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
{"title":"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","authors":"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","doi":"10.1016/j.ajcnut.2025.10.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>Investigate associations between preoperative plasma levels of microbial-derived metabolites and postoperative complications in CRC patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Clinical trial details: </strong>This study was registered at clinicaltrials.gov with registration number NCT03191110.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.9000,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Preoperative plasma short- and branched-chain fatty acids in relation to risk of complications after colorectal cancer surgery: a prospective cohort study.\",\"authors\":\"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\",\"doi\":\"10.1016/j.ajcnut.2025.10.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>Investigate associations between preoperative plasma levels of microbial-derived metabolites and postoperative complications in CRC patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Clinical trial details: </strong>This study was registered at clinicaltrials.gov with registration number NCT03191110.</p>\",\"PeriodicalId\":50813,\"journal\":{\"name\":\"American Journal of Clinical Nutrition\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.9000,\"publicationDate\":\"2025-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Clinical Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ajcnut.2025.10.001\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Clinical Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajcnut.2025.10.001","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Preoperative plasma short- and branched-chain fatty acids in relation to risk of complications after colorectal cancer surgery: a prospective cohort study.
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.
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.
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