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Dąbek A, Kaczmarczyk O, Dziubyna T, Piątek-Guziewicz A, Zwolińska-Wcisło M. The significance of nutritional strategies in patients with inflammatory bowel disease in the context of malnutrition and the development of malnourished obesity. Folia Med Cracov 2023; 63:41-56. [PMID: 37903378 DOI: 10.24425/fmc.2023.145912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, despite the increasing incidence, still do not have a specific etiology. Diet seems to be an important factor, modifying the occurrence of the disease and its course. Diet can affect the symptoms of IBD both directly, e.g., by alleviating diarrhea, bloating and constipation, and indirectly by shaping the microbiota. Bacterial metabolites produced under the influence of supplied nutrients may contribute to the modulation of pro- and anti-inflammatory pathways, depending on the diet used. So far, IBD has been associated with weight loss and malnutrition. In recent years, a trend of sarcopenic obesity with concomitant malnutrition has been observed. The new phenomenon is called malnubesity. This work aims to review the most commonly used diets in IBD in order to evaluate them in terms of alleviating ailments, but also maintaining proper nutritional status and lack of obesity. Low-fiber, low FODMAPs, Mediterranean diet and Crohn's Disease Exclusion Diet diet were considered. We assume that diet is modifiable factor that is related to nutritional status and healthy body weight. In addition, the current knowledge on the relationship between nutrition strategies, obesity and IBD will be demonstrated.
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Affiliation(s)
- Agnieszka Dąbek
- Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Olga Kaczmarczyk
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Dziubyna
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Małgorzata Zwolińska-Wcisło
- Unit of Clinical Dietetics and Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland.
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Kaczmarczyk O, Dąbek-Drobny A, Piątek-Guziewicz A, Woźniakiewicz M, Paśko P, Dobrowolska-Iwanek J, Woźniakiewicz A, Targosz A, Ptak-Belowska A, Szczyrk U, Strzałka M, Zagrodzki P, Zwolińska-Wcisło M. The Importance of Nutritional Aspects in the Assessment of Inflammation and Intestinal Barrier in Patients with Inflammatory Bowel Disease. Nutrients 2022; 14:4622. [PMID: 36364889 PMCID: PMC9658856 DOI: 10.3390/nu14214622] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 10/29/2023] Open
Abstract
Intestinal inflammation in inflammatory bowel disease (IBD) is closely linked to nutrition. This study aimed to evaluate associations between nutritional, inflammatory, and intestinal barrier parameters in patients with IBD. We assessed nutritional status, fecal short-chain fatty acid profile, serum cytokine levels, and mRNA expression of enzymes and tight junction proteins in intestinal biopsies obtained from 35 patients, including 11 patients with inactive IBD, 18 patients with active IBD, and six controls. Patients with active IBD were characterized by hypoalbuminemia, fluctuations in body weight, and restriction of fiber-containing foods. In addition, they had significantly reduced levels of isovaleric acid and tended to have lower levels of butyric, acetic, and propionic acids. Patients with active IBD had higher mRNA expression of peroxisome proliferator-activated receptor γ and inducible nitric oxide synthase, and lower mRNA expression of claudin-2 and zonula occludens-1, compared with patients with inactive IBD. Moreover, patients with a body mass index (BMI) of ≥25 kg/m2 had higher median tumor necrosis factor-α levels that those with a lower BMI. We comprehensively evaluated inflammatory parameters in relation to IBD activity and nutritional status. The discrepancies between proinflammatory and anti-inflammatory parameters depending on IBD activity may be related to nutritional factors, including diet and abnormal body weight.
