Quality and quantity of visceral fat tissue are associated with insulin resistance and survival outcomes after chemotherapy in patients with breast cancer

Iwase, Toshiaki; Sangai, Takafumi; Fujimoto, Hiroshi; Sawabe, Yuji; Matsushita, Hiroshi; Nagashima, Kengo; Sato, Yasunori; Nakagawa, Ayako; Masuda, Takuya; Nagashima, Takeshi; Ohtsuka, Masayuki

doi:10.1007/s10549-019-05467-7

Cited by 32 publications

(17 citation statements)

References 30 publications

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“…Clinically, increased VAT is associated with insulin resistance because VAT induces free fatty acid accumulation in the liver via portal vein circulation [17]. Our previous study showed that increased amount and lower quality of VAT was associated with shorter distant disease-free survival via increasing insulin resistance [9]. Many other preclinical and clinical studies have reported a positive relationship between increased VAT, poor NACT outcome [18], and shorter survival outcome [9,10]; however, recent studies have indicated that deep abdominal SAT (daSAT)-defined as adipose tissue at the deepest layer of abdominal SAT-is also metabolically active and has a similar metabolic function to that of VAT.…”

Section: Discussionmentioning

confidence: 99%

“…A plausible explanation for the obesity paradox is that BMI does not always reflect body composition, defined as the constitution of fat, muscle mass, bone, and water in the body. Understanding body composition is important for breast cancer treatment because recent studies indicated that body composition could be an imaging biomarker for insulin resistance, response to treatment, and prognosis in patients with breast cancer [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…We previously reported that patients with early breast cancer who had a higher amount of visceral adipose tissue (VAT) and the lower quality of VAT represented by the Hounsfield unit (HU) measured by computed tomography in the upper abdominal area had significantly shorter distant disease-free survival than those with a lower amount and higher quality of VAT, owing to increasing insulin resistance [9,10]. In addition to VAT, a significantly reduced amount of skeletal muscle mass (i.e., sarcopenia) was also associated with higher overall mortality rates in breast cancer survivors [12].…”

Section: Introductionmentioning

confidence: 99%

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The Prognostic Impact of Body Composition for Locally Advanced Breast Cancer Patients Who Received Neoadjuvant Chemotherapy

Iwase

Parikh

Dibaj

et al. 2021

Cancers

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Our previous study indicated that a high amount of visceral adipose tissue was associated with poor survival outcomes in patients with early breast cancer who received neoadjuvant chemotherapy. However, inconsistency was observed in the prognostic role of body composition in breast cancer treatment outcomes. In the present study, we aimed to validate our previous research by performing a comprehensive body composition analysis in patients with a standardized clinical background. We included 198 patients with stage III breast cancer who underwent neoadjuvant chemotherapy between January 2007 and June 2015. The impact of body composition on pathologic complete response and survival outcomes was determined. Body composition measurements had no significant effect on pathologic complete response. Survival analysis showed a low ratio of total visceral adipose tissue to subcutaneous adipose tissue (V/S ratio ≤ 34) was associated with shorter overall survival. A changepoint method determined that a V/S ratio cutoff of 34 maximized the difference in overall survival. Our study indicated the prognostic effect of body composition measurements in patients with locally advanced breast cancer compared to those with early breast cancer. Further investigation will be needed to clarify the biological mechanism underlying the association of V/S ratio with prognosis in locally advanced breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Prognostic Impact of Body Composition for Locally Advanced Breast Cancer Patients Who Received Neoadjuvant Chemotherapy

Iwase

Parikh

Dibaj

et al. 2021

Cancers

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“…Since muscle loss [24] and increased fat mass (in particular visceral fat [25]) are negatively associated with the outcome of breast cancer patients, we were interested how the individual diet types in uenced body composition. All three diet groups were able to reduce body weight, which was one of their personal goals since their physicians told them that normalizing body weight might improve outcome based on international guidelines [26].…”

Section: Energy Uptake/body Compositionmentioning

confidence: 99%

Low Carb (LCD) and Ketogenic (KD) Diets Increase Quality of Life, Physical Performance, Body Composition and Metabolic Health of Women with Breast Cancer Better Than a Standard Diet (SD)

