Introduction Faecal biomarkers are emerging non-invasive tools for diagnosing gastrointestinal disorders. Faecal volatile organic compounds (VOCs) have been studied more recently in clinical diagnosis. Pattern of faecal VOCs in healthy population may provide basis for understanding changes in disease conditions. The VOCs within the metaboloms may be different across the countries due to differences in dietary habits and environmental conditions and may have implications in developing their clinical utility.
Methods We aim to study the faecal VOCs of the healthy population from three different countries that is, England, Belgium and Canada. A total of 159 health volunteers (English=109, F=69), (Belgium=20, F=14), (Canada=30, F=17) donated faecal samples. Fresh samples were aliquoted in 18 mls sealed vials. VOCs were extracted using solid phase micro extraction and were analysed using gas chromatography–mass spectrometery. VOCs were identified using NIST library search comparing their fragment pattern.
Results A total of 232 VOCs were identified. Using binary data (presence or absence of VOCs), univariate analysis was used to identify those VOCs which were statistically significant (p<0.05) in discerning differences between the three population groups. Alcohols, ketones and esters were predominantly associated with English volunteers compared to both Canadian and Belgium volunteers while aldehydes and alkenes were predominantly detected VOCs in the Canadian and Belgium groups respectively. A multivariate discriminant function analysis utilising these VOCs was able to differentiate three groups with a sensitivity of 96% and specificity of 90%.
Conclusion The observed differences in the faecal VOCs metabolites of the healthy population in different countries may provide important basis in the clinical utility of faecal biomarkers. It may also provide information in studying the differences in disease prevalence and behaviour in different countries. Further studies are warranted to explore this area.
Competing interests None declared.
References 1. Probert CS, Ahmed I, Khalid T, et al. Volatile organic compounds as diagnostic biomarkers in gastrointestinal and liver diseases. J Gastrointestin Liver Dis 2009;18:337–43.
2. Angriman I, Scarpa M, D'Incà R, et al. Enzymes in feces: useful markers of chronic inflammatory bowel disease. Clin Chim Acta 2007;381:63–8.
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