Body Composition, Weight, and Colon Cancer Survival

身体成分、体重和结肠癌生存率

• 批准号: 9350253
• 负责人: BETTE J CAAN
• 金额: $ 58.25万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9350253
• 关键词: Adipose tissue; Biological; Body Composition; Body Weight; Body Weight Changes; Body fat; Body mass index; Body measure procedure; California; Cancer Prognosis; Cancer Survivor; Cessation of life; Chronic; Clinical; Colon; Colon Carcinoma; Colorectal; Colorectal Cancer; Data; Diabetes Mellitus; Diagnosis; Diet; Disease; Endocrine; Epidemiology; Equation; Fatty acid glycerol esters; Gender; Height; Hormonal; Hospitalization; Hyperinsulinism; Immune; Incidence; Individual; Inflammation; Insulin Resistance; Intervention; Lead; Malignant Neoplasms; Measurement; Measures; Methods; Morbid Obesity; Muscular Atrophy; Newly Diagnosed; Obesity; Operative Surgical Procedures; Outcome; Overweight; Patient-Focused Outcomes; Patients; Pattern; Persons; Physical activity; Physiological; Prognostic Factor; Rectal Cancer; Recurrence; Research; Risk; Role; Site; Staging; Subgroup; Thinness; Time; Weight; Weight Gain; Weight maintenance regimen; X-Ray Computed Tomography; abdominal CT; advanced disease; cancer recurrence; cancer risk; cancer survival; clinical practice; clinically relevant; cohort; colon cancer patients; cost; energy balance; functional status; high risk; improved; individualized medicine; insight; lean body mass; mortality; muscle form; novel; outcome forecast; prevent; prospective; public health relevance; rectal; reduced muscle mass; response; sarcopenia; sarcopenic obesity; sex; standard measure; tool; treatment strategy; tumor progression

DESCRIPTION (provided by applicant): Epidemiologic and scientific research shows that obesity has a significant influence on the risk of developing colorectal cancer. However, associations between adiposity and colorectal cancer (CRC) prognosis are less convincing. While some studies have found severely obese patients (BMI, e35 kg/m2) to have an increased risk of recurrence and/or death, most studies have found no association between body mass index (BMI) or weight gain after diagnosis and CRC prognosis. The lack of consistent findings between BMI and colorectal cancer endpoints may be due in part to the fact that BMI may be a poor surrogate for body composition in the context of illness. Adipose tissue and muscle mass exert powerful but different endocrine, immune, and hormonal influences within the body. Though overweight persons tend to have both higher amounts of lean and fat mass, low levels of muscle mass may be present in overweight or obese people; sarcopenia (muscle wasting) is common among cancer survivors, even in the presence of fat gain. Therefore, we propose to use abdominal CT scans collected as part of routine staging and surveillance both at diagnosis and 1-2 years after diagnosis, to assess fat and muscle mass and to examine the relationship of body composition to CRC survival in a cohort of persons (n=3546) diagnosed between 2005 and 2010 with Stage I-III invasive colorectal cancer (CRC) at Kaiser Permanente Northern California (KPNC). Specifically, we will examine the level of muscle wasting (sarcopenia) and excess fat mass (FM) in CRC survivors at diagnosis (Aim 1), the association between FM and muscle mass at diagnosis and CRC survival (Aim 2), whether changes in FM and muscle mass measured between diagnosis and 1 to 2 years after diagnosis vary by weight change post-diagnosis (Aim 3), and whether changes in FM and muscle mass measured between diagnosis and 1 to 2 years after diagnosis are associated with CRC survival (Aim 4). This study uses a novel, state-of-the art tool to collect more accurate measures of body composition than standard measures of height and weight, and could provide important insight into the role of energy balance and body composition in cancer survival. This study will enable identification of CRC patients who are at high risk for muscle wasting and may improve our understanding of why BMI is related to incident CRC but not CRC outcomes. The use of CT scans to assess fat/muscle mass could easily be done in the clinical or epidemiologic setting, adding an important physiologic measure to BMI to help target and personalize weight control strategies and other treatments to prevent muscle mass loss, potentially improving survival. Findings from this study may thus lead to altered clinical practice. Additionally, insights regarding the role of fat/muscle mass in CRC prognosis may provide new avenues for future research about the role of energy balance in cancer survival

描述（申请人提供）：流行病学和科学研究表明，肥胖对结直肠癌的发病风险有显著影响。然而，肥胖和结直肠癌（CRC）预后之间的关联不太令人信服。虽然一些研究发现严重肥胖患者（BMI，e35 kg/m2）复发和/或死亡的风险增加，但大多数研究发现诊断后体重指数（BMI）或体重增加与CRC预后之间没有关联。BMI和结直肠癌终点之间缺乏一致的结果，部分原因可能是BMI可能是疾病背景下身体组成的不良替代品。脂肪组织和肌肉质量在体内发挥强大但不同的内分泌，免疫和激素影响。虽然超重的人往往有更高的瘦肉和脂肪量，低水平的肌肉质量可能存在于超重或肥胖的人;肌肉减少症（肌肉萎缩）是常见的癌症幸存者，即使在脂肪增加的存在。因此，我们建议使用腹部CT扫描作为诊断时和诊断后1-2年常规分期和监测的一部分，在2005年至2010年期间在北方加州的Kaiser Permanente诊断为I-III期浸润性结直肠癌（CRC）的患者队列（n=3546）中评估脂肪和肌肉质量，并检查身体成分与CRC生存率的关系（KPNC）。具体来说，我们将检查肌肉萎缩的程度，诊断时CRC存活者中的肌肉减少症（肌肉减少症）和过量脂肪量（FM）（目标1），诊断时FM和肌肉量与CRC存活率之间的关联（目标2），诊断和诊断后1至2年之间测量的FM和肌肉量的变化是否因诊断后体重变化而变化（目标3），以及在诊断和诊断后1 - 2年之间测量的FM和肌肉质量的变化是否与CRC生存相关（目的4）。这项研究使用了一种新的、最先进的工具来收集比身高和体重标准测量更准确的身体组成测量值，并可以为能量平衡和身体组成在癌症生存中的作用提供重要的见解。这项研究将有助于识别肌肉萎缩高风险的CRC患者，并可能提高我们对BMI与CRC事件相关而与CRC结局无关的原因的理解。使用CT扫描来评估脂肪/肌肉质量可以很容易地在临床或流行病学环境中完成，为BMI增加了一个重要的生理指标，以帮助目标和个性化体重控制策略和其他治疗，以防止肌肉质量损失，可能提高生存率。因此，这项研究的结果可能会改变临床实践。此外，关于脂肪/肌肉作用的见解 在结直肠癌预后中的质量可能为未来关于能量平衡在癌症生存中的作用的研究提供新的途径