Abstract
Whether there are subsequent changes of metabolic profiles and microbiota status after partial colectomy remains unknown. We evaluated and compared long-term effects of microbiota status and metabolic profiles in early colorectal cancer (CRC) patients after curative colectomy to the controls. In this cross-sectional study, we analyzed metabolic syndrome occurrence in 165 patients after curative partial colectomy with right hemicolectomy (RH) or low anterior resection (LAR) and 333 age-sex matched controls. Fecal samples from some of those with RH, LAR, and controls were analyzed by next-generation sequencing method. The occurrences of metabolic syndrome were significantly higher in patients after RH, but not LAR, when compared with the controls over the long term (> 5 years) follow-up (P = 0.020). Compared with control group, RH group showed lower bacterial diversity (P = 0.007), whereas LAR group showed significantly higher bacterial diversity at the genera level (P = 0.016). Compared with the control group, the principal component analysis revealed significant differences in bacterial genera abundance after RH and LAR (P < 0.001). Furthermore, the Firmicutes to Bacteroidetes ratio was significantly lower in the RH group than the control group (22.0% versus 49.4%, P < 0.05). In conclusion, early CRC patients after RH but not LAR were associated with a higher occurrence of metabolic syndrome than the controls during long-term follow-up. In parallel with metabolic change, patients with RH showed dysbiosis with a tendency to decreased richness and a significant decrease in the diversity of gut microbiota.
Highlights
The gastrointestinal (GI) tract plays an important role in nutritional homeostasis and metabolic control [1]
When compared with the controls, there were no significant differences in the BMI, waist circumference, systolic BP, diastolic BP, serum fasting glucose, serum TG, total cholesterol, and HDL level as well as the occurrence of metabolic syndrome between low anterior resection (LAR) group and the control groups (P > 0.05) (Table 1)
Our findings are comparable to previous studies which reported that concomitant hyperglycemia and hyperinsulinemia, the key feature of metabolic syndrome, were the most consistent finding following total colectomy even though the underlying pathology for colectomy including inflammatory bowel disease, Hirschsprung’s disease and colorectal cancer (CRC) was different [4,5,16,17,18]
Summary
In line with this thinking, we aimed to investigate and compare long-term effects of metabolic profiles and microbiota status in CRC cancer patients receiving curative partial colectomy to the controls
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