Associations of Total Body Fat Mass and Skeletal Muscle Index with All-Cause and Cancer-Specific Mortality in Cancer Survivors
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Exposures of Interest
2.2. Outcomes
2.3. Other Covariates
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Cancer Survivors (N = 1682) No. (%) | ||||
---|---|---|---|---|
Overall | Low Total Fat Mass | Moderate Total Fat Mass | High Total Fat Mass | |
Participant Characteristics | 1682 (100) | 561 (33.3) | 560 (33.3) | 561 (33.3) |
Age (year) | ||||
<50 | 402 (23.9) | 161 (28.7) | 101 (18.0) | 140 (25.0) |
50–64 | 421 (25.0) | 169 (30.1) | 127 (22.7) | 125 (22.3) |
65–74 | 426 (25.3) | 150 (26.7) | 154 (27.5) | 122 (21.7) |
≥75 | 433 (25.7) | 81 (14.4) | 178 (31.8) | 174 (31.0) |
Sex | ||||
Female | 737 (43.8) | 164 (29.2) | 255 (45.5) | 318 (56.7) |
Male | 945 (56.2) | 397 (70.8) | 305 (54.5) | 243 (43.3) |
Race | ||||
White | 1213 (72.1) | 380 (67.7) | 410 (73.2) | 423 (75.4) |
Black | 216 (12.8) | 94 (16.8) | 58 (10.4) | 64 (11.4) |
Other | 253 (15.0) | 87 (15.5) | 92 (16.4) | 74 (13.2) |
Education | ||||
High school or less | 810 (48.2) | 272 (48.5) | 265 (47.3) | 273 (48.8) |
Attended college | 473 (28.2) | 179 (31.9) | 148 (26.4) | 146 (26.1) |
Graduated from college | 397 (23.6) | 110 (1.6) | 147 (26.3) | 140 (25.0) |
Marital status | ||||
Not married | 672 (40.6) | 235 (42.4) | 215 (39.2) | 222 (40.1) |
Married or living with partner | 983 (59.4) | 319 (57.6) | 333 (60.8) | 331 (59.9) |
Smoking status | ||||
Never | 664 (68.2) | 223 (70.3) | 229 (74.4) | 212 (60.7) |
Current | 275 (28.2) | 82 (25.9) | 70 (22.7) | 123 (35.2) |
Former | 35 (3.6) | 12 (3.8) | 9 (2.9) | 14 (4.0) |
BMI | ||||
Underweight | 28 (2.1) | 28 (6.2) | 0 (0.0) | 0 (0.0) |
Normal | 411 (30.7) | 307 (67.9) | 103 (22.4) | 1 (0.2) |
Overweight | 478 (35.8) | 116 (25.7) | 284 (61.7) | 78 (18.4) |
Obese | 420 (31.4) | 1 (0.2) | 73 (15.9) | 346 (81.4) |
Energy intake (kcal/day) | ||||
<1359.0 | 345 (26.4) | 117 (28.0) | 114 (25.5) | 114 (25.9) |
1360.0–1784 | 323 (24.7) | 107 (25.6) | 112 (25.1) | 104 (23.6) |
1785–2348 | 354 (27.1) | 112 (26.8) | 120 (26.8) | 122 (27.7) |
≥2349.0 | 284 (21.7) | 82 (19.6) | 101 (22.6) | 101 (22.9) |
ASMI | ||||
Without sarcopenia | 913 (75.0) | 326 (88.8) | 328 (78.3) | 259 (60.1) |
With sarcopenia | 304 (25.0) | 41 (11.2) | 91 (21.7) | 172 (39.9) |
No. comorbidities | ||||
0 | 519 (30.9) | 135 (24.1) | 178 (31.8) | 206 (36.7) |
1 | 450 (26.8) | 164 (29.2) | 156 (27.9) | 130 (23.2) |
≥2 | 713 (42.4) | 262 (46.7) | 226 (40.4) | 225 (40.1) |
Stroke | ||||
No | 1566 (93.3) | 525 (93.6) | 522 (93.7) | 519 (92.5) |
