109451
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.4 Breast Cancer (Dove Med Press)
- 3.2 Clin Epidemiol
- 2.6 Cancer Manag Res
- 2.9 Infect Drug Resist
- 3.7 Clin Interv Aging
- 5.1 Drug Des Dev Ther
- 3.1 Int J Chronic Obstr
- 6.6 Int J Nanomed
- 2.6 Int J Women's Health
- 2.9 Neuropsych Dis Treat
- 2.8 OncoTargets Ther
- 2.0 Patient Prefer Adher
- 2.2 Ther Clin Risk Manag
- 2.5 J Pain Res
- 3.0 Diabet Metab Synd Ob
- 3.2 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 1.8 Pharmgenomics Pers Med
- 2.0 Risk Manag Healthc Policy
- 4.1 J Inflamm Res
- 2.0 Int J Gen Med
- 3.4 J Hepatocell Carcinoma
- 3.0 J Asthma Allergy
- 2.2 Clin Cosmet Investig Dermatol
- 2.4 J Multidiscip Healthc
已发表论文
术前睡眠障碍对消化道肿瘤患者术后肠内营养不耐受的影响：一项前瞻性队列研究
Authors Chen M, Zhong W, Yu T, Cao C, Huang H, Yu J
Received 29 May 2025
Accepted for publication 23 September 2025
Published 17 October 2025 Volume 2025:17 Pages 2699—2713
DOI https://doi.org/10.2147/NSS.S539712
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Marco Veneruso
Moxi Chen,1,* Wentao Zhong,1,* Tian Yu,2 Can Cao,1 Hongyun Huang,1 Jianchun Yu1
1Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China; 2Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jianchun Yu, Department of General Surgery, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, People’s Republic of China, Email yu-jch@163.com
Purpose: To investigate the effect of preoperative sleep disorders (SD) on postoperative enteral nutrition intolerance (ENI) and intestinal barrier, and explore its potential mechanism.
Patients and Methods: This study was a prospective cohort study that included 67 patients (26 in SD group and 41 in non-SD group) undergoing digestive tract tumor surgery. Preoperative sleep status was assessed using the Pittsburgh Sleep Quality Index. Postoperative ENI was evaluated using the Enteral Nutrition Tolerance Scale. Perioperative serum cortisol, intestinal barrier markers (D-lactate, diamine oxidase and human lipopolysaccharide binding protein), ferroptosis markers (ferrous ions, reduced glutathione and lipid peroxide malondialdehyde) and intestinal flora characteristics were measured.
Results: The incidence of ENI in SD group was 53.8%, which was significantly higher than that in non-SD group (26.8%, P=0.038). Perioperative levels of serum intestinal barrier markers in SD group were higher than those in non-SD group (P< 0.05). The preoperative cortisol level was positively correlated with the increase in the intestinal barrier marker human lipopolysaccharide binding protein (r=0.3621, P=0.0170) and ferroptosis marker malondialdehyde (r=0.3660, P=0.0171). In SD group, the relative abundance of opportunistic pathogens (Enterobacteriaceae, Burkholderiaceae, etc) increased, while the relative abundance of probiotics (Bifidobacteriaceae) decreased.
Conclusion: Preoperative sleep disturbances were significantly associated with the occurrence of postoperative enteral nutrition intolerance in patients with gastrointestinal tumors. The intestinal barrier damage of these patients may be related to hypothalamic-pituitary-adrenal axis activation, oxidative stress induction and intestinal flora imbalance.
Plain Language Summary: Why was this study done?
We investigated whether sleep disorders before gastrointestinal cancer surgery affect patients’ ability to tolerate enteral nutrition after surgery and examined the biological reasons behind this.
What did the researchers do?
We followed 67 patients undergoing digestive tract tumor surgery (26 with sleep disorders, 41 without). Using standard medical tools: 1. Assessed sleep quality with the Pittsburgh Sleep Quality Index; 2. Measured enteral nutrition intolerance (ENI) symptoms; 3. Tested blood levels of: stress hormone (cortisol), gut damage markers (D-lactate, DAO, LBP), cell stress indicators (ferrous ions, glutathione, MDA) and gut bacteria.
What did we find?
