Frontiers in Nutrition (Jun 2022)

Association Between Fat Mass to Lean Body Mass Ratio and All-Cause Mortality Among Middle-Aged and Elderly Cancer Patients Without Obesity: A Multi-Center Observational Study in China

  • Hongmei Xue,
  • Hongmei Xue,
  • Hongzhen Du,
  • Hongzhen Du,
  • Ying Xie,
  • Ying Xie,
  • Yijing Zhai,
  • Yijing Zhai,
  • Shiming Song,
  • Shiming Song,
  • Bin Luo,
  • Bin Luo,
  • Hong Qiu,
  • Kunhua Wang,
  • Jiuwei Cui,
  • Chunhua Song,
  • Hongxia Xu,
  • Wei Li,
  • Hanping Shi,
  • Hanping Shi,
  • Zengning Li,
  • Zengning Li,
  • The Investigation on Nutrition Status and Its Clinical Outcome of Common Cancers (INSCOC) Group,
  • Zengqing Guo,
  • Zhenming Fu,
  • Chang Wang,
  • Min Weng,
  • Jingjing Cao,
  • Fuxiang Zhou,
  • Yuan Lin,
  • Suyi Li,
  • Yi Ba,
  • Kaitao Yuan,
  • Ming Liu,
  • Wen Hu,
  • Lan Zhou,
  • Hu Ma,
  • Qinghua Yao,
  • Minghua Cong,
  • Tao Li,
  • Zihua Chen,
  • Gongyan Chen,
  • Qingchuan Zhao,
  • Changyan Feng,
  • Ying He,
  • Jing Wu,
  • Jiajun Yang,
  • Xinxia Song,
  • Yaying Yu,
  • Wenjun Ma,
  • Suxia Luo,
  • Jin Zheng,
  • Junqiang Chen,
  • Qi Luo,
  • Wei Wang,
  • Qiuge Qiao,
  • Yongmei Shi,
  • Yumei Qi,
  • Yongdong Feng,
  • Haiping Jiang,
  • Wenxian Guan,
  • Jiaxin Chen,
  • He Huang,
  • Zheng Yu,
  • Yu Fang

DOI
https://doi.org/10.3389/fnut.2022.914020
Journal volume & issue
Vol. 9

Abstract

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ObjectiveWe aimed to investigate the association between fat mass to lean body mass ratio (RFL), percentage of body fat (PBF), and fat mass (FM) with mortality among middle-aged and elderly cancer patients without obesity.MethodsThis prospective hospital-based cohort study comprised 3,201 patients with stage I to IV cancer aged 40 years or above (mean age: 58 years for female patients and 61 years for male patients; mean length of follow-up was 1.67 years; the maximal follow-up length was 6.42 years). FM and PBF were measured by bioelectrical impedance analysis (BIA). Cox proportional hazard models were used, and adjusted hazard ratios (HRs) were estimated.ResultsWe revealed a significant association between RFL and all-cause mortality among men aged ≥60 years after adjusting for confounders. Compared with those in the lowest tertile of RFL, elderly men in the medium and highest tertile had a 35 and 34% lower hazard of death from any cause, respectively. After additionally adjusted for C-reaction protein (CRP), HRs of medium and high tertile of RFL became short of statistical significance [medium tertile: adjusted HRs (95% CI) = 0.74 (0.46, 1.20); highest tertile: adjusted HRs (95% CI) = 0.84 (0.53, 1.33)]. Among elderly women, RFL was significantly related to all-cause mortality only when the additional adjustment for CRP [medium tertile: adjusted HRs (95% CI) = 2.08 (1.08, 4.01); highest tertile: adjusted HRs (95% CI) = 0.90 (0.45, 1.81)]. No significant association between RFL and all-cause mortality was observed among female participants or male participants aged less than 60 years.ConclusionOur findings showed a significant non-linear association between RFL and all-cause mortality, which was observed only in elderly men, and might be attenuated by their inflammation state.

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