title: Volatile organic compounds in breath as markers for irritable bowel syndrome: a metabolomic approach.
abstract: The diagnosis of irritable bowel syndrome (IBS) is challenging because of its heterogeneity and multifactorial pathophysiology. No reliable biomarkers of IBS have been identified so far.
  
  
  
  In a case-control study, using a novel application of breath analysis to distinguish IBS patients from healthy controls based on the analysis of volatile organic compounds (VOCs). Subsequently, the diagnostic VOC-biomarker set was correlated with self-reported gastrointestinal (GI) symptoms of subjects of the Maastricht IBS clinical cohort and of a general population cohort, LifeLines DEEP.
  
  
  
  Breath samples were collected from 170 IBS patients and 153 healthy controls in the clinical cohort and from 1307 participants in general population cohort. Multivariate statistics were used to identify the most discriminatory set of VOCs in the clinical cohort, and to find associations between VOCs and GI symptoms in both cohorts.
  
  
  
  A set of 16 VOCs correctly predicted 89.4% of the IBS patients and 73.3% of the healthy controls (AUC = 0.83). The VOC-biomarker set correlated moderately with a set of GI symptoms in the clinical (r = 0.55, P = 0.0003) and general population cohorts (r = 0.54, P = 0.0004). A Kruskal-Wallis test showed no influence from possible confounding factors in distinguishing IBS patients from healthy controls.
  
  
  
  A set of 16 breath-based biomarkers that distinguishes IBS patients from healthy controls was identified. The VOC-biomarker set correlated significantly with GI symptoms in two independent cohorts. We demonstrate the potential use of breath analysis in the diagnosis and monitoring of IBS, and a possible application of VOC analyses in a general population cohort.
authors.affiliation: Top Institute Food and Nutrition, Wageningen, The Netherlands.|Department of Pharmacology and Toxicology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Baranska
authors.affiliation: Top Institute Food and Nutrition, Wageningen, The Netherlands.|Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Z
authors.initials: Z
authors.lastname: Mujagic
authors.affiliation: Top Institute Food and Nutrition, Wageningen, The Netherlands.|Department of Pharmacology and Toxicology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Smolinska
authors.affiliation: Department of Pharmacology and Toxicology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: Dallinga
authors.affiliation: Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: D M A E
authors.initials: DM
authors.lastname: Jonkers
authors.affiliation: Top Institute Food and Nutrition, Wageningen, The Netherlands.|Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: E F
authors.initials: EF
authors.lastname: Tigchelaar
authors.affiliation: Top Institute Food and Nutrition, Wageningen, The Netherlands.|Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Dekens
authors.affiliation: Top Institute Food and Nutrition, Wageningen, The Netherlands.|Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Zhernakova
authors.affiliation: Department of Developmental Physiology and Nutrition, Danone Nutricia Research, Utrecht, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Ludwig
authors.affiliation: Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: A A M
authors.initials: AA
authors.lastname: Masclee
authors.affiliation: Top Institute Food and Nutrition, Wageningen, The Netherlands.|Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Wijmenga
authors.affiliation: Department of Pharmacology and Toxicology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors.forename: F J
authors.initials: FJ
authors.lastname: van Schooten
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001944:Breath Tests; D016022:Case-Control Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D055549:Volatile Organic Compounds / Q000032:analysis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D055549:Volatile Organic Compounds