Does physical activity associate with gut microbiome and survival outcomes of Chinese metastatic colorectal cancer patients? A secondary analysis of a randomized controlled trial.
Does physical activity associate with gut microbiome and survival outcomes of Chinese metastatic colorectal cancer patients? A secondary analysis of a randomized controlled trial.
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DOI：
10.1016/j.heliyon.2022.e11615
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发表时间：
2022-11
期刊：
影响因子：
4
通讯作者：
Yang, Yufei
中科院分区：
文献类型：
--
作者：
Sun, Lingyun;Yan, Yunzi;Yan, Shaohua;Yang, Yufei
本研究旨在评估中国转移性结直肠癌（mCRC）患者的体力活动，肠道微生物组和生存结局之间的关系。我们在一项传统中草药治疗mCRC患者的随机对照临床试验（RCT）（ChiCTR 2000029599）中进行了二次分析。在一个月的干预后，我们每六个月随访一次患者的生存结局，最后一次随访是在2022年8月（中位随访时间为28.6个月）。我们通过国际体力活动问卷（IPAQ-SF）简表评估患者的体力活动（PA），并在基线时收集患者的粪便样本。Kaplan-Meier生存分析和考克斯回归模型用于评估PA水平与总生存结局之间的关系。16 S rRNA测序方法用于肠道微生物组分析。在入组原始RCT的40例mCRC患者中，15例患者在末次随访时仍存活。所有患者的平均IPAQ评分为2569.5 MET-min/周，表明PA水平中等。其中高PA水平组7例，低PA水平组2例，中PA水平组2例。肠道微生物群落差异分析显示，PA水平高的患者的α多样性显著高于PA水平中等的患者（131.53 vs. 98.12，p = 0.04），在属水平上，嗜乳杆菌和瘤胃球菌科的丰度增加，而巨球菌的丰度减少。考克斯回归模型显示，在控制原发肿瘤部位和中医治疗后，高PA水平与低死亡风险独立相关（相对风险0.13，p = 0.014）。高PA水平可能通过其调节肠道微生物组的潜在作用与中国mCRC患者的生存获益相关。本研究结果可作为病患教育及未来临床研究设计之参考。结直肠癌;肠道微生物学;体力活动;结直肠转移。
This study aimed to evaluate associations between physical activities, gut microbiome and survival outcomes among Chinese metastatic colorectal cancer (mCRC) patients. We conducted a secondary analysis nested in a randomized controlled clinical trial (RCT) of a traditional Chinese herbal medicine for mCRC patients (ChiCTR2000029599). After one-month intervention, we followed up patients every six months for survival outcomes and the last follow-up was in August 2022 (median follow-up time 28.6 months). We assessed patients’ physical activity (PA) through short form of the International Physical Activity Questionnaire (IPAQ-SF) and collected patients’ stool samples at baseline. Kaplan–Meier survival analyses and Cox regression models were used to evaluate the association between PA level and overall survival outcomes. 16S rRNA sequencing approaches were utilized for the gut microbiome analysis. Among 40 mCRC patients enrolled in the original RCT, 15 patients were still alive at the time of the last follow-up. The mean IPAQ score was 2569.5 MET-min/week for all patients, indicating a moderate PA level. Specifically, there were 7 patients in high PA level group, 2 patients in low PA level group and the rest were in middle PA group. Gut microbiome community difference analysis showed that patients with high PA levels had a significantly higher alpha diversity than that of the middle PA group (131.53 vs. 98.12, p = 0.04), an increased abundance of Phascolarctobacterium and Ruminococcaceae and a decreased abundance of Megasphaera at the genus level. Cox regression model showed that after controlling for the original tumor site and TCM treatment, high PA level was independently associated with a lower risk of death (relative risk 0.13, p = 0.014). High PA level could be associated with survival benefits among Chinese mCRC patient through its potential role on modulating gut microbiome. Our results could be referred to patients’ education and future clinical study design. Colorectal cancer; Intestinal microbiology; Physical activity; Colorectal metastases.
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