Diagnostic significance of the gut microbiota and its metabolites in cardiovascular risk assessment among patients with ulcerative colitis

Cardiovascular diseases (CVDs) rank among the leading causes of mortality. Studies suggest that ulcerative colitis (UC) is associated with an increased risk of CVDs. Gut microbiota and its metabolites play a pivotal role in the development of cardiovascular pathologies, including through the proatherogenic effects of trimethylamine N-oxide (TMAO) and disruptions in intestinal permeability. Objective: To evaluate the diagnostic value of markers characterizing gut microbiota metabolism and intestinal permeability in UC patients in the context of arterial hypertension (AH) risk. Materials and Methods. The study included 80 UC patients divided into two groups: those with UC and AH (Group 1) and those without AH (Group 2). TMAO levels in blood, zonulin, and short-chain fatty acids (SCFAs) in stool were assessed. Quantitative features with an alternative distribution were described using the median (Me), upper, and lower quartiles (P25, P75). The Mann-Whitney test and Bayesian approach were applied to evaluate diagnostic significance. Results. A significant increase in TMAO (1473.4 ng/mL vs. 785.02 ng/mL, p=0.01) and zonulin levels (318.42 ng/g vs. 164.22 ng/g, p=0.039) was observed in Group 1. Reduced acetic acid levels and anaerobic index were noted in the AH group, indicating gut microbiota imbalance. Conclusion. UC is a systemic inflammatory disease associated with an increased risk of CVDs. Investigating gut microbiota and its metabolites provides new opportunities for the prevention and treatment of cardiovascular complications in UC patients.