment success. In conclusion, adjunctive herbal supplements and probiotics did not significantly impact gas levels, but showed potential for clinical improvement, especially in CH4-SIBO.
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Affiliation(s)
- Lucia Redondo-Cuevas
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Lucia Belloch
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Vanesa Martín-Carbonell
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Angela Nicolás
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Iulia Alexandra
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Laura Sanchis
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Marina Ynfante
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Michel Colmenares
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - María Mora
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Ana Reyes Liebana
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Beatriz Antequera
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Francisco Grau
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - José Ramón Molés
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Rubén Cuesta
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Samuel Díaz
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Noelia Sancho
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Héctor Tomás
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - José Gonzalvo
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Mercedes Jaén
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Eva Sánchez
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Ana Garayoa
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Nadia Moreno
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Ana Gallén
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Ernesto Cortés-Castell
- Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, 03550 Elche, Spain;
| | - Xavier Cortés-Rizo
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
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Ivashkin VT, Fomin VV, Tkacheva ON, Medvedev OS, Poluektova EA, Abdulganieva DI, Abdulkhakov SR, Alexeeva OP, Alekseenko SA, Andreev DN, Baranovsky AY, Zharkova MS, Zolnikova OY, Ivashkin KV, Kliaritskaia IL, Korochanskaya NV, Mammaev SN, Maslennikov RV, Myazin RG, Perekalina MV, Povtoreyko AV, Ulyanin AI, Fadeeva MV, Khlynov IB, Tsukanov VV, Shifrin OS. Small Intestinal Bacterial Overgrowth in Various Specialties of Medical Practice (Literature Review and Expert Council Resolution). RUSSIAN JOURNAL OF GASTROENTEROLOGY, HEPATOLOGY, COLOPROCTOLOGY 2024; 34:14-34. [DOI: 10.22416/1382-4376-2024-954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
Aim: to discuss current views on the clinical significance, diagnostic opportunities, and therapeutic approaches in the treatment of small intestinal bacterial overgrowth (SIBO) as an important component in the gut microbiota function assessment, to assess the awareness of physicians and the opportunities in the diagnosis and treatment of this disease in patients in the Federal districts of the Russian Federation, as well as to present the proceedings of the Expert Council held on December 16, 2023 in Moscow.Key points. SIBO is a common syndrome often associated with irritable bowel syndrome, liver cirrhosis, asthma, and congestive heart failure, being also a predictor of early death in the elderly. Today, in many regions of the Russian Federation, there are limitations for instrumental diagnosis of this disease — lack of awareness among doctors, unavailability of gas analyzers for diagnosing SIBO, lack of information about the need to diagnose SIBO in the standards of compulsory health insurance. Rifaximin is the first-line treatment due to the highest therapeutic efficacy. One of the ways to increase the efficacy of SIBO treatment is to include strain-specific probiotics in the treatment regimen. Saccharomyces boulardii CNCM I-745 is thought to be the most studied, promising probiotic. The review also presents statistical data on the issues in the diagnosis and treatment of SIBO in the regions of the Russian Federation.Conclusion. Optimization of approaches to the diagnosis and treatment of SIBO, the development of domestic gas analyzers, increasing the awareness of physicians in all regions of the Russian Federation, as well as the development and optimization of clinical recommendations appear to be necessary measures to increase the effectiveness of medical care, the duration and quality of life of the Russian population. These goals can be achieved within the framework of Federal programs under the supervision of specialized reference centers of the Ministry of Health of the Russian Federation.