Yes | 113 (6.7) | 36 (6.4) | 35 (6.3) | 42 (7.5) |
Coronary heart disease | ||||
No | 1215 (89.8) | 395 (91.4) | 418 (89.7) | 402 (88.4) |
Yes | 138 (10.2) | 37 (8.6) | 48 (10.3) | 53 (11.6) |
Congestive heart failure | ||||
No | 1252 (91.5) | 401 (90.7) | 431 (91.7) | 420 (91.9) |
Yes | 117 (8.5) | 41 (9.3) | 39 (8.3) | 37 (8.1) |
Heart attack | ||||
No | 1521 (90.9) | 520 (93.4) | 499 (89.4) | 502 (89.8) |
Yes | 135 (9.1) | 37 (6.6) | 59 (10.6) | 57 (10.2) |
Continuous variables, mean (SD) | ||||
Waist circumference | 99.4 (15.0) | 113 (12.9) | 98.4 (9.3) | 87.1 (9.4) |
Height | 167 (9.8) | 167 (9.6) | 167 (10.2) | 167 (9.7) |
Weight | 79.5 (19.2) | 97.0 (17.3) | 76.8 (12.0) | 64.8 (11.4) |
No. Death/Person-Years | Age-Adjusted HR (95% CI) | aHR (95% CI) | aHR (95% CI) | |
---|---|---|---|---|
Model 1 | Model 2 | Model 3 | ||
All-cause mortality | ||||
Total fat mass | ||||
Low | 169/1602.3 | Ref | Ref | Ref |
Medium | 237/2144.8 | 1.48 (1.21–1.80) | 1.09 (0.89–1.34) | 1.09 (0.89–1.34) |
High | 262/2207.4 | 1.76 (1.45–2.13) | 1.30 (1.06–1.61) | 1.31 (1.06–1.61) |
Appendicular skeletal muscle mass | ||||
Without sarcopenia | 253/8624.7 | Ref | Ref | Ref |
With sarcopenia | 155/2422.8 | 1.58 (1.28–1.94) | 1.51 (1.22–1.88) | 1.60 (1.28–1.99) |
Waist circumference | ||||
Normal | 211/6320.0 | Ref | Ref | Ref |
High | 457/8801.2 | 0.85 (1.17–0.73) | 1.23 (0.98–1.54) | 1.01 (0.82–1.47) |
Body Mass Index | ||||
Normal | 219/4450.1 | Ref | Ref | Ref |
obese | 171/5007.4 | 0.68 (0.58–0.80) | 0.71 (0.50–1.10) | 0.66 (0.41–1.14) |
Cancer-specific mortality | ||||
Total fat mass | ||||
Low | 58/4768.8 | Ref | Ref | Ref |
Medium | 72/4416.3 | 1.04 (0.73–1.47) | 1.01 (0.71–1.44) | 0.99 (0.70–1.42) |
High | 83/4195.8 | 1.42 (1.01–2.00) | 1.24 (0.87–1.77) | 1.23 (0.86–1.75) |
Appendicular skeletal muscle mass | ||||
Without sarcopenia | 83/7840.7 | Ref | Ref | Ref |
With sarcopenia | 56/1976.5 | 1.88 (1.33–2.65) | 1.74 (1.23–2.29) | 1.84 (1.28–2.65) |
Waist circumference | ||||
Normal | 66/6320.0 | Ref | Ref | Ref |
High | 147/8801.2 | 0.72 (0.54–0.96) | 0.67 (0.50–0.90) | 0.62 (0.43–0.89) |
Body Mass Index | ||||
Normal | 82/4737.7 | Ref | Ref | Ref |
Overweight or obese | 126/10,104.8 | 0.63 (0.48–0.83) | 0.58 (0.43–0.78) | 0.51 (0.35–0.73) |
Measures of Body Composition | Obesity-Related Cancers (n = 699) | Non-Obesity-Related Cancers (n= 983) | ||
---|---|---|---|---|
Model 1 Age Adjusted HR (95 CI) | Model 2 Multivariable HR (95 CI) | Model 1 Age Adjusted HR (95 CI) | Model 2 Multivariable HR (95 CI) | |
All-cause mortality | ||||
Total fat mass | ||||
Low | Ref | Ref | Ref | Ref |
