Published online Jan 21, 2020. doi: 10.3748/wjg.v26.i3.335
Peer-review started: October 15, 2019
First decision: November 13, 2019
Revised: December 11, 2019
Accepted: December 21, 2019
Article in press: December 21, 2019
Published online: January 21, 2020
Processing time: 85 Days and 15.2 Hours
Obesity is a risk factor for colorectal cancer, yet metabolic distinctions between healthy right and left colon tissue, before cancer is diagnosed, remains largely unknown. This study compared right-ascending and left-descending colon tissue metabolomes to identify differences from the stool metabolome in normal weight, overweight, and obese adults.
To examine right and left colon tissue metabolites according to body mass index that may serve as mechanistic targets for interventions and biomarkers for colon cancer risk.
Global, non-targeted metabolomics was applied to assess right-ascending and left-descending colon tissue collected from healthy adults undergoing screening colonoscopies to test the hypothesis that BMI differentially impacts colon tissue metabolite profiles. The colon tissue and stool metabolome of healthy adults (n = 24) was analyzed for metabolite signatures and metabolic pathway networks implicated in progression of colorectal cancer.
Ascending and descending colon contained 504 host, food, and microbiota-derived metabolites from normal weight, overweight and obese adults grouped according to body mass index. Amino acids, lipids, and nucleotides were among the chemical types that further differentiated from the stool metabolite profiles. Normal weight adults had 46 significantly different metabolites between ascending and descending colon tissue locations, whereas there were 37 metabolite differences in overweight and 28 metabolite differences for obese adults (P < 0.05). Obese adults had trimethylamine N-oxide, endocannabinoids and monoacylglycerols with different relative abundances identified between ascending and descending colon. Primary and secondary bile acids, vitamins, and fatty acids also showed marked relative abundance differences in colon tissue from overweight/obese adults.
There were metabolite profile differences between right-ascending and left-descending colon tissue in healthy adults. Colon lipids and other metabolites in obese and overweight adults were distinguished from normal weight participants and associated with gut inflammation, nutrient absorption, and products of microbiota metabolism.
Core tip: This study identified metabolite profile differences between right-ascending and left-descending colon from normal, overweight or obese adults. We also show that stool metabolite composition does not accurately reflect the right-ascending colon. There is limited knowledge of human colon small molecules and metabolite signatures that may impact colon cancer risk. Colon cancer of the right-ascending colon has a poorer prognosis and reduced survival outcome when compared to colon cancer on the left-descending colon. Diet and lifestyle are additional factors of overweight and obesity that may influence colon tissue metabolite composition with respect to inflammation. Right and left colon metabolite profiles may be helpful to evaluate after interventions that seek to prevent or mitigate cancer risk.