Characteristics of gut microbiota and metabolites in patients with ulcerative colitis with fatigue.

Metabolomic profiles were significantly different among the four study groups.

• Principal component analysis/partial least squares discriminant analysis showed significant differences among all four groups (P = 0.001).
• Differential metabolites included linoleoyl ethanolamide, arachidonoyl ethanolamide, glycocholic acid, and thromboxane (TX).
• Thromboxane (TX) was detected exclusively in the HUCF (UC with fatigue) group and not in any other group.
• A total of 120 participants were recruited, divided into four groups of 30 each: HUCF, HUCN, HHF, and HHN.

KEGG pathway enrichment analysis revealed specific metabolic pathway alterations in the HUCF group.

• Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed on the metabolomic data.
• Altered pathways in the HUCF group included eicosanoid metabolism, tryptophan metabolism, and tyrosine metabolism.
• These pathway alterations were specific to the UC with fatigue group.

Gut microbial richness and diversity were significantly lower in patients with UC with fatigue compared to all other groups.

• The HUCF group had significantly lower microbial richness and diversity than the HUCN, HHF, and HHN groups.
• 16S rRNA sequencing was performed on fresh stool samples collected from all 120 participants.
• This finding suggests that UC combined with fatigue is associated with greater gut microbial depletion than either condition alone.

Each study group showed enrichment of distinct microbial taxa.

• The HUCF group was enriched with Hyphomicrobiales, Brucella, Eisenbergiella, Pediococcus, and Sellimonas.
• The HUCN (UC without fatigue) group showed enrichment of Campylobacter-related taxa.
• The HHF (healthy with fatigue) group showed enrichment of Fusobacterium, Desulfovibrionaceae, and Bilophila.
• The HHN (healthy without fatigue) group showed enrichment of beneficial genera such as Adlercreutzia.
• Notably, Anaerococcus, described as a beneficial genus, was uniquely enriched in the HUCF group.

Specific microbial genera were correlated with the severity of both UC and fatigue.

• Correlation analysis indicated that Faecalibacterium was associated with the severity of UC and fatigue.
• Escherichia-Shigella was also associated with the severity of UC and fatigue.
• These associations were identified through correlation analysis linking microbial abundance to clinical severity measures.

The study design stratified participants by both UC diagnosis and fatigue status to isolate condition-specific microbial and metabolic signatures.

• A total of 120 participants were recruited and divided into four equal groups (n = 30 per group).
• Groups were defined based on UC diagnosis and Fatigue Scale-14 (FS-14) scores.
• The four groups were: UC with fatigue (HUCF), UC without fatigue (HUCN), healthy with fatigue (HHF), and healthy without fatigue (HHN).
• Both 16S rRNA sequencing and untargeted metabolomic analysis were performed on fresh stool samples.