The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang, China; Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China; National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China; Laboratory for Clinical Medicine, Capital Medical University, Beijing, China; Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.
Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China; National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China; Laboratory for Clinical Medicine, Capital Medical University, Beijing, China; Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China.
Am J Clin Nutr. 2024 Jul;120(1):47-55. doi: 10.1016/j.ajcnut.2024.05.016. Epub 2024 May 18.
Anthropometric indicators have been shown to be associated with the prognosis of patients with cancer. However, any single anthropometric index has limitation in predicting the prognosis.
This study aimed to observe the predictive role of 7 anthropometric indicators based on body size on the prognosis of patients with cancer.
A principal component analysis (PCA) on 7 anthropometric measurements: height, weight, BMI, hand grip strength (HGS), triceps skinfold thickness (TSF), mid-upper arm circumference (MAC), and calf circumference (CAC) was conducted. Principal components (PCs) were derived from this analysis. Cox regression analysis was used to investigate the association between the prognosis of patients with cancer and the PCs. Subgroups and sensitivity analyses were also conducted.
Through PCA, 4 distinct PCs were identified, collectively explaining 88.3% of the variance. PC1, primarily characterized by general obesity, exhibited a significant inverse association with risk of cancer-related death (adjusted hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.83, 0.88). PC2 (short stature with high TSF) was not significantly associated with cancer prognosis. PC3 (high BMI coupled with low HGS) demonstrated a significant increase with risk of cancer-related death (adjusted HR: 1.08; 95% CI: 1.05, 1.11). PC4 (tall stature with high TSF) exhibited a significant association with increased cancer risk (adjusted HR: 1.05; 95% CI: 1.02, 1.07). These associations varied across different cancer stages. The stability of the results was confirmed through sensitivity analyses.
Different body sizes are associated with distinct prognostic outcomes in patients with cancer. The impact of BMI on prognosis is influenced by both HGS and subcutaneous fat. This finding may influence the clinical care of cancer and improve the survival of cancer patients.
人体测量指标已被证明与癌症患者的预后相关。然而,任何单一的人体测量指标在预测预后方面都存在局限性。
本研究旨在观察基于体型的 7 个人体测量指标对癌症患者预后的预测作用。
对 7 个人体测量指标(身高、体重、BMI、握力、三头肌皮褶厚度、上臂中部周长和小腿周长)进行主成分分析(PCA)。从该分析中得出主成分(PC)。使用 Cox 回归分析来研究癌症患者的预后与 PC 之间的关联。还进行了亚组和敏感性分析。
通过 PCA,确定了 4 个不同的 PC,它们共同解释了 88.3%的方差。PC1 主要表现为一般性肥胖,与癌症相关死亡的风险呈显著负相关(调整后的危险比[HR]:0.86;95%置信区间[CI]:0.83,0.88)。PC2(矮小身材伴高 TSF)与癌症预后无显著相关性。PC3(高 BMI 伴低 HGS)与癌症相关死亡风险显著增加(调整后的 HR:1.08;95% CI:1.05,1.11)。PC4(高 TSF 的高身材)与癌症风险增加显著相关(调整后的 HR:1.05;95% CI:1.02,1.07)。这些关联在不同的癌症阶段有所不同。通过敏感性分析证实了结果的稳定性。
不同的体型与癌症患者的不同预后结果相关。BMI 对预后的影响受到握力和皮下脂肪的影响。这一发现可能会影响癌症的临床治疗,并提高癌症患者的生存率。