Preoperative plasma short- and branched-chain fatty acids in relation to risk of complications after colorectal cancer surgery: a prospective cohort study.

IF 6.9 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition Pub Date : 2025-10-09 DOI:10.1016/j.ajcnut.2025.10.001

Niels Klaassen-Dekker, Erwin G Zoetendal, Edoardo Capuano, Renate M Winkels, Fränzel J B van Duijnhoven, N Tjarda van Heek, Flip M Kruyt, Arve Ulvik, Adrian McCann, Per Magne Ueland, Johannes H W de Wilt, Ellen Kampman, Dieuwertje E Kok

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引用次数: 0

Abstract

Background: Emerging evidence suggests that nutritional prehabilitation reduces risk of complications after colorectal cancer (CRC) surgery. The gut microbiota and its metabolic activity potentially link preoperative diet to postoperative outcomes.

Objective: Investigate associations between preoperative plasma levels of microbial-derived metabolites and postoperative complications in CRC patients.

Methods: We used data from a prospective cohort study among 1220 patients with non-metastatic CRC. The short-chain fatty acids (SCFAs) acetate, propionate, butyrate, and valerate, as well as the branched-chain fatty acids (BCFAs) isovalerate, isobutyrate and α-methylbutyrate were measured in plasma collected at diagnosis. Prevalence ratios (PR) were calculated using regression models adjusted for age, sex, tumor location, smoking status, and physical health status.

Results: Acetate levels of 40.0 μmol/L were associated with a lower risk of any postoperative complications compared to the reference of 20.0 μmol/L (PR 0.76; 95%CI 0.62, 0.93). Higher levels of propionate (per 1 μmol/L) were associated with a lower risk of any complications (PR 0.84; 95%CI 0.73, 0.96). Similar associations were found for acetate (per 20 μmol/L) and propionate (per 1 μmol/L) in relation to surgical complications (PR 0.75; 95%CI 0.60, 0.93; and PR 0.83; 95%CI 0.69, 1.00; respectively). No associations were found for BCFAs in relation to complications. Low (below median) total SCFA levels combined with high (above median) total BCFA levels were least favorable in terms of complication risk (PR 1.35; 95%CI 1.02, 1.80) when compared to a low SCFA/low BCFA profile.

Conclusions: Our findings suggest that microbial fermentation processes, mainly those resulting in higher SCFA levels, may be linked to postoperative recovery. These findings provide leads for future studies investigating the role of preoperative diet, especially the balance between fiber and protein intake, and microbial metabolism in relation to postoperative recovery of patients with CRC.

Clinical trial details: This study was registered at clinicaltrials.gov with registration number NCT03191110.

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术前血浆短链和支链脂肪酸与结直肠癌术后并发症风险的关系：一项前瞻性队列研究

背景：越来越多的证据表明，营养预适应可降低结直肠癌（CRC）手术后并发症的风险。肠道菌群及其代谢活动可能将术前饮食与术后预后联系起来。目的：探讨大肠癌患者术前血浆微生物衍生代谢物水平与术后并发症的关系。方法：我们使用了来自1220例非转移性结直肠癌患者的前瞻性队列研究数据。测定诊断时血浆中乙酸、丙酸、丁酸、戊酸短链脂肪酸（SCFAs）及支链脂肪酸（BCFAs）异戊酸、异丁酸和α-甲基丁酸。采用年龄、性别、肿瘤位置、吸烟状况和身体健康状况调整后的回归模型计算患病率（PR）。结果：与20.0 μmol/L的参考水平相比，40.0 μmol/L的乙酸水平与任何术后并发症的风险相关（PR为0.76；95%CI为0.62,0.93）。较高水平的丙酸（每1 μmol/L）与较低的并发症风险相关（PR = 0.84; 95%CI = 0.73, 0.96）。乙酸（每20 μmol/L）和丙酸（每1 μmol/L）与手术并发症的关系类似（PR分别为0.75；95%CI为0.60,0.93；PR为0.83；95%CI为0.69,1.00）。未发现BCFAs与并发症相关。与低SCFA/低BCFA相比，低（低于中位数）总SCFA水平结合高（高于中位数）总BCFA水平在并发症风险方面最不利（PR 1.35; 95%CI 1.02, 1.80）。结论：我们的研究结果表明，微生物发酵过程，主要是那些导致较高SCFA水平的过程，可能与术后恢复有关。这些发现为进一步研究术前饮食，特别是纤维和蛋白质摄入的平衡，以及微生物代谢在结直肠癌患者术后恢复中的作用提供了线索。临床试验详情：本研究已在clinicaltrials.gov注册，注册号为NCT03191110。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.