Dataset Information

Association of Abdominal Visceral Adiposity and Total Fat Mass with Cancer Incidence and Mortality in White and Black Adults.

ABSTRACT:

Background

Race modifies the association between anthropometric measures of obesity and cancer risk. However, the degree to which abdominal visceral adipose tissue (VAT) and total fat mass (FM) are associated with cancer risk is not known.

Methods

The sample included 3,017 White and 1,347 Black adults who were assessed between 1995 and 2016 and followed for outcome assessment through 2017. Abdominal VAT and FM were measured using imaging techniques. The co-primary endpoints were diagnosis of histologically confirmed invasive cancer (excluding nonmelanoma skin cancer) or death from cancer. Multivariable Cox proportional hazards models quantified the HR of incident cancer and cancer mortality.

Results

There were 353 incident cancer cases and 75 cancer deaths in an average of 12.9 years of follow-up. Both VAT [HR, 1.21; 95% confidence interval (CI), 1.09-1.36] and FM (HR, 1.25; 95% CI, 1.10-1.43) were significantly associated with incident cancer, while VAT (HR, 1.28; 95% CI, 1.01-1.61) was significantly associated with cancer mortality after adjustment for several covariates. VAT remained significantly associated with cancer incidence (HR, 1.22; 95% CI, 1.03-1.46) after additional inclusion of FM in the multivariable model, but not vice versa. There were no significant sex- or race-interactions.

Conclusions

VAT was associated with risk of cancer and cancer mortality in this cohort, and the associations did not differ by sex or race. The association between VAT and incident cancer was largely independent of total FM.

Impact

Our results suggest that utility of anthropometry in assessing obesity-related cancer risk may need to be further refined by including more direct measures of adiposity.

SUBMITTER: Katzmarzyk PT

PROVIDER: S-EPMC9357175 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association of Abdominal Visceral Adiposity and Total Fat Mass with Cancer Incidence and Mortality in White and Black Adults.

Katzmarzyk Peter T PT Brown Justin C JC Yang Shengping S Mire Emily F EF Wu Xiao-Cheng XC Miele Lucio L Ochoa Augusto C AC Zabaleta Jovanny J

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20220801 8

<h4>Background</h4>Race modifies the association between anthropometric measures of obesity and cancer risk. However, the degree to which abdominal visceral adipose tissue (VAT) and total fat mass (FM) are associated with cancer risk is not known.<h4>Methods</h4>The sample included 3,017 White and 1,347 Black adults who were assessed between 1995 and 2016 and followed for outcome assessment through 2017. Abdominal VAT and FM were measured using imaging techniques. The co-primary endpoints were d ...[more]

PMID: 35654355

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Project description:Few studies have explored the genetic underpinnings of intra-abdominal visceral fat deposition, which varies substantially by sex and race/ethnicity. Among 1,787 participants in the Multiethnic Cohort (MEC)-Adiposity Phenotype Study (MEC-APS), we conducted a genome-wide association study (GWAS) of the percent visceral adiposity tissue (VAT) area out of the overall abdominal area, averaged across L1-L5 (%VAT), measured by abdominal magnetic resonance imaging (MRI). A genome-wide significant signal was found on chromosome 2q14.3 in the sex-combined GWAS (lead variant rs79837492: Beta per effect allele = -4.76; P = 2.62 × 10-8) and in the male-only GWAS (lead variant rs2968545: (Beta = -6.50; P = 1.09 × 10-9), and one suggestive variant was found at 13q12.11 in the female-only GWAS (rs79926925: Beta = 6.95; P = 8.15 × 10-8). The negatively associated variants were most common in European Americans (T allele of rs79837492; 5%) and African Americans (C allele of rs2968545; 5%) and not observed in Japanese Americans, whereas the positively associated variant was most common in Japanese Americans (C allele of rs79926925, 5%), which was all consistent with the racial/ethnic %VAT differences. In a validation step among UK Biobank participants (N = 23,699 of mainly British and Irish ancestry) with MRI-based VAT volume, both rs79837492 (Beta = -0.026, P = 0.019) and rs2968545 (Beta = -0.028, P = 0.010) were significantly associated in men only (n = 11,524). In the MEC-APS, the association between rs79926925 and plasma sex hormone binding globulin levels reached statistical significance in females, but not in males, with adjustment for total adiposity (Beta = -0.24; P = 0.028), on the log scale. Rs79837492 and rs2968545 are located in intron 5 of CNTNAP5, and rs79926925, in an intergenic region between GJB6 and CRYL1. These novel findings differing by sex and racial/ethnic group warrant replication in additional diverse studies with direct visceral fat measurements.

