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<p>This study investigated whether the Dietary Index for Gut Microbiota (DI-GM), a measure of diet quality for gut health, is associated with IBS risk, and symptom severity, inflammation. A case–control study included 350 adults (175 IBS patients per Rome IV and 175 matched controls). Dietary intake was assessed using a validated food frequency questionnaire to calculate DI-GM scores. Irritable Bowel Syndrome severity and quality of life were measured via the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS), Irritable Bowel Syndrome Extended Symptom Severity Scale (IBS-EISSS), and Irritable Bowel Syndrome Quality of Life questionnaire (IBS-QOL). Serum inflammatory markers—including C-reactive protein (CRP), lipopolysaccharide (LPS), zonulin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and brain-derived neurotrophic factor (BDNF)—were quantified using ELISA. IBS patients had significantly lower DI-GM scores than controls (7.69 ± 3.12 vs. 12.15 ± 2.60; <i>p</i> &lt; 0.001). Participants in the highest DI-GM tertile showed significantly lower zonulin (31.33 ± 0.58 vs. 56.01 ± 22.49 ng/mL; <i>p</i> &lt; 0.001), LPS (1.03 ± 0.30 vs. 1.84 ± 0.47 EU/mL; <i>p</i> &lt; 0.001), and CRP (3.10 ± 0.03 vs. 5.53 ± 1.41&#xa0;mg/L; <i>p</i> &lt; 0.001). Higher DI-GM scores were associated with lower psychological scores and IBS symptom severity (all <i>p</i> &lt; 0.001). Importantly, IBS symptom severity showed strong positive correlations with inflammatory markers, suggesting that symptom severity may drive dietary modifications and inflammatory responses. Logistic regression indicated that individuals in the highest DI-GM tertile had substantially lower odds of IBS compared to the lowest tertile. Higher DI-GM scores were associated with lower IBS odds and favorable profiles. However, strong correlations between symptom severity and inflammation suggest reverse causality—symptoms may drive dietary changes rather than diet determining disease. Due to the cross-sectional design, causal inference is not permitted, and prospective studies are required.</p>

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Dietary index for gut microbiota (DI-GM) and irritable bowel syndrome: a case–control study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月9日

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  • Yatian Wang,
  • Guoshan Zhang,
  • Shen Lin,
  • Xiaoyuan Zhuang

摘要

This study investigated whether the Dietary Index for Gut Microbiota (DI-GM), a measure of diet quality for gut health, is associated with IBS risk, and symptom severity, inflammation. A case–control study included 350 adults (175 IBS patients per Rome IV and 175 matched controls). Dietary intake was assessed using a validated food frequency questionnaire to calculate DI-GM scores. Irritable Bowel Syndrome severity and quality of life were measured via the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS), Irritable Bowel Syndrome Extended Symptom Severity Scale (IBS-EISSS), and Irritable Bowel Syndrome Quality of Life questionnaire (IBS-QOL). Serum inflammatory markers—including C-reactive protein (CRP), lipopolysaccharide (LPS), zonulin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and brain-derived neurotrophic factor (BDNF)—were quantified using ELISA. IBS patients had significantly lower DI-GM scores than controls (7.69 ± 3.12 vs. 12.15 ± 2.60; p < 0.001). Participants in the highest DI-GM tertile showed significantly lower zonulin (31.33 ± 0.58 vs. 56.01 ± 22.49 ng/mL; p < 0.001), LPS (1.03 ± 0.30 vs. 1.84 ± 0.47 EU/mL; p < 0.001), and CRP (3.10 ± 0.03 vs. 5.53 ± 1.41 mg/L; p < 0.001). Higher DI-GM scores were associated with lower psychological scores and IBS symptom severity (all p < 0.001). Importantly, IBS symptom severity showed strong positive correlations with inflammatory markers, suggesting that symptom severity may drive dietary modifications and inflammatory responses. Logistic regression indicated that individuals in the highest DI-GM tertile had substantially lower odds of IBS compared to the lowest tertile. Higher DI-GM scores were associated with lower IBS odds and favorable profiles. However, strong correlations between symptom severity and inflammation suggest reverse causality—symptoms may drive dietary changes rather than diet determining disease. Due to the cross-sectional design, causal inference is not permitted, and prospective studies are required.