Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Perioperative Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Ann Surg Oncol. 2019 Dec;26(13):4805-4813. doi: 10.1245/s10434-019-07707-y. Epub 2019 Aug 12.
This study investigated the correlation between the fecal profile and muscle mass, which has not been elucidated before.
This study included patients who underwent hepatectomy, pancreatoduodenectomy, or esophagectomy and had fecal samples collected preoperatively and mesenteric lymph nodes (MLNs) harvested intraoperatively to determine the fecal profile and presence of bacteria in the MLNs. Total psoas area (TPA) was measured at the third lumbar vertebra using preoperative computed tomography images. TPA was standardized by body surface area (BSA) using the following equation: standardized TPA (mm/m) (stTPA) = TPA (mm)/BSA (m). The fecal concentrations of representative microorganisms and organic acids also were measured.
A total of 127 patients undergoing hepatectomy (n = 48), pancreatoduodenectomy (n = 44), and esophagectomy (n = 35) were included. The fecal levels of predominant obligate anaerobes showed a positive correlation with stTPA, whereas that of pathogenic microorganisms showed a negative correlation with stTPA. The fecal concentrations of total short chain fatty acids (the sum of acetic acid, propionic acid, and butyric acid) also showed a positive correlation with stTPA. The stTPA was significantly lower in patients with positive microorganisms in the MLNs (patients with bacterial translocation) compared to those without microorganisms in the MLNs (p = 0.047).
This study was the first to demonstrate the association between muscle mass and the fecal profile, as well as their association with bacterial translocation.
本研究旨在探讨粪便谱与肌肉量之间的相关性，这一点以前尚未阐明。
本研究纳入了接受肝切除术、胰十二指肠切除术或食管切除术的患者，这些患者在术前采集粪便样本，并在术中采集肠系膜淋巴结（MLN）以确定粪便谱和 MLN 中细菌的存在。使用术前计算机断层扫描图像在第三腰椎处测量总腰大肌面积（TPA）。通过以下公式将 TPA 标准化为体表面积（BSA）：标准化 TPA（mm/m）（stTPA）= TPA（mm）/BSA（m）。还测量了代表性微生物和有机酸的粪便浓度。
共纳入 127 例接受肝切除术（n=48）、胰十二指肠切除术（n=44）和食管切除术（n=35）的患者。主要专性厌氧菌的粪便水平与 stTPA 呈正相关，而致病性微生物的粪便水平与 stTPA 呈负相关。总短链脂肪酸（乙酸、丙酸和丁酸的总和）的粪便浓度也与 stTPA 呈正相关。与 MLN 中存在微生物（细菌易位患者）的患者相比，MLN 中无微生物的患者的 stTPA 显著降低（p=0.047）。
本研究首次证明了肌肉量与粪便谱之间的关联，以及它们与细菌易位之间的关联。
