Alterations in gut endocrine cells and hormone levels have been measured in patients with irritable bowel syndrome (IBS). The hypothesis of the present study was that hormone levels would change after 4 weeks of a starch- and sucrose-reduced diet (SSRD) intervention corresponding to decreased carbohydrate intake and symptoms. Among 105 IBS patients from primary and tertiary healthcare, 80 were randomized to SSRD, while 25 followed their ordinary diet. Food diaries, Rome IV, and IBS-symptom severity score (IBS-SSS) questionnaires were completed, and blood samples were collected at baseline and after the intervention. Serum C-peptide, gastric inhibitory peptide, glucagon, glucagon-like peptide-1, insulin, leptin, luteinizing hormone, polypeptide YY, and glucose were measured, along with the prevalence of autoantibodies against gonadotropin-releasing hormone; its precursor, progonadoliberin-2, and receptor; and tenascin C. Carbohydrate intake was lower in the intervention group than in controls at week 4 (median: 88 [66-128] g vs 182 [89-224] g; P < .001). The change in carbohydrate intake, adjusted for weight, was associated with a decrease in C-peptide (β: 14.43; 95% confidence interval [CI]: 4.12-24.75) and insulin (β: 0.18; 95% CI: 0.04-0.32) levels. Glucose levels remained unchanged. The IBS-SSS scores were lower in the intervention group but not in controls (P < .001), without any association with changes in hormone concentrations. There was no difference in autoantibody prevalence between patients and healthy controls. In conclusion, the hypothesis that reduced carbohydrate intake corresponded to altered hormonal levels in IBS was accepted; however, there was no relationship between hormonal concentrations and symptoms.

中文翻译：

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肠易激综合征患者的碳水化合物限制饮食导致 C 肽、胰岛素和瘦素的血清水平降低，但与症状减轻没有任何相关性

已经在肠易激综合征 (IBS) 患者中测量了肠道内分泌细胞和激素水平的变化。本研究的假设是，在 4 周的淀粉和蔗糖减少饮食 (SSRD) 干预后，激素水平会发生变化，这与碳水化合物摄入量和症状的减少相对应。在来自初级和三级医疗保健机构的 105 名 IBS 患者中，80 名被随机分配到 SSRD，而 25 名遵循他们的普通饮食。完成食物日记、罗马 IV 和 IBS 症状严重程度评分 (IBS-SSS) 问卷，并在基线和干预后收集血液样本。测定血清C肽、抑胃肽、胰高血糖素、胰高血糖素样肽-1、胰岛素、瘦素、促黄体激素、多肽YY和葡萄糖，随着针对促性腺激素释放激素的自身抗体的流行；其前体、progonadoliberin-2 和受体；第 4 周时，干预组的碳水化合物摄入量低于对照组（中位数：88 [66-128] g vs 182 [89-224] g；P < .001）。根据体重调整的碳水化合物摄入量的变化与 C 肽（β：14.43；95% 置信区间 [CI]：4.12-24.75）和胰岛素（β：0.18；95% CI：0.04-0.32）的减少有关) 水平。葡萄糖水平保持不变。干预组的 IBS-SSS 评分较低，而对照组则不然（P < .001），与激素浓度的变化没有任何关联。患者和健康对照之间的自身抗体流行率没有差异。综上所述，减少碳水化合物摄入与 IBS 激素水平改变相对应的假设被接受；然而，激素浓度与症状之间没有关系。