Metabolomic Associations With Fatigue and Physical Function in Children With Cancer: A Pilot Study.

Area of Science:

• Pediatric Oncology
• Metabolomics
• Exercise Physiology

Background:

• Fatigue is a common symptom in children undergoing cancer treatment.
• Previous research indicates an inverse relationship between fatigue and physical activity.
• The connection between fatigue, physical function, and underlying biological mechanisms in pediatric cancer patients requires further investigation.

Purpose of the Study:

• To explore the associations among fatigue, physical function, and associated metabolites in children undergoing cancer therapy.
• To identify specific metabolites linked to fatigue and physical function in this population.
• To understand the biological underpinnings of fatigue in pediatric cancer patients.

Main Methods:

• Serum samples and self-reported fatigue and physical function (mobility) were collected from children (7-18 years) using PROMIS surveys at two timepoints.
• High-resolution liquid chromatography-mass spectrometry was used to analyze 29 targeted metabolites.
• Linear mixed-effects models were employed to assess metabolite associations, adjusting for covariates.

Main Results:

• A significant inverse relationship was observed between physical function and fatigue (T1: r = -0.64; T2: r = -0.63).
• Indole-3-lactic acid differentiated between low and high fatigue levels.
• Five metabolites (4-Hydroxybenzoic acid, m-Coumaric acid, myoinositol, tryptophan, and tyrosine) were significantly associated with physical function.

Conclusions:

• Metabolites, particularly amino acids, are significantly associated with fatigue and physical function in pediatric cancer patients.
• All identified significant metabolites showed associations with the gut microbiome.
• The inverse correlation between physical function and fatigue suggests physical function as a potential target for fatigue management interventions.