Clinical and pathogenetic significance of intestinal permeability markers and low-grade inflammation in patients with symptomatic uncomplicated diverticular disease in the setting of obesity

Neiko V.Ye.,Dzvonkovska V.V.,Salyzhyn T.I.,Feshovets N.M.

Main
Publications
Clinical and pathogenetic significance of intestinal permeability markers and low-grade inflammation in patients with symptomatic uncomplicated diverticular disease in the setting of obesity

May 29, 2026

УДК: 616.34-007.64-06:616-056.52]-092-074

DOI: 10.32471/umj.1680-3051.277519

Keywords :

abdominal pain syndrome,

bacterial translocation,

visceral hypersensitivity

Specialities :

Gastroenterology

Endocrinology

Resume

Objective: assessment of the impact of comorbid pathology on the level of low-grade inflammation in the long-term post-hospital period in patients with symptomatic uncomplicated diverticular disease of the colon through determination of the clinical and pathogenetic significance of serum zonulin and the IBS-SSS clinical index. Methods. Sixty individuals were examined and allocated to a control group (10 apparently healthy individuals) and two main subgroups of 25 patients each with verified symptomatic uncomplicated diverticular disease — with normal body weight and with concomitant obesity. Serum zonulin concentration was determined and IBS-SSS questionnaire assessment was performed twice in all participants, at admission and after 75 days. Statistical processing was carried out in MedCalc using the Student t-test for paired and unpaired samples and the parametric Pearson correlation analysis; differences at p<0.05 were considered significant. Results. At admission, both main subgroups showed a significant excess over control values (zonulin 22.4±3.1 ng/ml, IBS-SSS 35.2±8.5 points). In the subgroup without obesity, zonulin reached 75.8±8.4 ng/ml and IBS-SSS 215.4±24.6 points, whereas in the presence of obesity higher values were recorded (zonulin 94.5±10.2 ng/ml, IBS-SSS 285.6±31.2 points; p<0.01). After 75 days, parameters normalised in patients without obesity (zonulin 25.1±4.2 ng/ml, IBS-SSS 45.8±12.3 points, p>0.05 versus control), whereas in obesity a significant excess over the norm persisted (zonulin 48.3±6.1 ng/ml, IBS-SSS 112.4±18.5 points; p<0.01). Correlation analysis revealed a very strong direct association between zonulin and IBS-SSS in the obesity subgroup (r=0.91), a strong one without obesity (r=0.74) and a weak one in the control group (r=0.28). Conclusions. Zonulin concentration and the IBS-SSS index objectively reflect the severity of intestinal barrier impairment and low-grade inflammation in symptomatic uncomplicated diverticular disease. Obesity drives persistence of the inflammatory process and incomplete restoration of intestinal wall permeability in the long-term period, which substantiates the appropriateness of personalised, prolonged anti-inflammatory and barrier-protective treatment regimens for this category of patients.

References

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