Deciphering the circulating lipidome signature associated with physical performance in gastric cancer patients: an exploratory study.

INTRODUCTION

Physical performance strongly influences peri-treatment outcomes in gastric cancer (GC), yet simple molecular markers reflecting functional status are lacking. Lipidomics may help identify circulating biomarkers linked to physical fitness.

OBJECTIVES

To assess whether physical performance is associated with distinct plasma lipidomic profiles in GC patients.

METHODS

Nineteen male GC patients (60-75 years) from the PROTECT trial were classified as high- (HighP) or low-performance (LowP) based on the 6-min walk test. Plasma lipidomics (LC-MS/MS) quantified 232 lipid species and a total of 25 fatty acids were quantified by gas chromatography-MS. Multivariate and univariate analyses, group comparisons, and correlations examined associations with clinical, anthropometric, and fitness parameters.

RESULTS

Lipid profiles differed by performance status. HighP patients showed higher phosphatidylinositol (PI 36:2) and trends toward increased plasmalogen phosphatidylethanolamines (PE), whereas sphingomyelin (SM 43:2) was higher in LowP patients. Plasmenyl-PE species correlated positively with functional tests, muscle mass, body mass index, and nutritional status; SM 43:2 correlated negatively. Acylcarnitines showed minimal associations.

CONCLUSION

GC patients with different physical performance status display distinct circulating lipid signatures. PI 36:2, PE plasmalogens, and SM 43:2 species appear linked to physical fitness, suggesting potential value as preoperative biomarkers. Validation in larger cohorts is warranted.