Patients with preoperative sleep disorders: 1. Had significantly more ENI (54% vs 27%); 2. Showed higher gut barrier damage markers; 3. Had abnormal ferroptosis-related substances (↓glutathione, ↑MDA); 4. Had more harmful bacteria (Enterobacteriaceae) and fewer probiotics (Bifidobacteriaceae).
What do these results mean?
Sleep disorders before surgery may increase postoperative ENI through: 1. Stress system activation (HPA axis → cortisol ↑); 2. Iron-related cell damage (ferroptosis); 3. Gut bacteria imbalance.
Practical implications:
• For patients: Improving sleep quality before surgery may aid recovery
• For doctors: Monitoring cortisol or probiotics could help high-risk patients
Keywords: sleep wake disorders, postoperative gastrointestinal motility disorders, gastrointestinal microbiome, oxidative stress
1Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China; 2Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jianchun Yu, Department of General Surgery, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, People’s Republic of China, Email yu-jch@163.com
Purpose: To investigate the effect of preoperative sleep disorders (SD) on postoperative enteral nutrition intolerance (ENI) and intestinal barrier, and explore its potential mechanism.
Patients and Methods: This study was a prospective cohort study that included 67 patients (26 in SD group and 41 in non-SD group) undergoing digestive tract tumor surgery. Preoperative sleep status was assessed using the Pittsburgh Sleep Quality Index. Postoperative ENI was evaluated using the Enteral Nutrition Tolerance Scale. Perioperative serum cortisol, intestinal barrier markers (D-lactate, diamine oxidase and human lipopolysaccharide binding protein), ferroptosis markers (ferrous ions, reduced glutathione and lipid peroxide malondialdehyde) and intestinal flora characteristics were measured.
Results: The incidence of ENI in SD group was 53.8%, which was significantly higher than that in non-SD group (26.8%, P=0.038). Perioperative levels of serum intestinal barrier markers in SD group were higher than those in non-SD group (P< 0.05). The preoperative cortisol level was positively correlated with the increase in the intestinal barrier marker human lipopolysaccharide binding protein (r=0.3621, P=0.0170) and ferroptosis marker malondialdehyde (r=0.3660, P=0.0171). In SD group, the relative abundance of opportunistic pathogens (Enterobacteriaceae, Burkholderiaceae, etc) increased, while the relative abundance of probiotics (Bifidobacteriaceae) decreased.
Conclusion: Preoperative sleep disturbances were significantly associated with the occurrence of postoperative enteral nutrition intolerance in patients with gastrointestinal tumors. The intestinal barrier damage of these patients may be related to hypothalamic-pituitary-adrenal axis activation, oxidative stress induction and intestinal flora imbalance.
Plain Language Summary: Why was this study done?
We investigated whether sleep disorders before gastrointestinal cancer surgery affect patients’ ability to tolerate enteral nutrition after surgery and examined the biological reasons behind this.
What did the researchers do?
We followed 67 patients undergoing digestive tract tumor surgery (26 with sleep disorders, 41 without). Using standard medical tools: 1. Assessed sleep quality with the Pittsburgh Sleep Quality Index; 2. Measured enteral nutrition intolerance (ENI) symptoms; 3. Tested blood levels of: stress hormone (cortisol), gut damage markers (D-lactate, DAO, LBP), cell stress indicators (ferrous ions, glutathione, MDA) and gut bacteria.
What did we find?
Patients with preoperative sleep disorders: 1. Had significantly more ENI (54% vs 27%); 2. Showed higher gut barrier damage markers; 3. Had abnormal ferroptosis-related substances (↓glutathione, ↑MDA); 4. Had more harmful bacteria (Enterobacteriaceae) and fewer probiotics (Bifidobacteriaceae).
What do these results mean?
Sleep disorders before surgery may increase postoperative ENI through: 1. Stress system activation (HPA axis → cortisol ↑); 2. Iron-related cell damage (ferroptosis); 3. Gut bacteria imbalance.
Practical implications:
• For patients: Improving sleep quality before surgery may aid recovery
• For doctors: Monitoring cortisol or probiotics could help high-risk patients
Keywords: sleep wake disorders, postoperative gastrointestinal motility disorders, gastrointestinal microbiome, oxidative stress