Sex-Dependent Efficacy of Dietary Fiber in Pediatric Functional Abdominal Pain.

Autor:	So SY; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas; Texas Children's Microbiome Center, Texas Children's Hospital, Houston, Texas; Department of Pathology, Texas Children's Hospital, Houston, Texas., Badu S; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas; Texas Children's Microbiome Center, Texas Children's Hospital, Houston, Texas; Department of Pathology, Texas Children's Hospital, Houston, Texas., Wu Q; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas; Texas Children's Microbiome Center, Texas Children's Hospital, Houston, Texas; Department of Pathology, Texas Children's Hospital, Houston, Texas., Yalcinkaya N; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas; Texas Children's Microbiome Center, Texas Children's Hospital, Houston, Texas; Department of Pathology, Texas Children's Hospital, Houston, Texas., Mirabile Y; Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas., Castaneda R; Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas., Musaad S; Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas., Heitkemper M; Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington., Savidge TC; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas; Texas Children's Microbiome Center, Texas Children's Hospital, Houston, Texas; Department of Pathology, Texas Children's Hospital, Houston, Texas., Shulman RJ; Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas. Electronic address: rshulman@bcm.edu.
Jazyk:	angličtina
Zdroj:	Gastroenterology [Gastroenterology] 2024 Apr; Vol. 166 (4), pp. 645-657.e14. Date of Electronic Publication: 2023 Dec 19.
DOI:	10.1053/j.gastro.2023.12.011
Abstrakt:	Background & Aims: Functional abdominal pain disorders (FAPDs) are more prevalent in female patients. Dietary fiber may alleviate FAPD symptoms; however, whether this effect is sex dependent remains unclear. We investigated the sex dependency of dietary fiber benefit on abdominal pain in children with FAPDs and explored the potential involvement of the gut microbiome. Methods: In 2 cross-sectional cohorts of children with FAPDs (n = 209) and healthy control individuals (n = 105), we correlated dietary fiber intake with abdominal pain symptoms after stratifying by sex. We also performed sex-stratified and sex-interaction analyses on data from a double-blind trial in children with irritable bowel syndrome randomized to psyllium fiber (n = 39) or placebo (n = 49) for 6 weeks. Shotgun metagenomics was used to investigate gut microbiome community changes potentially linking dietary fiber intake with abdominal pain. Results: In the cross-sectional cohorts, fiber intake inversely correlated with pain symptoms in boys (pain episodes: r = -0.24, P = .005; pain days: r = -0.24, P = 0.004) but not in girls. Similarly, in the randomized trial, psyllium fiber reduced the number of pain episodes in boys (P = .012) but not in girls. Generalized linear regression models confirmed that boys treated with psyllium fiber had greater reduction in pain episodes than girls (P = .007 for fiber × sex × time interaction). Age, sexual development, irritable bowel syndrome subtype, stool form, and microbiome composition were not significant determinants in the dietary fiber effects on pain reduction. Conclusions: Dietary fiber preferentially reduces abdominal pain frequency in boys, highlighting the importance of considering sex in future dietary intervention studies for FAPDs. (ClincialTrials.gov, Number NCT00526903). (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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