He Jianyun, Cheng Lan, Cheng Xinxin, Wang Yuting, Lin Xiaoxia, Xia Shufang
Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China.
Nutrients. 2024 Dec 18;16(24):4371. doi: 10.3390/nu16244371.
Cancer-related fatigue (CRF) is highly prevalent in patients with breast cancer, resulting in undesirable outcomes and even reduced survival rates. This cross-sectional study investigated the relationship between dietary quality and CRF in patients with breast cancer, and the potential role of gut microbiota (GM) in this association.
Dietary intake and CRF were evaluated in 342 patients, with 64 fecal samples collected for 16sRNA sequencing and 106 plasma samples for tryptophan (TRP) metabolite determination.
A total of 149 (43.6%) patients experienced CRF, which was significantly associated with low intakes of protein, vitamin A, vitamin E, dietary fiber, phosphorus, magnesium, potassium, iron, and copper ( < 0.05), and a remarkably low Chinese Healthy Eating Index (CHEI) score ( < 0.05). CRF patients had decreased GM diversity, an unhealthier GM composition, lower TRP concentrations, and a higher kynurenine (KYN)/TRP ratio ( < 0.05). Mediation analyses revealed that both the Sobs index (ACME = -0.0005; 95% CI -0.0051, -0.0001; = 0.034) and the Chao index (ACME = -0.0005; 95% CI -0.0050, -0.0001; = 0.033) were significant mediators of the correlation between total CHEI score and CRF.
The presence of CRF in patients with breast cancer might be correlated with inadequate nutrient intake and low dietary quality via GM-dependent pathways.
癌症相关疲劳（CRF）在乳腺癌患者中非常普遍，会导致不良后果，甚至降低生存率。这项横断面研究调查了乳腺癌患者饮食质量与CRF之间的关系，以及肠道微生物群（GM）在这种关联中的潜在作用。
对342例患者的饮食摄入和CRF进行评估，收集64份粪便样本进行16sRNA测序，106份血浆样本进行色氨酸（TRP）代谢物测定。
共有149例（43.6%）患者出现CRF，这与蛋白质、维生素A、维生素E、膳食纤维、磷、镁、钾、铁和铜的摄入量低（<0.05）以及中国健康饮食指数（CHEI）得分极低（<0.05）显著相关。CRF患者的GM多样性降低，GM组成更不健康，TRP浓度降低，犬尿氨酸（KYN）/TRP比值更高（<0.05）。中介分析显示，Sobs指数（ACME=-0.0005；95%CI-0.0051，-0.0001；P=0.034）和Chao指数（ACME=-0.0005；95%CI-0.0050，-0.0001；P=0.033）都是总CHEI得分与CRF之间相关性的显著中介因素。
乳腺癌患者中CRF的存在可能通过GM依赖途径与营养摄入不足和饮食质量低相关。