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Affiliation(s)
- Olga Kaczmarczyk
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Agnieszka Dąbek-Drobny
- Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Agnieszka Piątek-Guziewicz
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Michał Woźniakiewicz
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387 Krakow, Poland
| | - Paweł Paśko
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Justyna Dobrowolska-Iwanek
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Aneta Woźniakiewicz
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387 Krakow, Poland
| | - Aneta Targosz
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, 31-531 Krakow, Poland
| | - Agata Ptak-Belowska
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, 31-531 Krakow, Poland
| | - Urszula Szczyrk
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, 31-531 Krakow, Poland
| | - Małgorzata Strzałka
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, 31-531 Krakow, Poland
| | - Paweł Zagrodzki
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Małgorzata Zwolińska-Wcisło
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 31-008 Krakow, Poland
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Kaczmarczyk O, Dąbek-Drobny A, Woźniakiewicz M, Paśko P, Piątek-Guziewicz A, Zwolińska-Wcisło M. Altered fecal short‑chain fatty acid profile as a potential marker of disease activity in patients with ulcerative colitis and Crohn's disease: a pilot study. Pol Arch Intern Med 2022; 132. [PMID: 35535572 DOI: 10.20452/pamw.16254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Olga Kaczmarczyk
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Dąbek-Drobny
- Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Michał Woźniakiewicz
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Kraków, Poland
| | - Paweł Paśko
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
| | | | - Małgorzata Zwolińska-Wcisło
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland; Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland.
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Kaczmarczyk O, Dąbek-Drobny A, Woźniakiewicz M, Paśko P, Dobrowolska-Iwanek J, Woźniakiewicz A, Targosz A, Ptak-Belowska A, Piątek-Guziewicz A, Wcisło K, Zagrodzki P, Zwolińska-Wcisło M. Association between fecal levels of Short-Chain Fatty Acids and serum Pro- and Anti-Inflammatory Cytokines in patients with Inflammatory Bowel Disease. Folia Med Cracov 2022; 62:43-55. [PMID: 36088592 DOI: 10.24425/fmc.2022.141690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Inflammatory bowel disease (IBD) represents a group of chronic inflammatory disorders characterized by dysbiosis and altered short-chain fatty acid (SCFA) level. The association between individual SCFA levels and cytokine levels is unknown. OBJECTIVES We aimed to determine the fecal SCFA levels in patients with IBD in relation to disease severity and the serum levels of pro- and anti-inflammatory cytokines. PATIENTS AND METHODS The study included 61 patients with IBD (inactive, 22; active, 39) and 16 controls. Fecal levels of organic acids (acetic, lactic, propionic, butyric, isovaleric, isobutyric, and valeric), serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), IL-17, and IL-22, complete blood count and C-reactive protein (CRP) were measured. RESULTS Patients with active IBD had reduced butyric, acetic, valeric, and isovaleric acid levels and elevated lactic acid levels in stool. Hemoglobin levels were positively correlated with the levels of acetic and butyric acids (R = 0.266 and R = 0.346, respectively; P <0.05). In addition, CRP levels were inversely correlated with butyric acid levels (R = -0.573; P <0.05). Higher serum TNF-α levels were observed in patients with active IBD compared with controls (6.64 pg/ml vs 2.05 pg/ml, P <0.05). No relationship was noted between the SCFA profile and cytokine levels. CONCLUSIONS The study showed that determination of SCFA levels can be used to evaluate the activity of IBD. The relationship between individual SCFA and cytokine levels seems to be complex and requires further studies.
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Affiliation(s)
- Olga Kaczmarczyk
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Dąbek-Drobny
- Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Michał Woźniakiewicz
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Kraków, Poland
| | - Paweł Paśko
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
| | | | - Aneta Woźniakiewicz
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Kraków, Poland
| | - Aneta Targosz
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Agata Ptak-Belowska
- Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | | | - Kacper Wcisło
- Department of Pathomorphology, University Hospital, Kraków, Poland
| | - Paweł Zagrodzki
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Zwolińska-Wcisło
- Department of Gastroenterology and Hepatology; Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland.
