Plasma profile and urine excretion of amino acids in children with celiac disease on gluten-free diet after oligofructose-enriched inulin intervention: results of a randomised placebo-controlled pilot study

Natalia Drabińska, Urszula Krupa-Kozak, Ewa Ciska, Elżbieta Jarocka-Cyrta, Natalia Drabińska, Urszula Krupa-Kozak, Ewa Ciska, Elżbieta Jarocka-Cyrta

Abstract

The circulating amino acid (AAs) concentrations are indicators of dietary protein intake and metabolic status. In celiac disease (CD), the AA imbalance is frequently observed. Prebiotics are found to alleviate nutrient deficiencies. Therefore, the aim of this study was to analyse the impact of oligrofructose-enriched inulin (Synergy 1), administered for 3 months as a gluten-free diet (GFD) supplement to children with CD, on the plasma and urine concentrations of AAs. CD children (N = 34) were randomised into two groups, receiving Synergy 1 (10 g/day) or placebo (maltodextrin) for 3 months. The AA profile and concentration was determined in plasma and urine before and after the dietary intervention by gas chromatography. 22 and 28 AAs were determined in plasma and urine samples, respectively. After the intervention, the plasma concentrations of several AAs (Ala, Pro, Asn, Glu, Tyr, Lys, His, Orn) increased significantly in both experimental groups, while Gln increased only in the Synergy 1 group. The urinary excretion of Asn, Lys and Aaa increased significantly in the Synergy 1 group, and the excretion of Asp and Met decreased (p < 0.05) in the placebo group. The Gln:Glu ratio in urine increased in both groups after the intervention. An increased urinary excretion of AAs observed in Synergy 1 group with a simultaneous increase in the content of circulating AAs could be attributed to higher absorption or intensified metabolism of AAs, and on the other hand further healing of the intestinal mucosa being the result of continuous treatment with GFD. Moreover, the observed changes in Glu concentration suggest that oligofructose-enriched inulin could improve the intestinal condition and permeability. To conclude, a prebiotic-supplemented GFD influences beneficially the overall AAs metabolism in CD children; however, further prospective cohort studies are needed to confirm the results obtained.

Keywords: Amino acids; Celiac disease; Clinical trial; Dietary intervention; Gluten-free diet; Oligofructose-enriched inulin.

Conflict of interest statement

Conflict of interest

As authors of this manuscript, we declare no conflict of interest, either financial or otherwise.

Research involving human participants and/or animals

This study had been approved by the Bioethics Committee of the Faculty of Medicine of the University of Warmia and Mazury in Olsztyn, Poland (decision No. 23/2015 of 16 June 2015). The study protocol and all procedures performed in this study involving human participants were done in accordance with the ethical principles of the World Medical Association (WMA) 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain or report any studies with animals performed by any of the authors. The study was registered at www.clinicaltrials.gov as NCT03064997.

Informed consent

Written informed consent was obtained from the parents or legal guardians of all study participants.

Figures

Fig. 1
Fig. 1
Box-and-whisker plots of the Gln:Glu ratio in the plasma a and urine b of children with celiac disease: a comparison of the group supplemented with Synergy 1 and the placebo group at baseline and after 3 months of supplementation; Mann–Whitney test
Fig. 2
Fig. 2
Summarized values of total concentrations of all, essential (EAAs), non-essential (NEAAs) and branched-chain (BCAAs) amino acids in plasma a and urine b of children with CD from Synergy 1 and placebo group, before (T0) and after (T1) the intervention

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