Perfiles Cardiometabólicos y Metabólicos en el Síndrome del Intestino Irritable Asociado con la Diabetes Tipo 2

Irritable bowel syndrome (IBS), a common disorder of gut-brain interaction, has been increasingly associated with metabolic dysfunction and cardiometabolic risk. This study aimed to comprehensively assess cardiometabolic risk factors in individuals with IBS and to characterize their metabolic profiles in comparison with those of healthy and diabetic cohorts. First, in a retrospective database analysis, cardiometabolic risk factors of patients with IBS (n = 582,377) were compared with healthy controls (HC) (n = 1,492,376). Following propensity score matching (n = 492,468), cardiometabolic parameters were analyzed during a follow-up period of one to 24 months post-index. Second, a total of 234 individuals underwent comprehensive metabolic phenotyping utilizing state-of-the-art nuclear magnetic resonance spectroscopy, comparing blood profiles of patients diagnosed with type 2 diabetes (T2D), IBS, and HC. We observed an increased cardiometabolic risk profile in patients with IBS compared to HC, characterized by higher mean body mass index, higher triglyceride levels, lower high-density lipoprotein cholesterol, and higher hemoglobin A1c levels. Odds ratios (OR) were significantly increased in IBS, particularly for chronic hypergylcemia (OR = 16.32; p < 0.001). Results were confirmed by deep metabolic phenotyping, revealing a metabolic tendency in IBS patients toward profiles characteristic of T2D by alterations in amino acid (glycine, histidine, phenylalanine), glucose (glucose, lactate, pyruvate), and lipid metabolism (parameters related to very low-density lipoproteins, VLDL). Our findings confirm that IBS is linked to a distinct cardiometabolic risk profile and reveal metabolic associations relevant to T2D.