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Dąbek-Drobny A, Kaczmarczyk O, Woźniakiewicz M, Paśko P, Dobrowolska-Iwanek J, Woźniakiewicz A, Piątek-Guziewicz A, Zagrodzki P, Zwolińska-Wcisło M. Association between Fecal Short-Chain Fatty Acid Levels, Diet, and Body Mass Index in Patients with Inflammatory Bowel Disease. Biology (Basel) 2022; 11:biology11010108. [PMID: 35053106 PMCID: PMC8772864 DOI: 10.3390/biology11010108] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 12/31/2021] [Accepted: 01/07/2022] [Indexed: 12/12/2022]
Abstract
Simple Summary Inflammatory bowel disease (IBD) is a chronic disorder of the gastrointestinal tract associated with gut inflammation and a disturbance in the amount of bacteria living in the human intestines. As a result, there is a reduction in the production of bacterial metabolites, especially short-chain fatty acids (SCFAs), which are formed from dietary fiber. The aim of our study was to assess the relationship between body mass index (BMI), the type of diet used, and changes in fecal SCFA levels in patients with IBD. We enrolled 61 patients with IBD and 16 patients as a control group. We asked all participants about their daily diet, using the simplified FF questionnaire, and measured the levels of SCFA in their stool samples. Our results revealed that underweight subjects had higher levels of isobutyric acid, whereas those with excessive weight had lower level of butyric, isovaleric, and propionic acids. Furthermore, we observed higher levels of valeric acid in controls than in IBD patients. However, we did not observe a relationship between diet habits and fecal SCFA levels. In conclusion, we demonstrated that BMI is associated with SCFA levels in patients with IBD. Abstract Disturbances in the production of bacterial metabolites in the intestine have been reported in diseases associated with dysbiosis, such as inflammatory bowel diseases (IBDs) that include two conditions: Crohn disease (CD) and ulcerative colitis (UC). Short-chain fatty acids (SCFAs) are the main dietary-fiber-derived bacterial metabolites associated with the course of intestinal inflammation. In this study, we assessed the relationship between body mass index (BMI), the type of diet used, and changes in fecal SCFA levels in patients with IBD. We performed nutritional assessments using a nutritional questionnaire and determined fecal SCFA levels in 43 patients with UC, 18 patients with CD, and 16 controls. Our results revealed that subjects with a BMI > 24.99 kg/m2 had higher levels of isobutyric acid, whereas those with a BMI < 18.5 kg/m2 had lower level of butyric, isovaleric, and propionic acids. Furthermore, we observed higher levels of valeric acid in controls than in IBD patients. We did not reveal a relationship between a specific SCFA and the type of diet, but eating habits appear to be related to the observed changes in the SCFA profile depending on BMI. In conclusion, we demonstrated that BMI is associated with SCFA levels in patients with IBD.
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Affiliation(s)
- Agnieszka Dąbek-Drobny
- Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 30-688 Krakow, Poland;
| | - Olga Kaczmarczyk
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 30-688 Krakow, Poland; (O.K.); (A.P.-G.)
| | - Michał Woźniakiewicz
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, 30-387 Krakow, Poland; (M.W.); (A.W.)
| | - Paweł Paśko
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, 30-688 Krakow, Poland; (P.P.); (J.D.-I.); (P.Z.)
| | - Justyna Dobrowolska-Iwanek
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, 30-688 Krakow, Poland; (P.P.); (J.D.-I.); (P.Z.)
| | - Aneta Woźniakiewicz
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, 30-387 Krakow, Poland; (M.W.); (A.W.)
| | - Agnieszka Piątek-Guziewicz
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 30-688 Krakow, Poland; (O.K.); (A.P.-G.)
| | - Paweł Zagrodzki
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, 30-688 Krakow, Poland; (P.P.); (J.D.-I.); (P.Z.)
| | - Małgorzata Zwolińska-Wcisło
- Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 30-688 Krakow, Poland;
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, 30-688 Krakow, Poland; (O.K.); (A.P.-G.)
