BACKGROUND Microscopic colitis (MC) is an increasingly common cause of watery diarrhea particularly in older individuals. The role of diet in MC has received little study. METHODS We conducted a case-control study at a single institution enrolling patients referred for elective outpatient colonoscopy for diarrhea. Patients were classified as cases with MC or non-MC controls after a review of colon biopsies by 1 research pathologist. Study subjects were interviewed by a trained telephone interviewer using a validated food frequency questionnaire. Adherent microbes were evaluated from colonic biopsies using 16s rRNA sequencing. RESULTS The study population included 106 cases with MC and 215 controls. Compared with controls, the cases were older, better educated, and more likely to be female. Cases with MC had lower body mass index and were more likely to have lost weight. Subjects in the highest quartile of dietary calcium intake had a lower risk of MC compared with those in the lowest quartile (adjusted odds ratio 0.22, 95% confidence interval 0.07-0.76). The findings were not explained by dairy intake, body mass index, or weight loss. We found that dietary calcium intake had significant associations with the abundance of Actinobacteria and Coriobacteriales in the microbial community of colonic biopsies. DISCUSSION Compared with patients with diarrhea, cases with MC had a lower intake of dietary calcium. Diet can be associated with alterations in the gut microbiota and with luminal factors that could affect the risk of MC.

中文翻译：

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膳食钙和显微镜下结肠炎的风险。

背景技术显微结肠炎(MC)是水样腹泻的日益常见的原因，尤其是在老年人中。饮食在 MC 中的作用很少受到研究。方法 我们在一家机构开展了一项病例对照研究，招募因腹泻而转诊接受选择性门诊结肠镜检查的患者。一名研究病理学家对结肠活检进行审查后，将患者分为 MC 病例或非 MC 对照病例。研究对象由经过培训的电话采访员使用经过验证的食物频率问卷进行采访。使用 16s rRNA 测序评估结肠活检中的粘附微生物。结果 研究人群包括 106 名 MC 病例和 215 名对照者。与对照组相比，这些病例年龄更大，受教育程度更高，而且更有可能是女性。MC 病例的体重指数较低，体重减轻的可能性更大。与膳食钙摄入量最低四分位的受试者相比，膳食钙摄入量最高四分位的受试者发生 MC 的风险较低（调整优势比 0.22，95% 置信区间 0.07-0.76）。这些发现并不能用乳制品摄入量、体重指数或体重减轻来解释。我们发现膳食钙摄入量与结肠活检微生物群落中放线菌和红曲菌的丰度显着相关。讨论 与腹泻患者相比，MC 患者的膳食钙摄入量较低。饮食可能与肠道微生物群的改变以及可能影响 MC 风险的管腔因素有关。