Correlation Between Zinc Nutritional Status with Serum Zonulin and Gastrointestinal Symptoms in Diarrhea-Predominant Irritable Bowel Syndrome: A Case-Control Study

Abstract

Background Zinc is known to have a critical role in the maintenance of intestinal homeostasis, immune cells, and anti-diarrheal and anti-inflammatory actions. Aims The aim of this study was to evaluate the correlation between zinc status with serum zonulin and gastrointestinal symptoms in diarrhea-predominant patients with irritable bowel syndrome (IBS-D). Methods This case-control study included 61 newly diagnosed IBS-D patients and 61 healthy matched controls. Dietary zinc intake, serum zinc, and zonulin levels were measured. IBS severity was evaluated using the IBS severity score system (IBS-SSS) questionnaire. Results Serum zinc levels were lower in the IBS-D group compared with the controls (p = 0.001). Serum zinc was negatively correlated with serum zonulin in IBS-D patients (r = - 0.271; p = 0.035). Also, a reverse association between the serum zinc and odds of IBS-D was found OR = 0.979; 95% CI (0.966-0.992). Conclusions Our results suggest that zinc may have a role in the pathogenesis of IBS. However, clinical trial studies are warranted to evaluate this finding.