Kämmerer¹,

Klement²,

Sütterlin³

et al. 2020

Preprint

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Background: Breast Cancer (BC) patients often ask for a healthy diet. Here, we compared three different diets which could support BC patients during the rehabilitation process: a healthy standard diet (SD), a low carb diet (LCD) and a ketogenic diet (KD).Patients and Methods:KOLIBRI was a one-site nutritional intervention trial, combining inpatient and outhouse phases for 20 weeks. Female BC patients (n=152; mean age 51.7 years) could select their diet. Data collected were: quality of life (QoL), spiroergometry, body composition, blood biochemistry. 30, 92 and 30 patients started the KD, LCD and SD, respectively. Of those, 20, 72 and 25 completed the final examination.Results:Patients rated all diets as feasible in daily life. No adverse effects occurred in any diet group. KD offered the highest amount of energy and protein. All groups improved in QoL, body composition and physical performance. KD was superior in improving fatigue, insomnia and physical functioning. KD participants finished with the best physical performance and the highest muscle/fat ratio. Despite their increased cholesterol, KD patients had the best triglyceride/HDL ratio and HOMA-IR. Most metabolic parameters significantly improved in the LCD group. SD participants ended with remarkably low cholesterol levels, but did not improve triglyceride/HDL or HOMA-IR.Conclusions:A well-defined KD and LCD are safe and beneficial for BC. Both diets could thus be recommended for patients wanting to self-support their rehabilitation process.Trial registration IDNCT02092753 Protocol Registration date:02/26/2014Ketogenic Or LOGI Diet In a Breast Cancer Rehabilitation Intervention (KOLIBRI)URL: https://clinicaltrials.gov/ct2/show/NCT02092753?cond=KOLIBRI&draw=2&rank=1

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“…Abdominal obesity and the endocrinologically active visceral adipose tissue (VAT) are strongly linked to a higher overall mortality, often caused by cardiac, vascular, or metabolic diseases (3)(4)(5)(6)(7). Therefore, VAT quantification plays an important role in the evaluation of such patients but it may also be useful for a periprocedural assessment in the surgical disciplines (8)(9)(10)(11)(12)(13)(14). Anthropometric measures like BMI or waist to hip ratio usually correlate poorly with VAT only, whereas dual-energy x-ray absorptiometry has shown both VAT under-and overestimation in comparison with magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 99%

Toward a Routine Assessment of Visceral Adipose Tissue Volume from Computed Tomographic Data

Schaudinn

Hudak

Linder

et al. 2020

Obesity

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The study's aim was to determine to what extent total visceral adipose tissue (VAT) volume (V VAT-T) measured from segmented VAT areas (A VAT) on all axial computed tomography (CT) sections (thickness of 5 mm) between the diaphragm and pelvic floor can be predicted by the A VAT of commonly selected landmark sections in patients with overweight or obesity. Methods: A total of 113 patients (31 females, 82 males) with images of full abdominopelvic coverage and proper image quality were included (BMI = 25.0-64.1 kg/m 2 , 29.5 ± 4.9 kg/m 2). Linear regression between A VAT and V VAT-T (reference) was used to determine approximate equations for VAT volume for all parameters (single sex, different anatomical landmarks or lumbar intervertebral disc spaces, one or five axial sections). Agreement was evaluated by the multivariate coefficient of determination and by the SD of the percentage difference (s d%) between the estimated VAT volume on one or five sections and V VAT-T. Results: The V VAT-T was 0.9 to 8.4 (3.8 ± 2.2) L for females and 2.7 to 11.7 (5.6 ± 2.1) L for males. Best agreement was found at L2-3 (s d% = 14.3%-15.5%) for females and at L1-2 or L2-3 (11.7%-12.4%) for males. Agreement at the umbilicus or the femoral heads was poor (20.2%-57.9%). Segmentation of one or five sections was substantially faster (11/70 seconds) than whole-abdomen processing (15 minutes). Conclusions: V VAT-T can be rapidly estimated by VAT segmentation of axial CT sections at sex-specific lumbar intervertebral disc spaces.

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Quality and quantity of visceral fat tissue are associated with insulin resistance and survival outcomes after chemotherapy in patients with breast cancer

Cited by 32 publications

References 30 publications

The Prognostic Impact of Body Composition for Locally Advanced Breast Cancer Patients Who Received Neoadjuvant Chemotherapy

The Prognostic Impact of Body Composition for Locally Advanced Breast Cancer Patients Who Received Neoadjuvant Chemotherapy

Low Carb (LCD) and Ketogenic (KD) Diets Increase Quality of Life, Physical Performance, Body Composition and Metabolic Health of Women with Breast Cancer Better Than a Standard Diet (SD)

Toward a Routine Assessment of Visceral Adipose Tissue Volume from Computed Tomographic Data

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