European Journal of Nutrition

, Volume 58, Issue 8, pp 3109–3119 | Cite as

Metabolomics analysis revealed metabolic changes in patients with diarrhea-predominant irritable bowel syndrome and metabolic responses to a synbiotic yogurt intervention

  • Hamid Noorbakhsh
  • Masoud YavarmaneshEmail author
  • Seyed Ali Mortazavi
  • Peyman Adibi
  • Ali A. Moazzami
Original Contribution



Irritable bowel syndrome is a gastrointestinal disorder which can influence human metabolism. It has been demonstrated that probiotics are beneficial in controlling IBS. Thus, the main objective of the present study was to determine metabolic changes in response to diarrhea predominant irritable bowel syndrome (IBS-D) and to investigate the metabolic effects of a synbiotic intervention on serum, urine, and stool samples from IBS-D patients and healthy controls using proton nuclear magnetic resonance (1HNMR).


A 1HNMR-based metabolomics study was conducted on urine and serum metabolites from 16 healthy and eight IBS-D participants at baseline and after 4 weeks of a synbiotic yogurt intervention.


At the baseline, serum acetoacetate, myo-inositol, and sarcosine concentrations were higher and threonine and methionine concentrations were lower in the IBS-D cohort than the control group. Moreover, Indoxyl-sulfate concentration of urine was lower and dimethylamine and taurine were higher in the IBS-D group. After intervention, serum concentration of ketone bodies decreased, choline, phenylalanine, and branched-chain amino acids increased in IBS-D group. Metabolomics analysis indicated a shift in one-carbon metabolism. Thus, the level of serum homocysteine was determined and found to be higher in the IBS-D cohort at baseline, and then decreased after the intervention.


IBS causes a shift in one-carbon metabolism and these changes can be reversed by a synbiotic intervention. An increase in the number of fecal Lactobacilli and an improvement in the health status of IBS-D patients were also observed in response to intervention.


Diarrhea-predominant irritable bowel syndrome Gut microbiota Homocysteine Metabolomics One-carbon metabolism 



Branched-chain amino acid


Cross-validated analysis of variance


Gastrointestinal tract


Diarrhea-predominant irritable bowel syndrome


Orthogonal partial least squares discriminant analysis


Principal component analysis


Partial least squares discriminant analysis


Sulfur-containing amino acids


Variable importance for projection





The authors thank Professor Ahmad Yaraghi for help in collection of human samples. The authors’ responsibilities were as follows: HN: performed the study; MY and SAM: led the design of the microbiological experiments; PA: selected the participants and led the clinical part of study; AAM: led the design of the experiment, performing the metabolomics study, interpretation of results, and writing the manuscript. All of the authors read and approved the final manuscript.


This study was initiated and financially supported by the Ferdowsi University of Mashhad, Iran, as part of a PhD project (Grant No. 37938).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

394_2018_1855_MOESM1_ESM.docx (371 kb)
Supplementary material 1 (DOCX 371 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Hamid Noorbakhsh
    • 1
  • Masoud Yavarmanesh
    • 1
    Email author
  • Seyed Ali Mortazavi
    • 1
  • Peyman Adibi
    • 2
  • Ali A. Moazzami
    • 3
  1. 1.Department of Food Science and Technology, Collage of AgricultureFerdowsi University of MashhadMashhadIran
  2. 2.Integrative Functional Gastroenterology Research CenterIsfahan University of Medical SciencesIsfahanIran
  3. 3.Department of Molecular SciencesSwedish University of Agricultural SciencesUppsalaSweden

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