Muscle attenuation, not skeletal muscle index, is an independent prognostic factor for survival in gastric cancer patients with overweight and obesity

超重 骨骼肌 医学 肥胖 癌症 内科学 体质指数 肥胖悖论 肿瘤科 肌萎缩 风险因素
作者
Cheng‐Le Zhuang,Hao-Fan Wu,Haojie Jiang,Feng‐Min Zhang,Hanping Shi,Zhen Yu,Xian Shen,Xiaolei Chen,Su-Lin Wang
出处
期刊:Nutrition [Elsevier BV]
卷期号:122: 112391-112391 被引量:2
标识
DOI:10.1016/j.nut.2024.112391
摘要

Skeletal muscle index (SMI) is insufficient for evaluating muscle in obesity and muscle attenuation (MA) may be a preferred indicator. We aim to investigate whether MA has greater prognostic value than SMI in gastric cancer patients with overweight and obesity. Clinical parameters of 1312 patients with gastric cancer who underwent radical gastrectomy were prospectively collected between 2013 and 2019. MA and SMI were analyzed by computed tomography scan. Overweight and obesity was defined as body mass index (BMI) ≥ 24. The hazard ratio (HR) for death was calculated using Cox regression analysis. Among all patients, 405 were identified as overweight and obese and 907 were identified as normal and underweight. MA was inversely associated with BMI and visceral fat area. Among the 405 patients with overweight and obesity, 212 patients (52.3%) were diagnosed with low MA. In the overweight/obese group, MA was an independent predictor for overall survival (OS) (HR, 1.610; P = 0.021) in multivariate Cox regression analyses, while SMI did not remain in the model. In the normal/underweight group, both low MA (HR, 1.283; P = 0.039) and low SMI (HR, 1.369; P = 0.008) were independent factors of OS. Additionally, 318 patients were identified as having visceral obesity in the overweight/obese group and low MA was also an independent prognostic factor for survival in these patients (HR, 1.765; P = 0.013). MA had a higher prognostic value than SMI in overweight and obese patients with gastric cancer after radical gastrectomy.
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