- Correspondence: ; Tel.: +48-12-400-31-50
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Piątek-Guziewicz A, Paśko P, Wcisło K, Dąbek-Drobny A, Przybylska-Feluś M, Kaczmarczyk O, Zagrodzki P, Mach T, Zwolińska-Wcisło M. Serum levels of selected micronutrients in patients with inflammatory bowel disease in clinical remission. Pol Arch Intern Med 2021; 131:701-708. [PMID: 34002971 DOI: 10.20452/pamw.15999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Patients with inflammatory bowel disease (IBD) can experience micronutrient deficiency regardless of disease activity and extent. OBJECTIVES We aimed to evaluate serum concentrations of selected trace elements in adult patients with IBD in clinical remission with involvement limited to the colon who received immunosuppressive treatment. PATIENTS AND METHODS We enrolled 32 patients with IBD (mean [SD] age, 41 [15.2] years) and 30 healthy controls (mean [SD] age, 39.1 [11.8] years). Serum selenium, iron, copper, and zinc levels as well as complete blood count were measured in both groups. RESULTS Patients with IBD had lower zinc concentrations than controls (mean [SD], 0.76 [0.13] mg/l vs 0.83 [0.13] mg/l; P = 0.047). No differences were observed for selenium (mean [SD], 0.90 [0.24] μmol/l vs 0.93 [0.19] μmol/l) and copper levels (mean [SD], 1.03 [0.27] mg/l vs 0.97 [0.22] mg/l). Compared with controls, patients with IBD had lower red blood cell count (mean [SD], 4.4 [0.6] 106/μl vs 4.7 [0.4] 106/μl; P = 0.03), hemoglobin (mean [SD], 12.7 [2.2] g/dl vs 14.3 [0.8] g/dl; P = 0.001), and iron levels (mean [SD], 14.2 [9.4] μmol/l vs 23.4 [2.7] μmol/l; P = 0.0001). Patients with IBD showed a positive correlation between selenium and iron (R = 0.499; P = 0.004) as well as selenium and hemoglobin levels (R = 0.579; P = 0.001). CONCLUSIONS Patients with IBD, despite maintaining clinical remission, should undergo systematic laboratory test for anemia or micronutrient deficiencies.
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Affiliation(s)
| | - Paweł Paśko
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
| | - Kacper Wcisło
- Students’ Scientific Association, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Dąbek-Drobny
- Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Magdalena Przybylska-Feluś
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
- Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Olga Kaczmarczyk
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Zagrodzki
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Mach
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Zwolińska-Wcisło
- Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland; Unit of Clinical Dietetics, Department of Gastroenterology and Hepatology, Jagiellonian University Medical College, Kraków, Poland.
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Piątek-Guziewicz A, Dąbek A, Przybylska-Feluś M, Zagrodzki P, Mach T, Zwolińska-Wcisło M. The role of oral vitamin E supplementation in reducing nitrosative stress in adult treated patients with celiac disease: a pilot study. Pol Arch Intern Med 2020; 130:711-713. [DOI: 10.20452/pamw.15369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kaczmarczyk O, Przybylska-Feluś M, Piątek-Guziewicz A, Wcisło K, Krośniak M, Kryczyk-Kozioł J, Kleszcz K, Zagrodzki P, Cibor D, Mach T, Zwolińska-Wcisło M. Effect of long-term proton pump inhibitor therapy on complete blood count parameters and selected trace elements: a pilot study. Pol Arch Intern Med 2019; 130:179-186. [PMID: 31825323 DOI: 10.20452/pamw.15101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Proton pump inhibitors (PPIs) are widely prescribed for several gastrointestinal conditions, often as long‑term therapy. The effects of term PPI use have not been fully elucidated. OBJECTIVES We aimed to determine the association between long‑term PPI use and complete blood count parameters, particularly red blood cell (RBC) count, white blood cell (WBC) count, and hemoglobin concentrations, as well as serum levels of selected micronutrients such as selenium (Se), iron (Fe), copper (Cu), and zinc (Zn). PATIENTS AND METHODS We enrolled 37 patients on long‑ term PPI therapy (mean [SD] age, 57.1 [15.4] years) and 30 healthy controls (mean [SD] age, 39.3 [11.8] years). In each group, complete blood count, and serum Fe levels were performed, and serum Cu, Zn, and Se levels were measured using atomic absorption spectrometry. RESULTS Red blood cell and WBC counts were lower in the PPI group compared with controls (mean [SD], 4.24 [0.55] ×106/μl vs 4.7 [0.4] ×106/μl; P <0.001 and 6.13 [1.44] ×103/μl vs 7.3 [1.28] ×103/μl; P <0.001, respectively). Hemoglobin and serum Fe concentrations were also lower in the PPI group (mean [SD], 12.5 [1.8] g /dl vs 14.3 [0.8] g /dl; P <0.001 and 16.3 [5.4] μmol/l vs 23.4 [2.7] μmol/l; P <0.001, respectively). Serum Zn and Cu concentrations were higher in PPI users than in controls. CONCLUSIONS Long‑term PPI therapy may reduce RBC and WBC counts as well as hemoglobin levels, leading to iron deficiency. It may also aff ect concentrations of some micronutrients, although the underlying mechanism of this association is not fully clear.
