Research Original Research: Brief| Volume 120, ISSUE 4, P650-659, April 2020

Fecal Akkermansia muciniphila Is Associated with Body Composition and Microbiota Diversity in Overweight and Obese Women with Breast Cancer Participating in a Presurgical Weight Loss Trial

Published:November 09, 2018DOI:



      Akkermansia muciniphila (AM) is a gram-negative, mucin-degrading bacteria inhabiting the gastrointestinal tract associated with host phenotypes and disease states.


      Explore characteristics of overweight and obese female early-stage (0 to II) breast cancer patients with low AM relative abundance (LAM) vs high (HAM) enrolled in a presurgical weight-loss trial.


      Secondary analysis of pooled participants in a randomized controlled trial (NCT02224807).


      During the period from 2014 to 2017, 32 female patients with breast cancer were randomized to weight-loss or attention-control arms from time of diagnosis-to-lumpectomy (mean=30±9 days).


      All were instructed to correct nutrient deficiencies via food sources and on upper-body exercises. The weight-loss group received additional guidance to promote 0.5 to 1 kg/wk weight-loss via energy restriction and aerobic exercise.

      Main outcome measures

      At baseline and follow-up, sera, fecal samples, two-24 hour dietary recalls and dual x-ray absorptiometry were obtained. Bacterial DNA was isolated from feces and polymerase chain reaction (16S) amplified. Inflammatory cytokines were measured in sera.

      Statistical analyses performed

      Differences between LAM and HAM participants were analyzed using t tests and nonparametric tests. Spearman correlations explored relationships between continuous variables.


      Participants were aged 61±9 years with body mass index 34.8±6. Mean AM relative abundance was 0.02% (0.007% to 0.06%) and 1.59% (0.59% to 13.57%) for LAM and HAM participants, respectively. At baseline, women with HAM vs LAM had lower fat mass (38.9±11.2 kg vs 46.4±9.0 kg; P=0.044). Alpha diversity (ie, species richness) was higher in women with HAM (360.8±84.8 vs 282.4±69.6; P=0.008) at baseline, but attenuated after weight-loss (P=0.058). At baseline, interleukin-6 level was associated with species richness (ρ=–0.471, P=0.008) and fat mass (ρ=0.529, P=0.002), but not AM. Change in total dietary fiber was positively associated with AM in LAM (ρ=0.626, P=0.002), but not HAM (ρ=0.436, P=0.180) participants.


      Among women with early-stage breast cancer, body composition is associated with AM, microbiota diversity, and interleukin-6 level. AM may mediate the effects of dietary fiber in improving microbiota composition.


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      A. D. Frugé is an assistant professor, Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL.


      W. Van der Pol is a bioinformatician II, Department of Computational Biology and Bioinformatics, University of Alabama at Birmingham, Birmingham.


      C. D. Morrow is a professor, Department of Cell Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham.


      L. Q. Rogers is a professor, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham.


      Y. Tsuruta is a project coordinator, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham.


      W. Demark-Wahnefried is a professor and Webb Endowed Chair, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham.