Association of body composition with risk of overall and site-specific cancers: A population-based prospective cohort study.

Although excess adiposity has been linked with various cancers, association between body composition and some cancers remains unclear, like lung and prostate cancers. We investigated associations of body composition with risk of overall cancer and major site-specific cancers in a prospective cohort of 454 079 cancer-free participants from UK-Biobank. Body composition was measured with bioimpedance analysis. We evaluated hazard ratio (HR) and 95% confidence interval (CI) with multivariate Cox linear and nonlinear models in men and women separately. We identified 27 794 cancers over 7.6 years of follow-up. Multivariable adjusted models including fat-free mass (FFM) and fat mass (FM) showed that FFM was positively associated with overall cancer risk in men and women (HR 1.03, 95% CI 1.01-1.04 and 1.07, 1.04-1.10, respectively); while the association between FM and overall cancer disappeared after adjusting for FFM. FFM was associated with higher risks of obesity-related cancers combined, stomach (women only), malignant melanoma, postmenopausal breast, corpus uteri, prostate, kidney (men only), and blood cancers and lower risk of lung cancer. FM was associated with higher risks of obesity-related cancers combined, esophageal, colon, lung (men only), postmenopausal breast (at the lower end of FM range), and corpus uteri cancers and lower risks of rectal, malignant melanoma (women only), prostate and blood cancers. FFM and FM seemed to have different effects on cancer risk, and the effects varied substantially by cancer type, in both direction and size. Higher FM/FFM ratio was also associated with some cancers risk, and might be a useful predictor of cancer risk.

He Q ，Xia B ，Liu A ，Li M ，Zhou Z ，Cheung EC ，Kuo ZC ，Wang B ，Li F ，Tang Y ，Zheng Z ，Sun R ，Hu YJ ，Meng W ，He Y ，Yuan J ，Zhang C ... -  《-》

Body composition and risk of major gynecologic malignancies: Results from the UK Biobank prospective cohort.

To evaluate the association between body composition and subsequent risk of the major gynecologic malignancies. This is a prospective analysis of participants from the UK Biobank. We measured baseline body composition and confirmed cancer diagnosis through linkage to cancer and death registries. We evaluated hazard ratios (HRs) and confidence interval (CIs) with COX models adjusting for potential confounders. We document 1430 cases of the top three gynecologic malignancies (uterine corpus cancer 847 cases, ovarian cancer 514 cases, and cervical cancer 69 cases) from 245,084 female participants (75,307 were premenopausal and 169,777 were postmenopausal). For premenopausal women, whole body fat-free mass (WBFFM) was associated with an increased risk of uterine corpus cancer (Adjusted HR per unit increase 1.04, 95% CI 1.02-1.06). For postmenopausal women, compared with the first quartile, the fourth quartile of WBFFM and whole body fat mass(WBFM) was associated with 2.16 (95% CI 1.49-3.13) times and 1.89 (95% CI 1.31-2.72) times of increased uterine corpus cancer risk, respectively. Regarding the distribution of body fat mass (FM)/fat-free mass (FFM), FFM distributed in the trunk was associate with increased uterine corpus cancer risk in premenopausal (HR 1.18,95% CI 1.07-1.31) and postmenopausal women (HR 1.13,95% CI 1.09-1.18). Meanwhile, FM/FFM distributed in the limbs present an U-shaped associations with uterine corpus cancer risk. We did not observe any association between aforementioned body composition indices with ovarian or cervical cancer. FM is associated with an increased risk of uterine corpus cancer in postmenopausal women. Meanwhile, FFM is found to be a risk factor for uterine corpus cancer in both premenopausal and postmenopausal women. No association of body composition with ovarian or cervical cancer was observed.

Yun P ，Xia B ，Tian XH ，Gong T ，Liu AR ，Yuan JQ ，Li FP ... -  《Cancer Medicine》

Association of anthropometric measures with fat and fat-free mass in the elderly: The Rotterdam study.

