To evaluate the effect of Clostridium difficile infection (CDI) on nutrition and metabolism of patients with colorectal cancer (CRC).

Stool samples were collected from 205 preoperative CRC patients who were scheduled to have radical cancer resection. The samples were divided into the CDI group (33 cases) and non-CDI group (172 cases). The levels of albumin and total protein at different T stage, N stage, occult blood (OB) test were detected, and the levels of free fatty acid in whether being overweighted [body mass index (BMI) ≥ 24] and gender were measured. Meanwhile, the samples in BMI ≥ 24 and male were further divided into two subgroups according to the age whether ≥ 60 years old, and the levels of free fatty acid were compared.

The levels of albumin [(38 ± 3)g/L vs. (41 ± 5) g/L, t=2.211, P<0.05], total protein [(63 ± 7) g/L vs. (68 ± 6) g/L, t=2.424, P<0.05] at T₄ (tumour penetrates the serosa) in the CDI group were much lower than those in the non-CDI group. The levels of albumin [(38 ± 5)g/L vs. (42 ± 4) g/L, t=2.904, P<0.05], total protein [(64 ± 8) g/L vs. (68 ± 6) g/L, t=2.537, P<0.05] at OB positive in the CDI group also decreased markedly as compared with the non-CDI group. However, the total protein levels only at N₂ (lymph nodes metastasis more than 3) in the CDI group was much lower than those in the non-CDI group [(64 ± 5) g/L vs. (69 ± 6) g/L, t=2.085, P<0.05]. Meanwhile, the levels of free fatty acid at BMI ≥ 24 [(0.25 ± 0.12) mmol/L vs. (0.38 ± 0.21) mmol/L, t=3.191, P<0.05] and male [(0.26 ± 0.12) mmol/L vs. (0.37 ± 0.20) mmol/L, t=3.239, P<0.05] decreased markedly in the CDI group as compared with the non-CDI group. After further subgrouping, the levels of free fatty acid with age ≥ 60 years old at BMI ≥ 24 [(0.24 ± 0.13) mmol/L vs. (0.38 ± 0.22) mmol/L, t=2.143, P<0.05] and male [(0.23 ± 0.12) mmol/L vs. (0.37 ± 0.21) mmol/L, t=3.392, P<0.05] in the CDI group were much lower than those in the non-CDI group.

CDI can reduce the serum levels of albumin, total protein and free fatty acid of T₄ and OB positive CRC patients. Dyslipidiaemia can occur in CRC patients with CDI who were over 60 years old in BMI ≥ 24 and male population.