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Affiliation(s)
- Olga Kaczmarczyk
- Department of Gastroenterology and Hepatology, University Hospital, Kraków, Poland
| | - Magdalena Przybylska-Feluś
- Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków, Poland; Unit of Clinical Dietetics, Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Piątek-Guziewicz
- Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków, Poland
| | - Kacper Wcisło
- Students’ Scientific Association, Department of Gastroenterology, Hepatology and Infectious diseases, Jagiellonian University Medical College, Kraków, Poland
| | - Mirosław Krośniak
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
| | - Jadwiga Kryczyk-Kozioł
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
| | | | - Paweł Zagrodzki
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Kraków, Poland
| | - Dorota Cibor
- Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Mach
- Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Zwolińska-Wcisło
- Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków, Poland; Unit of Clinical Dietetics, Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Kraków Poland.
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Olszanecka A, Schönborn M, Trynkiewicz A, Cebeńko M, Piątek-Guziewicz A, Mach T, Czarnecka D. Zapalenie osierdzia i mięśnia sercowego — niecodzienna pozajelitowa manifestacja wrzodziejącego zapalenia jelita grubego. Folia Cardiologica 2017. [DOI: 10.5603/fc.2017.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Piątek-Guziewicz A, Zagrodzki P, Paśko P, Krośniak M, Ptak-Belowska A, Przybylska-Feluś M, Mach T, Zwolińska-Wcisło M. Alterations in serum levels of selected markers of oxidative imbalance in adult celiac patients with extraintestinal manifestations: a pilot study. Pol Arch Intern Med 2017; 127:532-539. [PMID: 28475169 DOI: 10.20452/pamw.4020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Oxidative stress is considered to be one of the mechanisms responsible for gluten toxicity, but its role in celiac disease (CD) remains unclear. OBJECTIVES The aim of the study was to evaluate oxidative imbalance in the pathomechanism of CD by determining the concentrations of nitric oxide (NO) and selected antioxidant parameters. PATIENTS AND METHODS The study involved 197 adult patients: 53 patients with untreated active CD, 92 celiac patients on gluten‑free diet (GFD), and 52 controls. The serum levels of antioxidants (uric acid, bilirubin, ferritin, albumin), celiac antibodies, NO, glutathione peroxidase 3 (GPx3), and vitamin E were measured. A histopathological study of duodenal biopsy was performed. RESULTS Celiac patients had higher uric acid concentrations than controls (P <0.001). NO levels were higher in patients with active CD than in controls (P <0.01) and were correlated with the degree of mucosal damage (r2 = 0.04; P = 0.01). Vitamin E levels were decreased in celiac patients (P <0.01), and GPx3 activity was reduced in patients with active CD compared with controls (P <0.001). CONCLUSIONS Oxidative imbalance may be involved in the pathomechanism of CD in adults. GFD only partially reduces oxidative stress. Serum NO levels seem to be a marker of the effectiveness of treatment. Uric acid may act as an antioxidant in CD.
