Associations of Abdominal Skeletal Muscle Mass, Fat Mass, and Mortality among Men and Women with Stage I–III Colorectal Cancer

Abstract

Background: The associations of abdominal skeletal muscle mass index (SMI), visceral and subcutaneous adipose tissue (VAT and SAT, respectively), and mortality among patients with stage I-III colorectal cancer may differ for men and women, but only few studies stratified their data into men and women. We investigated associations of abdominal SMI, VAT, and SAT with overall mortality among men and among women with stage I-III colorectal cancer.Methods: SMI, VAT, and SAT were assessed from abdominal CT images for 1,998 patients with stage I-III colorectal cancer diagnosed between 2006 and 2015. Restricted cubic splines (RCS) were used to investigate associations of SMI, VAT, and SAT with overall mortality.Results: Average age of the participants was 67.9 AE 10.6 years and 58% were men. During a median follow-up of 4.3 years, 546 (27%) patients died. Among men, the association of SMI and mortality was statistically significant in a nonlinear way in the RCS analyses, with lower SMI levels associated with higher mortality. SMI was not associated with mortality among women. SAT was associated with mortality in a nonlinear way for men and for women, with lower SAT levels being associated with higher mortality. VAT was not significantly associated with mortality in men or women.Conclusion: Associations of abdominal skeletal muscle mass with mortality among patients with colorectal cancer were not the same for men and for women.Impact: This study stresses the importance for more attention on sex-related differences in body composition and cancer outcomes.

Mid‐Arm Muscle and Subcutaneous Fat Associated with All‐Cause Mortality Independent of BMI: A Prospective Cohort Study

“…Given that TSF thickness is a reliable indicator of subcutaneous adipose tissues of the mid‐arm, the association between high TSF thickness and lower all‐cause mortality may be largely attributed to the metabolic benefits of subcutaneous fat and peripheral fat distribution. Moreover, opposite effects of visceral and subcutaneous fat (28‐30) and peripheral and central fat distribution on mortality have been reported (5). Interestingly, in our study, WHR and WC (as surrogates of visceral and central fat distribution) were strongly and positively associated with all‐cause mortality in apparent contrast to TSF thickness.…”

“…These apparent opposite effects between WHR (or WC) and TSF thickness further demonstrated the different functions of subcutaneous and visceral fat in relation to human health. Numerous studies have reported the detrimental effects of visceral fat (28,29) and have found that subcutaneous fat has health benefits (5,27).…”

Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests

“…Last, we did not include information on muscle mass, as this information is only available at diagnosis for a subset of our population. Our group previously showed that muscle mass tended to increase with increasing BMI among stage I-III CRC patients [ 53 ]. Thus, lower BMIs might serve as a proxy for low muscle mass in the current analyses.…”

Learning from East to West and vice versa: Clinical epidemiology of colorectal cancer in China

“…Several recent studies have indicated that the amount of skeletal muscle or adipose tissue has important ramifications for colorectal cancer survival. 14,15 Low skeletal muscle mass and low skeletal muscle radiodensity (more fat infiltration) are strongly associated with worse survival. 16,17 In addition, it has been described that the adipose tissue area may have a U-shaped association with mortality, in which patients who have small areas of abdominal adipose tissue and those who have very large areas of abdominal adipose tissue may have a greater risk of mortality compared with patients who have modest areas of adipose tissue.…”

“…16,17 In addition, it has been described that the adipose tissue area may have a U-shaped association with mortality, in which patients who have small areas of abdominal adipose tissue and those who have very large areas of abdominal adipose tissue may have a greater risk of mortality compared with patients who have modest areas of adipose tissue. 15,18 It would be highly interesting to be able to study those associations in a large Asian cohort because body composition is known to differ between race/ethnic groups, in which, generally, with a similar BMI, Asian populations appear to have higher percentage of body fat than US or other Caucasian populations. 19 To the best of our knowledge, there is no large cohort of Asian populations with colorectal cancer that have information on body composition, at least not in the Englishlanguage scientific literature.…”