Sex‐based differences in fecal short‐chain fatty acid and gut microbiota in irritable bowel syndrome patients

Objective To explore alterations in fecal short‐chain fatty acids (SCFA) and gut microbiota in patients with diarrhea‐predominant irritable bowel disease (IBS‐D) and their relationships with clinical manifestations. Methods We recruited 162 patients with IBS‐D and 66 healthy controls (HC). Their manifestations and psychological status were evaluated using the IBS severity scoring system and the Hospital Anxiety and Depression Scale (HADS). Colorectal visceral sensitivity was evaluated using a barostat. Systemic inflammation was evaluated using plasma cytokine levels. Fecal SCFA were quantified using ultra‐performance liquid chromatography‐tandem mass spectrometry, and fecal microbiota communities were analyzed using 16S rRNA sequencing. Results More men presented with IBS‐D than women in our patient cohort. Patients with IBS‐D had more severe manifestations, higher HADS score, and a higher rate of previous infectious enteritis than HC. Notably, female patients had significantly higher HADS scores than male patients. Male patients had significantly higher levels of plasma interleukin (IL)‐12, fecal propionate and colorectal visceral sensitivity than male HC, while no differences were observed between female patients and female HC. Fecal acetate, butyrate and valerate correlated with the initial visceral sensory threshold, stressors, and IL‐10 and IL‐12 levels. The propionate‐producing Prevotella 9 genus was significantly increased in male patients and positively correlated with fecal propionate. Conclusion Distinct sex‐based differences in clinical manifestations, fecal SCFA and microbiota richness are found in Chinese patients with IBS‐D, which may be used to diagnose dysbiosis in these patients.
We found distinct sex differences in clinical manifestations, fecal short‐chain fatty acids (SCFA) and fecal microbiota in Chinese patients with diarrhea‐predominant irritable bowel syndrome (IBS‐D), indicating that there may be sex‐based differences in the pathophysiological mechanisms of the disease. Patient's sex should be considered when developing treatment strategies for Chinese patients.The changes in fecal SCFA may indicate whether there is dysbiosis in patients with IBS‐D.