Niu XT, Wang XY, Linghu EQ. Paradoxical nutrient hyperabsorption despite diarrhea: Insights from jejunal transcriptomic reanalysis in Linghu’s obesity-diarrhea syndrome. World J Gastrointest Pathophysiol 2026; 17(3): 121798 [DOI: 10.4291/wjgp.121798]
Corresponding Author of This Article
En-Qiang Linghu, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, No. 94 Weijin Road, Beijing 100853, China. linghuenqiang@vip.sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
review-article
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World J Gastrointest Pathophysiol. Sep 22, 2026; 17(3): 121798 Published online Sep 22, 2026. doi: 10.4291/wjgp.121798
Paradoxical nutrient hyperabsorption despite diarrhea: Insights from jejunal transcriptomic reanalysis in Linghu’s obesity-diarrhea syndrome
Xiao-Tong Niu, Xiang-Yao Wang, En-Qiang Linghu
Xiao-Tong Niu, Xiang-Yao Wang, En-Qiang Linghu, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Linghu EQ designed research; Niu XT, Wang XY conducted research; Niu XT analyzed data and wrote the paper; Linghu EQ had primary responsibility for final content. All authors read and approved the final manuscript.
AI contribution statement: Generative AI tools were used for limited language editing (Deepseek-V3.2, Gemini 3 Pro) and initial draft layout assistance for Figure 1 (Nano banana). Nano banana was used strictly for minor layout adjustments to Figure 1, and the authors manually finalized the content and design of all figures. All scientific content, including the conceptual framework, pathways, and data interpretation, was manually designed and verified by the authors. No AI tools were used to generate, analyze, or interpret any raw scientific data. The authors manually reviewed, corrected, and finalized all text and figures and take full responsibility for the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: En-Qiang Linghu, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, No. 94 Weijin Road, Beijing 100853, China. linghuenqiang@vip.sina.com
Received: April 2, 2026 Revised: May 6, 2026 Accepted: June 22, 2026 Published online: September 22, 2026 Processing time: 160 Days and 1.3 Hours
Abstract
The transcriptomic changes in the jejunum involved in Linghu’s obesity-diarrhea syndrome (ODS) are revealed in the previous study. In the present study, we performed a reanalysis of differentially expressed genes related to nutrient absorption from this dataset and found that gene sets involved in the digestion and absorption of three major nutrients - fats, carbohydrates, and proteins - were predominantly upregulated in the jejunal epithelium of patients with ODS. These changes specifically pertain to fat digestion and absorption, carbohydrate uptake and transport, and protein catabolism. These findings suggest that the jejunum of patients with ODS may exhibit a unique state of “diarrhea-hyperabsorption”. In this article, we provide an in-depth discussion of this phenomenon and propose hypotheses, aiming to offer insights for the study of the pathological mechanisms underlying ODS and its clinical management.
Core Tip: The jejunal mucosa of patients with Linghu’s obesity-diarrhea syndrome exhibits a unique state of “diarrhea-hyperabsorption”, involving fat digestion and absorption, carbohydrate uptake and transport, and protein catabolism. We hypothesize that this hyperabsorption state may be co-induced by physiological compensation, pathological drivers, and microbial dysbiosis. These findings provide a novel perspective for the clinical management of patients with obesity-diarrhea syndrome.
