Faecal metabolome and its determinants in inflammatory bowel disease
Objective Inflammatory bowel disease (IBD) is a multifactorial immune-mediated inflammatory disease of the intestine, comprising Crohn’s disease and ulcerative colitis. By characterising metabolites in faeces, combined with faecal metagenomics, host genetics and clinical characteristics, we aimed to unravel metabolic alterations in IBD.Design We measured 1684 different faecal metabolites and 8 short-chain and branched-chain fatty acids in stool samples of 424 patients with IBD and 255 non-IBD controls. Regression analyses were used to compare concentrations of metabolites between cases and controls and determine the relationship between metabolites and each participant’s lifestyle, clinical characteristics and gut microbiota composition. Moreover, genome-wide association analysis was conducted on faecal metabolite levels.Results We identified over 300 molecules that were differentially abundant in the faeces of patients with IBD. The ratio between a sphingolipid and L-urobilin could discriminate between IBD and non-IBD samples (AUC=0.85). We found changes in the bile acid pool in patients with dysbiotic microbial communities and a strong association between faecal metabolome and gut microbiota. For example, the abundance of Ruminococcus gnavus was positively associated with tryptamine levels. In addition, we found 158 associations between metabolites and dietary patterns, and polymorphisms near NAT2 strongly associated with coffee metabolism.Conclusion In this large-scale analysis, we identified alterations in the metabolome of patients with IBD that are independent of commonly overlooked confounders such as diet and surgical history. Considering the influence of the microbiome on faecal metabolites, our results pave the way for future interventions targeting intestinal inflammation.Data are available on reasonable request. Tables containing the levels of faecal metabolites and bacterial taxa abundances are provided with the manuscript. The raw metagenomics, host genomics and phenotypic data used in this study are available from the European Genome–Phenome Archive data repository: 1000 Inflammatory bowel disease (IBD) cohort (https://www.ebi.ac.uk/ega/datasets/EGAD00001004194), Lifelines DEEP cohort (https://www.ebi.ac.uk/ega/datasets/EGAD00001001991). This includes submitting a letter of intent to the corresponding data access committees. Codes are publicly available at: [https://github.com/GRONINGEN-MICROBIOME-CENTRE/Fecal\_Metabolites\_IBD][1] [1]: https://github.com/GRONINGEN-MICROBIOME-CENTRE/Fecal_Metabolites_IBD