Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2024; 16(6): 2419-2428
Published online Jun 15, 2024. doi: 10.4251/wjgo.v16.i6.2419
Analysis of metabolic characteristics of metabolic syndrome in elderly patients with gastric cancer by non-targeted metabolomics
Huan Zhang, Wen-Bing Shen, Lin Chen
Huan Zhang, Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing 100853, China
Wen-Bing Shen, Department of Gastrointestinal Surgery, Shanghai Sixth People’s Hospital, Shanghai 250063, China
Lin Chen, Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Zhang H wrote the manuscript; Shen WB collected the data; Chen L guided the study; and all authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Institutional review board statement: This study was approved by the Ethics Review Committee of Shanghai Sixth People’s Hospital (No: GYZL-048).
Informed consent statement: The informed consent of the patients was obtained for this study, and informed consent for relevant treatment was signed.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All the data collected and analyzed in this study are included in this article, and the technical appendix, statistical code, and dataset are available from the corresponding author at chenlinbj@sina.com.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin Chen, Doctor, Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. chenlinbj@sina.com
Received: March 9, 2024
Revised: April 29, 2024
Accepted: May 16, 2024
Published online: June 15, 2024
Processing time: 97 Days and 16.8 Hours
Abstract
BACKGROUND

The relationship between metabolic syndrome (MetS) and gastric cancer (GC), which is a common metabolic disease, has attracted much attention. However, the specific metabolic characteristics of MetS in elderly patients with GC remain unclear.

AIM

To investigate the differentially abundant metabolites and metabolic pathways between preoperative frailty and MetS in elderly patients with GC based on nontargeted metabolomics techniques.

METHODS

In this study, 125 patients with nonfrail nonmeal GC were selected as the control group, and 50 patients with GC in the frail group were selected as the frail group. Sixty-five patients with GC combined with MetS alone were included in the MetS group, and 50 patients with GC combined with MetS were included in the MetS group. Nontargeted metabolomics techniques were used to measure plasma metabolite levels by ultrahigh-performance liquid chromatography-mass spectrometry. Multivariate statistical analysis was performed by principal component analysis, orthogonal partial least squares, pattern recognition analysis, cluster analysis, and metabolic pathway annotation.

RESULTS

A total of 125 different metabolites, including amino acids, glycerophospholipids, sphingolipids, fatty acids, sugars, nucleosides and nucleotides, and acidic compounds, were identified via nontargeted metabolomics techniques. Compared with those in the control group, there were 41, 32, and 52 different metabolites in the MetS group, the debilitated group, and the combined group, respectively. Lipid metabolites were significantly increased in the MetS group. In the weak group, amino acids and most glycerol phospholipid metabolites decreased significantly, and fatty acids and sphingosine increased significantly. The combined group was characterized by significantly increased levels of nucleotide metabolites and acidic compounds. The alanine, aspartic acid, and glutamate metabolic pathways were obviously enriched in the asthenic group, and the glycerol and phospholipid metabolic pathways were obviously enriched in the combined group.

CONCLUSION

Elderly GC patients with simple frailty, simple combined MetS, and frailty combined with MetS have different metabolic characteristics, among which amino acid and glycerophospholipid metabolite levels are significantly lower in frail elderly GC patients, and comprehensive supplementation of fat and protein should be considered. Many kinds of metabolites, such as amino acids, lipids, nucleotides, and acidic compounds, are abnormally abundant in patients with MetS combined with fthenia, which may be related to tumor-related metabolic disorders.

Keywords: Nervous breakdown; Metabolic syndrome; Elderly individuals; Gastric cancer; Nontargeted metabolomics

Core Tip: Nontargeted metabolomics techniques were used to systematically analyze the metabolic characteristics of metabolic syndrome (MetS) in elderly patients with gastric cancer (GC). By comparing metabolomic data, we explored the unique metabolic characteristics of MetS in patients with GC and identified potential biomarkers and metabolic pathways. This study combined metabolomics technology with the study of MetS in elderly patients with GC, providing a new perspective and theoretical support for the diagnosis and treatment of elderly patients with GC.