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Piątek-Guziewicz A, Zagrodzki P, Paśko P, Krośniak M, Mach T, Zwolińska-Wcisło M. Ferric reducing ability of plasma and assessment of selected plasma antioxidants in adults with celiac disease. Folia Med Cracov 2017; 57:13-26. [PMID: 29337974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Oxidative stress with an excessive free radical production and a reduction in the activity of protective antioxidants is considered as one of the mechanisms responsible for gluten toxicity. However, its role in celiac disease (CD) is unclear. OBJECTIVES Evaluation of plasma nonenzymatic antioxidant capacity in patients with CD (both untreated patients and those receiving gluten-free diet [GFD]) by measuring the ferric reducing ability of plasma (FRAP) as well as assessing selected plasma antioxidants. PATIENTS AND METHODS The study included 169 adult patients: 48 patients with untreated active CD, 72 patients with CD on a GFD, and 49 healthy controls. In each group, we measured the serum levels of selected antioxidants (uric acid, bilirubin, albumin, and vitamin E) and used the FRAP assay to assess the total antioxidant capacity (TAC) of plasma. In each patient, serological and histopathological activity of CD was also evaluated. RESULTS There were no significant differences in the TAC of plasma measured with the FRAP assay between the study groups. Patients with CD had higher uric acid levels compared with controls (p <0.001), while bilirubin levels were lower in patients with active disease than in controls (p <0.05). Serum vitamin E levels were lower in all patients with CD compared with controls (p <0.01). CONCLUSIONS The FRAP assay is not the method of choice for assessing the TAC of plasma in patients with CD. Owing to high serum uric acid levels, the FRAP assay results in these patients may be overestimated despite the reduced levels of other plasma antioxidants.
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Affiliation(s)
| | | | | | | | | | - Małgorzata Zwolińska-Wcisło
- Unit for Clinical Dietetics, Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Śniadeckich 5, Kraków, Poland.
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Przybylska-Feluś M, Zwolińska-Wcisło M, Piątek-Guziewicz A, Furgała A, Sałapa K, Mach T. Concentrations of antiganglioside M1 antibodies, neuron-specific enolase, and interleukin 10 as potential markers of autonomic nervous system impairment in celiac disease. ACTA ACUST UNITED AC 2016; 126:763-771. [PMID: 27545437 DOI: 10.20452/pamw.3512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Celiac disease (CD) is an immune-mediated enteropathy related to permanent gluten intolerance, characterized by gastrointestinal symptoms as well as nongastrointestinal symptoms, including neurologic ones. The presence of neuron-specific enolase (NSE), interleukin 10 (IL-10), and antiganglioside M1 (anti-GM1) antibodies has been demonstrated for neurologic conditions as well as immune disorders with neurologic manifestations. OBJECTIVES The aim of the study was to determine the concentrations of IL-10, NSE, and anti-GM1 antibodies in the course of CD and their correlation with changes in electrogastrography (EGG) and with heart rate variability (HRV). PATIENTS AND METHODS The study included 68 participants: 34 patients with CD and 34 healthy individuals. We assessed the concentrations of IL-10 and NSE as well as the presence of anti-GM1 antibodies in serum. We investigated correlations between the concentrations of IL-10, NSE, and anti-GM1 antibodies and the results of EGG and HRV. RESULTS Patients with CD had a higher level of anti-GM1 antibodies than controls (1.38 ng/ml [0.98-2.03 ng/ml] vs 0.81 ng/ml [0.35-1.15 ng/ml]). Median IL-10 concentrations in patients with CD differed significantly from those in controls (7 pg/ml [4.33-11.48 pg/ml] vs 4.27 pg/ml [2.44-7 pg/ml]; P = 0.010). In HRV analysis, a positive correlation between IL-10 concentrations and very low frequency spectrum was observed (r = 0.63; P = 0.003). There was no correlation between the concentrations of IL-10, NSE, or anti-GM1 antibodies and EGG parameters. CONCLUSIONS Chronic inflammation in the course of CD may lead to autonomic nervous system impairment and development of neurologic disorders. Therefore, anti-GM1 antibodies and IL-10 may be considered as markers of nervous system impairment in the course of CD.
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