Association Between Visceral Fat Area and Cancer Prognosis: A Population-Based Multicenter Prospective Study

Lingyu Li; Wenqian Li; Dongsheng Xu; Hua He; Wang Yang; Hanfei Guo; Xiangliang Liu; Wei Ji; Chunhua Song; Hongxia Xu; Wei Li; Hanping Shi; Jiuwei Cui

doi:10.1016/j.ajcnut.2023.07.001

Association Between Visceral Fat Area and Cancer Prognosis: A Population-Based Multicenter Prospective Study

Am J Clin Nutr. 2023 Sep;118(3):507-517. doi: 10.1016/j.ajcnut.2023.07.001. Epub 2023 Jul 6.

Authors

Lingyu Li¹, Wenqian Li¹, Dongsheng Xu¹, Hua He¹, Wang Yang¹, Hanfei Guo¹, Xiangliang Liu¹, Wei Ji¹, Chunhua Song², Hongxia Xu³, Wei Li⁴, Hanping Shi⁵, Jiuwei Cui⁶

Affiliations

¹ Cancer Center, The First Hospital of Jilin University, Changchun, China.
² Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.
³ Department of Nutrition, Daping Hospital & Research Institute of Surgery, Third Military Medical University, Chongqing, China.
⁴ Cancer Center, The First Hospital of Jilin University, Changchun, China. Electronic address: liwei66@jlu.edu.cn.
⁵ Departments of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China. Electronic address: shihp@ccmu.edu.cn.
⁶ Cancer Center, The First Hospital of Jilin University, Changchun, China. Electronic address: cuijw@jlu.edu.cn.

PMID: 37422158
DOI: 10.1016/j.ajcnut.2023.07.001

Abstract

Background: Diverse indicators have been used to represent adipose tissue, while the relationship between body adipose mass and the prognosis of patients with cancer remains controversial.

Objective: This study aimed to explore the indicators of optimal body composition that represent body fat mass to predict risk of cancer-related mortality.

Methods: We conducted a population-based multicenter prospective cohort study of patients with initial cancer between February 2012 and September 2020. Clinical information, body composition indicators, hematologic test results, and follow-up data were collected. Body composition indicators were analyzed using principal component analysis to select the most representative indicators, and the cutoff value was set according to the optimal stratification method. The hazard ratio (HR) for mortality was calculated using Cox proportional hazards regression models.

Results: Among 14,018 patients with complete body composition data, visceral fat area (VFA) is a more optimal indicator for body fat content (principal component index: 0.961) than body mass index (principal component index: 0.850). The cutoff points for VFA in terms of time to mortality were 66 cm² and 102 cm² for gastric/esophageal cancer and other cancers, respectively. Among the 2788 patients treated systemically, multivariate analyses demonstrated that a lower VFA was associated with a higher risk of death in patients with cancer of diverse types (HR: 1.33; 95% CI: 1.08, 1.64; P = 0.007), especially gastric cancer (HR: 2.13; 95% CI: 1.3, 3.49; P = 0.003), colorectal cancer HR: 1.81; 95% CI: 1.06, 3.08; P = 0.030) and nonsmall-cell lung cancer (HR: 1.27; 95% CI: 1.01, 1.59; P = 0.040).

Conclusion: VFA is an independent prognostic indicator of muscle mass in patients with diverse types of cancer, particularly gastric, colorectal, and nonsmall-cell lung cancers.

Trial registration number: ChiCTR1800020329.

Keywords: body composition; cancer; nutritional status; prognosis; visceral fat area.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Body Composition
Body Mass Index
Female
Humans
Intra-Abdominal Fat*
Male
Middle Aged
Neoplasms* / diagnosis
Prognosis

Associated data

ChiCTR/ChiCTR1800020329