Medium | 1.14 (0.84–1.54) | 1.26 (0.93–1.71) | 1.02 (0.77–1.35) | 0.99 (0.74–1.32) |
High | 1.81 (1.34–2.43) | 1.69 (1.23–2.32) | 1.27 (0.97–1.67) | 1.14 (0.86–1.52) |
Appendicular skeletal muscle mass | ||||
Without sarcopenia | Ref | Ref | Ref | Ref |
With sarcopenia | 1.49 (1.09–2.03) | 1.53 (1.10–2.13) | 1.79 (1.35–2.36) | 1.61 (1.18–2.19) |
Cancer-specific mortality | ||||
Whole body fat mass | ||||
Low | Ref | Ref | Ref | Ref |
Medium | 1.09 (0.65–1.81) | 1.08 (0.65–1.81) | 1.00 (0.60–1.67) | 0.99 (0.59–1.67) |
High | 1.51 (0.91–2.52) | 1.42 (0.84–2.41) | 1.54 (0.95–2.48) | 1.35 (0.81–2.23) |
Appendicular skeletal muscle mass | ||||
Without sarcopenia | ||||
With sarcopenia | Ref | Ref | Ref | Ref |
1.65 (0.98–2.77) | 1.76 (1.03–3.02) | 2.23 (1.38–3.62) | 1.80 (1.04–3.12) |
Measures of Body Composition | Whites | Blacks | ||
---|---|---|---|---|
Model 1 Age Adjusted HR (95 CI) | Model 2 Multivariable HR (95 CI) | Model 1 Age Adjusted HR (95 CI) | Model 2 Multivariable HR (95 CI) | |
All-cause mortality | ||||
Total fat mass | ||||
Low | Ref | Ref | Ref | Ref |
Medium | 1.27 (0.97–1.56) | 1.24 (0.97–1.57) | 1.02 (0.98–0.59) | 0.78 (0.44–1.38) |
High | 1.50 (1.18–1.50) | 1.37 (1.07–1.75) | 1.80 (1.12–1.78) | 1.27 (0.73–2.22) |
Appendicular skeletal muscle mass index | ||||
Without sarcopenia | Ref | Ref | Ref | Ref |
With sarcopenia | 1.57 (1.23–1.98) | 1.53 (1.19–1.95) | 2.76 (1.44–5.32) | 2.99 (1.39–6.06) |
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© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Aduse-Poku, L.; Karanth, S.D.; Wheeler, M.; Yang, D.; Washington, C.; Hong, Y.-R.; Manini, T.M.; Fabregas, J.C.; Cheng, T.-Y.D.; Braithwaite, D. Associations of Total Body Fat Mass and Skeletal Muscle Index with All-Cause and Cancer-Specific Mortality in Cancer Survivors. Cancers 2023, 15, 1081. https://doi.org/10.3390/cancers15041081
Aduse-Poku L, Karanth SD, Wheeler M, Yang D, Washington C, Hong Y-R, Manini TM, Fabregas JC, Cheng T-YD, Braithwaite D. Associations of Total Body Fat Mass and Skeletal Muscle Index with All-Cause and Cancer-Specific Mortality in Cancer Survivors. Cancers. 2023; 15(4):1081. https://doi.org/10.3390/cancers15041081
Chicago/Turabian StyleAduse-Poku, Livingstone, Shama D. Karanth, Meghann Wheeler, Danting Yang, Caretia Washington, Young-Rock Hong, Todd M. Manini, Jesus C. Fabregas, Ting-Yuan David Cheng, and Dejana Braithwaite. 2023. "Associations of Total Body Fat Mass and Skeletal Muscle Index with All-Cause and Cancer-Specific Mortality in Cancer Survivors" Cancers 15, no. 4: 1081. https://doi.org/10.3390/cancers15041081