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Meta-Analysis
. 2022 Oct 3;20(1):323.
doi: 10.1186/s12916-022-02529-4.

Short-chain fatty acid concentrations in the incidence and risk-stratification of colorectal cancer: a systematic review and meta-analysis

Ehsan Alvandi  1   2 , Wilson K M Wong  1   3 , Mugdha V Joglekar  1   3 , Kevin J Spring  4   5   6 , Anandwardhan A Hardikar  7   8   9
Affiliations
Meta-Analysis

Short-chain fatty acid concentrations in the incidence and risk-stratification of colorectal cancer: a systematic review and meta-analysis

Ehsan Alvandi et al. BMC Med. .

Abstract

Background: The beneficial role of gut microbiota and bacterial metabolites, including short-chain fatty acids (SCFAs), is well recognized, although the available literature around their role in colorectal cancer (CRC) has been inconsistent.

Methods: We performed a systematic review and meta-analysis to examine the associations of fecal SCFA concentrations to the incidence and risk of CRC. Data extraction through Medline, Embase, and Web of Science was carried out from database conception to June 29, 2022. Predefined inclusion/exclusion criteria led to the selection of 17 case-control and six cross-sectional studies for quality assessment and analyses. Studies were categorized for CRC risk or incidence, and RevMan 5.4 was used to perform the meta-analyses. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. Studies lacking quantitation were included in qualitative analyses.

Results: Combined analysis of acetic, propionic, and butyric acid revealed significantly lower concentrations of these SCFAs in individuals with a high-risk of CRC (SMD = 2.02, 95% CI 0.31 to 3.74, P = 0.02). Additionally, CRC incidence was higher in individuals with lower levels of SCFAs (SMD = 0.45, 95% CI 0.19 to 0.72, P = 0.0009), compared to healthy individuals. Qualitative analyses identified 70.4% of studies reporting significantly lower concentrations of fecal acetic, propionic, butyric acid, or total SCFAs in those at higher risk of CRC, while 66.7% reported significantly lower concentrations of fecal acetic and butyric acid in CRC patients compared to healthy controls.

Conclusions: Overall, lower fecal concentrations of the three major SCFAs are associated with higher risk of CRC and incidence of CRC.

Keywords: Adenoma; Colorectal cancer; Incidence; Meta-analysis; Risk; Short-chain fatty acid.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The PRISMA flowchart shows the selection process of the systematic review. The abstracts of all the studies were imported into Endnote from the indicated databases. SCFA, short-chain fatty acid; CRC, colorectal cancer; CRA, colorectal adenoma
Fig. 2
Fig. 2
Forest plots representing the meta-analyses of the fecal concentrations of A acetic, propionic, and butyric acid in CRC risk category; B total SCFA in CRC risk category; and C acetic, propionic, and butyric acid in CRC incidence category. Note that in B, the total SCFA indicates the collection of all the SCFA molecules—not only acetic, propionic, and butyric acid
See this image and copyright information in PMC

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