The decrease in fat-free mass (FFM) seen in many elderly people is usually associated with an increase in fat mass (FM), a state referred to as sarcopenic obesity. It is not clear which anthropometric measures are best used to identify sarcopenic obesity. We therefore evaluated which anthropometric measures are differentially associated with FM and FFM. The anthropometric measures tested were body mass index (BMI), waist circumference (WC), and a body shape index (ABSI = WC/(BMI(2/3)*Height(1/2))). FM and FFM were estimated by dual-energy X-ray absorptiometry. An index-score was calculated for both FM (FMI) and FFM (FFMI) by dividing FM and FFM by height. Multivariable linear regression models were used to assess the associations of BMI, WC and ABSI with FMI and FFMI among 3612 participants (2092 women) from the prospective population-based Rotterdam Study. In multivariate models adjusted for confounders, BMI and WC were positively associated with both FMI and FFMI in men and women. ABSI was positively associated with FMI (β 1.01, 95% confidence interval (95%CI) 0.85, 1.17) and negatively associated with FFMI (β -0.28, 95%CI -0.38, -0.17) in men. In women, ABSI was not associated with FMI and was positively associated with FFMI (β 0.18, 95%CI 0.10, 0.26). While BMI and WC were both positively associated with FM and FFM, ABSI showed a differential association with FM and FFM in men, but not in women. Since sarcopenic obesity is associated with decreased FFM and increased FM, ABSI could be a useful tool for identifying men at higher risk of sarcopenic obesity.

Dhana K ，Koolhaas CM ，Schoufour JD ，Rivadeneira F ，Hofman A ，Kavousi M ，Franco OH ... -  《-》

The association of body fat composition with risk of breast, endometrial, ovarian and colorectal cancers among normal weight participants in the UK Biobank.

Arthur RS ，Dannenberg AJ ，Kim M ，Rohan TE ... -  《-》

Adiposity and risk of prostate cancer death: a prospective analysis in UK Biobank and meta-analysis of published studies.

The association of adiposity with prostate cancer specific mortality remains unclear. We examined how adiposity relates to fatal prostate cancer and described the cross-sectional associations of commonly used adiposity measurements with adiposity estimated by imaging in UK Biobank. We also conducted a dose-response meta-analysis to integrate the new data with existing prospective evidence. 218,237 men from UK Biobank who were free from cancer at baseline were included. Body mass index (BMI), total body fat percentage (using bioimpedance), waist circumference (WC) and waist-to-hip ratio (WHR) were collected at recruitment. Risk of dying from prostate cancer (primary cause) by the different adiposity measurements was estimated using multivariable-adjusted Cox proportional hazards models. Results from this and other prospective cohort studies were combined in a dose-response meta-analysis. In UK Biobank, 661 men died from prostate cancer over a mean follow-up of 11.6 years. In the subsample of participants with magnetic resonance imaging and dual-energy X-ray absorptiometry, BMI, body fat percentage and WC were strongly associated with imaging estimates of total and central adiposity (e.g. visceral fat, trunk fat). The hazard ratios (HR) for prostate cancer death were 1.07 (95% confidence interval = 0.97-1.17) per 5 kg/m2 higher BMI, 1.00 (0.94-1.08) per 5% increase in total body fat percentage, 1.06 (0.99-1.14) per 10 cm increase in WC and 1.07 (1.01-1.14) per 0.05 increase in WHR. Our meta-analyses of prospective studies included 19,633 prostate cancer deaths for BMI, 670 for body fat percentage, 3181 for WC and 1639 for WHR, and the combined HRs for dying from prostate cancer for the increments above were 1.10 (1.07-1.12), 1.03 (0.96-1.11), 1.07 (1.03-1.11), and 1.06 (1.01-1.10), respectively. Overall, we found that men with higher total and central adiposity had similarly higher risks of prostate cancer death, which may be biologically driven and/or due to differences in detection. In either case, these findings support the benefit for men of maintaining a healthy body weight.

Perez-Cornago A ，Dunneram Y ，Watts EL ，Key TJ ，Travis RC ... -  《-》