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Affiliation(s)
- V. T. Ivashkin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - V. V. Fomin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - O. N. Tkacheva
- N.I. Pirogov Russian National Research Medical University
| | - O. S. Medvedev
- M.V. Lomonosov Moscow State University; National Medical Research Center of Cardiology names after Academician E.I. Chazov
| | - E. A. Poluektova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | | | - S. R. Abdulkhakov
- Kazan State Medical University; Kazan (Volga Region) Federal University
| | | | | | | | | | - M. S. Zharkova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - O. Yu. Zolnikova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - K. V. Ivashkin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | | | | | | | - R. V. Maslennikov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | | | | | | | - A. I. Ulyanin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - M. V. Fadeeva
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | | | - V. V. Tsukanov
- Scientific Research Institute of Medical Problems of the North, Federal Research Center “Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences”
| | - O. S. Shifrin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Li J, Ma J, Wang W, Du H, Tang S, Li Y, Zhu W, Zhang R, Wan J. Alterations of ileal mucosa-associated microbiota in hypercholesterolemia patients. Heliyon 2023; 9:e22116. [PMID: 38076161 PMCID: PMC10709208 DOI: 10.1016/j.heliyon.2023.e22116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/11/2023] [Accepted: 11/05/2023] [Indexed: 01/03/2025] Open
Abstract
Many metabolic diseases have been demonstrated to be associated with changes in the microbiome. However, no studies have yet been conducted to examine the characteristics of the mucosal microbiota of patients with hypercholesterolemia. We aimed to examine mucosa-associated microbiota in subjects with hypercholesterolemia. We conducted a case-control study, in which ileal mucosal samples were collected from 13 hypercholesterolemia patients and 13 controls for 16S rRNA gene sequencing. There were differences in the composition of ileal mucosal microbiota based on beta diversity between the hypercholesterolemia and control groups (P < 0.05). Compared with the control group, the phylum Bacteroidetes and the genera Bacteroides, Butyricicoccus, Parasutterella, Candidatus_Soleaferrea, and norank_f__norank_o__Izemoplasmatales were less abundant in the hypercholesterolemia group (P < 0.05), while the genus Anaerovibrio was enriched in the hypercholesterolemia group (P < 0.05). The relative abundance of Bacteroides was negatively correlated with total cholesterol and low-density lipoprotein cholesterol (P < 0.01). The relative abundance of Coprococcus was negatively correlated with triglycerides and body mass index (all P < 0.05). PICRUSt functional prediction analysis showed that pathways related to Glycerophospholipid metabolism, ABC transporters, Phosphotransferase system, and Biofilm formation - Escherichia coli, and infectious diseases of pathogenic Escherichia coli were enriched in the hypercholesterolemia group. This work suggests a potential role of ileal mucosal microbiota in the development of hypercholesterolemia.
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Affiliation(s)
- Jia Li
- Department of Gastroenterology, The 983rd Hospital of Joint Logistic Support Force of PLA, No. 60, Huangwei Road, Hebei District, Tianjin 300142, China
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Jinxia Ma
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Weihua Wang
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Haitao Du
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Shuai Tang
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Yi Li
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Wenya Zhu
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Ru Zhang
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
| | - Jun Wan
- Department of Gastroenterology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
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Liu Y, Chu M, Wang D, Luo Y, Liu Z, Zhao J. Risk factors for small intestinal bacterial overgrowth in patients with acute ischaemic stroke. J Med Microbiol 2023; 72. [PMID: 36762525 DOI: 10.1099/jmm.0.001666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Introduction. The intestinal flora has become a promising new target in acute ischaemic stroke (AIS), and small intestinal bacterial overgrowth (SIBO) is a common pathological condition of the intestinal flora. Recently, the lactose hydrogen-methane breath test has emerged as a non-invasive and economical method for the detection of SIBO in AIS patients. Exploring the prevalence of SIBO and its associated risk factors will provide a clinical basis for the association between intestinal flora and AIS.Hypothesis/Gap Statement. Given that the prevalence of SIBO and its risk factors in patients with AIS remain to be studied, there is a need to investigate them.Aim. This study aimed to investigate the prevalence and risk factors of SIBO in patients with AISMethodology. Eighty patients tested for SIBO using the lactulose hydrogen-methane breath test were evaluated. Patients were divided into SIBO-positive and SIBO-negative groups according to the presence or absence of SIBO, respectively. The baseline characteristics and clinical biochemical indicators of the patients were compared between the two groups. The independent risk factors and predictive value of SIBO in AIS patients were determined using multivariate logistic regression and receiver operating characteristic (ROC) curve analyses.Results. Of the 80 consecutive patients with AIS, 23 (28.8 %) tested positive for SIBO. Triglyceride (TG) and homocysteine (Hcy) levels were identified as independent risk factors for SIBO in patients with AIS using multivariate logistic regression analysis (P<0.005). ROC curve analysis showed that the area under the curve (AUC) of TG was 0.690 (95 % CI 0.577-0.789, P=0.002). The sensitivity, specificity and optimal cut-off values were 95.7 %, 35.1 % and 1.14 mmol l-1, respectively. The AUC of Hcy was 0.676 (95 % CI 0.562-0.776, P=0.01). The sensitivity, specificity and optimal cut-off values were 73.9 %, 59.7 % and 14.1 µmol-1, respectively. When TG and Hcy levels were combined, the AUC increased to 0.764 (95 % CI 0.656-0.852, P<0.001). The specificity and sensitivity were 61.4 and 82.6 %, respectively. This showed that the combined detection of TG and Hcy levels had a higher predictive valueConclusion. The prevalence of SIBO in patients with AIS was 28.8 %. TG and Hcy levels are independent risk factors for SIBO in patients with AIS. Both markers had good predictive value for the occurrence of SIBO. In the future, we should actively utilize these indicators to prevent intestinal flora imbalance and the occurrence of SIBO.
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Affiliation(s)
- Yang Liu
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, PR China
| | - Min Chu
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, PR China
| | - Daosheng Wang
- Department of Neurosurgery, Minhang Hospital, Fudan University, Shanghai, PR China
| | - Yunhe Luo
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, PR China
| | - Zhuohang Liu
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, PR China
| | - Jing Zhao
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, PR China
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