Dietary and metabolomic determinants of relapse in ulcerative colitis patients: A pilot prospective cohort study

Table 1 Comparison of demographic, anthropometric, body composition, and clinical characteristics of ulcerative colitis patients at baseline according to their relapse status after 12 mo n (%)

	Remission (n = 13)	Relapse (n = 7)	P value
Age, yr	46.0 (32.5-56.5)	33.0 (28.0-52.0)	0.18
Females	7 (53.8)	4 (57.1)	1.00
Current smoker	2 (15.4)	0 (0.0)	0.52
Body mass index, kg/m2	28.1 (25.3-32.7)	22.0 (20.3-22.8)	< 0.01
Overweight/obese	10 (76.9)	1 (14.3)	0.02
Waist circumference, cm	99.1 (84.4-105.3)	82.8 (70.1-89.0)	0.03
Waist to height ratio	0.6 (0.5-0.6)	0.5 (0.4-0.5)	0.02
Body fat percentage	35.8 (27.0-47.6)	29 (20.4-34.1)	0.16
Fat mass, kg	34.1 (20.4-45.5)	20.1 (16.3-24.6)	0.04
Age at diagnosis, yr	26.0 (22.5-44.5)	25.0 (17-29)	0.39
Months since last relapse	12.0 (4.5-33)	11.0 (6.0-40)	0.76
UC subtype
Proctitis	1 (7.7)	1 (14.3)
Left-sided	4 (30.8)	3 (42.9)	0.71
Pancolitis	8 (61.5)	3 (42.9)
Medication
5-ASA	9 (69.2)	4 (57.1)	0.65
Immunosuppressants	4 (30.8)	2 (28.6)	1.00
No medication	3 (23.1)	1 (14.3)	1.00

Numerical variables are presented as median (interquartile range). UC: Ulcerative colitis.

Table 2 Dietary intake of nutrients and food groups at baseline in ulcerative colitis patients with and without clinical relapse¹²

	Patient groups		P value3
	Remission (n = 13)	Relapse (n = 7)
Energy (Kcal/d)	1530.8 (1258.3-2121.4)	1820.2 (1430.8-2337.1)	0.70
Nutrients
Carbohydrate (g/d)	229.6 (217.0-253.4)	201.5 (156.4-237.1)	0.21
Protein (g/d)	61.6 (55.0-74.9)	62.0 (40.6-70.0)	0.70
Fat (g/d)	59.0 (50.7-61.6)	62.3 (46.2-76.0)	0.21
Cholesterol (g/d)	198.0 (155.9-275.4)	166.8 (117.6-207.4)	0.18
SFA (g/d)	18.5 (16.4-20.3)	20.4 (11.9-23.8)	0.52
MUFA (g/d)	21.3 (17.3-23.1)	21.7 (15.0-30.4)	0.64
PUFA (g/d)	14.4 (12.9-14.8)	12.9 (9.1-15.5)	0.70
TFA (g/d)	3.3 (2.8-3.5)	3.5 (1.7-4.5)	0.97
Vitamin C (mg/d)	112.3 (101.2-166.7)	100.1 (93.6-124.3)
Vitamin B6 (mg/d)	1.8 (1.5-2.5)	1.7 (1.3-1.9)	0.52
Total folate (mcg/d)	401.3 (289.5-540.9)	402.3 (222.8-474.9)	0.77
Vitamin B12 (mcg/d)	3.8 (3.3-5.7)	4.6 (2.3-5.7)	0.90
Vitamin E (IU)	14.8 (8.7-20.8)	10.2 (4.4-14.4)	0.13
Calcium (mg/d)	832.0 (730.8-1234.0)	719.9 (551.7-924.0)	0.21
Iron (mg/d)	13.4 (10.4-25.6)	11.7 (7.4-15.0)	0.42
Zinc (mg/d)	9.7 (9.4-16.2)	9.8 (6.9-10.2)	0.64
Sodium (mg/d)	2558.6 (2175.3-2900.6)	2521.9 (1818.8-2810.8)	0.77
Potassium (mg/d)	2948.8 (2216.0-3624.5)	2951.9 (1890.8-3330.1)	0.83
Fibre (g/d)	16.1 (13.5-26.0)	14.1 (9.7-22.2)	0.32
Sucrose (g/d)	40.2 (29.9-47.3)	27.6 (20.6-40.4)	0.11
Fructose (g/d)	31.1 (18.4-42.3)	25.5 (11.7-38.5)	0.64
Lactose (g/d)	13.6 (9.4-19.0)	9.8 (1.8-17.5)	0.32
Maltose (g/d)	3.9 (3.1-4.3)	1.6 (1.1-3.0)	< 0.01
Food groups
Fruit (cup equivalents/d)	2.1 (0.8-2.6)	1.4 (0.7-2.0)	0.28
Vegetable (cup equivalents/d)	1.8 (1.5-2.4)	1.8 (1.0-3.1)	0.77
Whole grain (oz equivalents/d)	1.0 (0.5-1.3)	0.7 (0.2-1.1)	0.32
Meat (oz/d)	1.0 (0.6-1.3)	1.0 (0.3-1.8)	1.00
Processed meat (oz/d)	0.3 (0.1-0.5)	0.2 (0.0-1.0)	0.83
Fish (oz/d)	0.3 (0.2-0.8)	0.5 (0.2-2.2)	0.64
Poultry (oz/d)	0.9 (0.1-1.3)	0.2 (0.1-0.3)	< 0.01
Dairy (cup equivalents/d)	1.4 (1.0-1.8)	1.2 (0.3-2.0)	0.52
Eggs (oz equivalents/d)	0.4 (0.2-0.8)	0.2 (0.2-0.4)	0.42
Alcohol (drink/d)	0.6 (0.0-0.8)	0.6 (0.0-3.5)	0.90

¹Values are presented as median (interquartile range);

²Intake of different nutrients and foods were adjusted for total energy intake using the residual method;

³Obtained from Mann-Whitney U test. SFA: Saturated fatty acids; MUFA: Monounsaturated fatty acids; PUFA: Polyunsaturated fatty acids; TFA: Trans fatty acids.

Table 3 Comparison of major serum and urinary metabolites responsible for the separation between two groups of ulcerative colitis patients¹²

	UC groups		VIP score	Fold change (remission/relapse)	P value3
	Remission	Relapse
Trans-aconitate (urine)	0.5 (0.5-1.6)	3.6 (1.9-5.5)	1.9	0.2	0.02
3-hydroxybutyrate (serum)	21.0 (15.0-33.9)	127.8 (37.5-232.0)	1.4	0.2	< 0.01
Cystine (urine)	5.3 (4.0-8.6)	3.3 (1.4-5.9)	1.4	2.7	0.07
Acetamide (urine)	4.9 (2.7-7.1)	2.6 (0.8-3.8)	1.3	2.4	0.05
Acetoacetate (serum)	7.8 (5.8-13.0)	25.6 (10.5-60.2)	1.2	0.3	0.02
Acetone (serum)	5.3 (4.2-8.7)	11.9 (6.0-24.7)	1.1	0.4	0.06

¹Concentrations are presented as median (interquartile range);

²Unit of concentration for the metabolites in serum and urine is μmol and μmol/mmol, respectively;

³Obtained from Mann-Whitney U test.