Thresholds of visceral fat area and percent of body fat to define sarcopenic obesity and its clinical consequences in Chinese cancer patients

Abstract

Background & aims: The current criteria for defining sarcopenic obesity (SOB) combines the threshold criteria for sarcopenia and obesity, but no consensus has been reached on the criteria. Given the variations among ethnic groups and in the prevalence of sarcopenia, the study aim was to establish sex-specific cutoff points for Chinese cancer patients and investigate the effect of SOB on clinical consequences.

Methods: A prospective study of 2480 cancer patients was conducted. Clinical materials, bioelectrical impedance analysis measurements, and follow-up data were analyzed. The survival receiver operating characteristic curve was used to determine threshold values. The odds ratios for nutrition risk, severe malnutrition, and quality of life were calculated. The global and sex-specific survival statistics were extracted from the Kaplan-Meier curve and Cox proportional hazard regression models.

Results: The cutoff points of visceral fat area to best classify patients regarding time to death were >75.6 cm² for males and >61.2 cm² for females. And the cutoff points of percent of body fat were 15% in males and 25% in females. Among all participants, the prevalence of SOB was 3.03% in males and 4.46% in females. SOB significantly increased the nutrition risk and severe malnutrition probability and worsened quality of life. Finally, SOB was significantly associated with overall cancer mortality [hazard ratio 2.772, 95% confidence interval 2.080-3.694, P < 0.001].

Conclusions: On the basis of sex-specific cutoff values, SOB was strongly associated with unfavorable clinical consequences and mortality in cancer patients. These results indicate the importance of SOB detection in routine clinical practice for improving patient assessments, cancer prognosis, and intervention.

Keywords: Cancer; Mortality; Nutrition; Sarcopenia; Sarcopenic obesity; Thresholds.