Identification of Circulating Lipidomic Biomarkers of Malnutrition Risk among Oncology Patients in the Total Cancer Care (TCC) Study: A Cross-Sectional Analysis

IF 4.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Nutrition Pub Date : 2026-07-01 Epub Date: 2026-05-20 DOI:10.1016/j.tjnut.2026.101603

Rachel Hoobler, J Alan Maschek, Bai Luo, E Angela Murphy, Jason L Kubinak, Paul A Stewart, James E Cox, Amandine Chaix, Kary Woodruff, Alejandro Sanchez, Adriana M Coletta, Fred K Tabung, Sumati Gupta, Sheetal Hardikar, Howard Colman, Mary C Playdon

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引用次数: 0

Abstract

Background

Early identification of malnutrition is critical for improving clinical outcomes in oncology patients. However, there are no established biomarkers for malnutrition screening.

Objectives

This study aimed to identify circulating lipid species associated with malnutrition risk among oncology patients through lipidomic analysis.

Methods

A cross-sectional study was conducted using plasma samples from oncology patients classified as at risk (n = 90) or not at risk (n = 90) for malnutrition using the Malnutrition Screening Tool (Malnutrition Screening Tool score = 0 compared with ≥2). All participants had head and neck, lungs, or gastrointestinal cancer. Targeted lipidomics were conducted using liquid chromatography-mass spectrometry. Elastic net regression adjusted for confounding variables identified lipids associated with malnutrition risk. A weighted lipid malnutrition risk score was derived and evaluated using the receiver operating characteristic area under the curve. Conditional multivariable logistic regression assessed the association of the lipid score with malnutrition risk. Lipid enrichment analysis was performed using the lipid ontology enrichment framework.

Results

Elastic net regression identified 12 lipids species that were inversely associated with malnutrition risk: cholesterol ester 20:0, ceramide 18:2;O2/26:0, lysophosphatidylcholine 26:0/0:0, lysophosphatidylinositol 18:2/0:0, phosphatidylcholine 34:5, phosphatidylcholine 40:8, phosphatidylethanolamine (PE) P-18:0/20:3, PE P-18:1/18:2, PE P-18:1/20:4, sulfated hexosylceramide 18:1;O2/16:0, sphingomyelin 18:2;O2/23:0, and triglyceride (O-50:1). One lipid, dihexosylceramide 18:1;O2/20:0, was positively associated with malnutrition risk. The weighted lipid malnutrition risk score was associated with increased risk for malnutrition [odds ratio: 3.57; 95% confidence interval (CI): 1.97, 6.47, P < 0.001]. Addition of the lipid score to established malnutrition risk factors improved model predictive performance, increasing the receiver operating characteristic area under the curve from 0.78 (95% CI: 0.71, 0.84) to 0.90 (95% CI: 0.86, 0.94). Lipid ontology enrichment analysis indicated downregulation of membrane structure and signaling lipids and upregulation of storage lipids.

Conclusions

This study highlights the potential of lipidomics to identify biomarkers of malnutrition risk among oncology patients. Large, prospective studies are warranted to validate these findings.

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总癌症护理（TCC）研究中肿瘤患者营养不良风险循环脂质组学生物标志物的鉴定：一项横断面分析

背景：早期识别营养不良对改善肿瘤患者的临床结果至关重要。然而，目前还没有确定的用于营养不良筛查的生物标志物。目的：本研究旨在通过脂质组学分析确定与肿瘤患者营养不良风险相关的循环脂质种类。方法：采用营养不良筛查工具（MST评分= 0对≥2），对营养不良风险（n = 90）和非营养不良风险（n = 90）肿瘤患者的血浆样本进行横断面研究。所有参与者都患有头颈癌、肺癌或胃肠道癌。采用LC-MS进行靶向脂质组学研究。弹性净回归校正了混杂变量，确定了与营养不良风险相关的脂质。采用受试者工作特征曲线下面积（ROC-AUC）得出并评估加权脂质营养不良风险评分。条件多变量logistic回归评估脂质评分与营养不良风险的关系。脂质富集分析使用脂质本体（LION）富集框架进行。结果：弹性网回归确定了12种与营养不良风险负相关的脂类：胆固醇酯20:0，神经酰胺18:2；02 /26:0，溶血磷脂酰胆碱26:0/0:0，溶血磷脂酰肌醇18:2/0:0，磷脂酰胆碱34:5，磷脂酰胆碱40:8，磷脂酰乙醇胺P-18:0/20:3，磷脂酰乙醇胺P-18:1/18:2，磷脂酰乙醇胺P-18:1/20:4，硫酸己糖神经酰胺18:1；02 /16:0，鞘磷脂18:2；O2/23:0和甘油三酯（O-50:1）。一种脂质，二己糖神经酰胺18:1；0 /20:0，与营养不良风险呈正相关。加权脂质营养不良风险评分与营养不良风险增加相关（OR = 3.57, 95% CI 1.97-6.47, p < 0.001）。将脂质评分添加到已建立的营养不良危险因素中，提高了模型的预测性能，将ROC-AUC从0.78 （95% CI 0.71-0.84）提高到0.90 （95% CI 0.86-0.94）。LION富集分析表明，膜结构和信号脂质下调，储存脂质上调。结论：本研究强调了脂质组学在鉴别肿瘤患者营养不良风险生物标志物方面的潜力。有必要进行大规模的前瞻性研究来验证这些发现。

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

Journal of Nutrition 医学-营养学

CiteScore

7.60

自引率

4.80%

发文量

260

审稿时长

39 days

期刊介绍： The Journal of Nutrition (JN/J Nutr) publishes peer-reviewed original research papers covering all aspects of experimental nutrition in humans and other animal species; special articles such as reviews and biographies of prominent nutrition scientists; and issues, opinions, and commentaries on controversial issues in nutrition. Supplements are frequently published to provide extended discussion of topics of special interest.