Project description:BackgroundCharacterization of abdominal and intra-abdominal fat requires imaging, and thus is not feasible in large epidemiologic studies.ObjectiveWe investigated whether biomarkers may complement anthropometry (body mass index [BMI], waist circumference [WC], and waist-hip ratio [WHR]) in predicting the size of the body fat compartments by analyzing blood biomarkers, including adipocytokines, insulin resistance markers, sex steroid hormones, lipids, liver enzymes and gastro-neuropeptides.MethodsFasting levels of 58 blood markers were analyzed in 60 healthy, Caucasian or Japanese American postmenopausal women who underwent anthropometric measurements, dual energy X-ray absorptiometry (DXA), and abdominal magnetic resonance imaging. Total, abdominal, visceral and hepatic adiposity were predicted based on anthropometry and the biomarkers using Random Forest models.ResultsTotal body fat was well predicted by anthropometry alone (R(2) = 0.85), by the 5 best predictors from the biomarker model alone (leptin, leptin-adiponectin ratio [LAR], free estradiol, plasminogen activator inhibitor-1 [PAI1], alanine transaminase [ALT]; R(2) = 0.69), or by combining these 5 biomarkers with anthropometry (R(2) = 0.91). Abdominal adiposity (DXA trunk-to-periphery fat ratio) was better predicted by combining the two types of predictors (R(2) = 0.58) than by anthropometry alone (R(2) = 0.53) or the 5 best biomarkers alone (25(OH)-vitamin D(3), insulin-like growth factor binding protein-1 [IGFBP1], uric acid, soluble leptin receptor [sLEPR], Coenzyme Q10; R(2) = 0.35). Similarly, visceral fat was slightly better predicted by combining the predictors (R(2) = 0.68) than by anthropometry alone (R(2) = 0.65) or the 5 best biomarker predictors alone (leptin, C-reactive protein [CRP], LAR, lycopene, vitamin D(3); R(2) = 0.58). Percent liver fat was predicted better by the 5 best biomarker predictors (insulin, sex hormone binding globulin [SHBG], LAR, alpha-tocopherol, PAI1; R(2) = 0.42) or by combining the predictors (R(2) = 0.44) than by anthropometry alone (R(2) = 0.29).ConclusionThe predictive ability of anthropometry for body fat distribution may be enhanced by measuring a small number of biomarkers. Studies to replicate these data in men and other ethnic groups are warranted.

Project description:Abstract Objectives It is imperative to accurately estimate whole body fat percentage (%fat) in order to understand the deleterious nature of excess adiposity on cardiometabolic disease risk. However, cost and accessibility often preclude the use of advanced assessment methods. Relative fat mass (RFM), an emerging estimator of whole body %fat based upon waist circumference, height, and biological sex, has yet to be evaluated in an older adult population. The purpose of this study was to examine the relationship between RFM and gold standard measures of adiposity among older adults, and to evaluate whether changes in RFM reflected changes in %fat following a 12-month lifestyle intervention. Methods This study was ancillary to a randomized controlled trial investigating the effects of a lifestyle intervention with and without intentional energy restriction. (Clinicaltrials.gov #NCT00955903). Older adults with obesity (N = 163, 37.4% male, 70.3 ± 4.7 years) were randomized to one of three groups: exercise only, exercise + nutrient-dense weight maintenance diet, or exercise + nutrient-dense energy restriction of 500 kcal/d. Total and regional adiposity were determined by dual-energy X-ray absorptiometry (DXA) at baseline and 12 months. Data were analyzed using Spearman's correlations, Wilcoxon, Kruskal-Wallis, and linear regression tests. Results At baseline, significant correlations were observed between RFM and DXA whole body %fat (r = 0.751, P < 0.001), DXA total fat (r = 0.353, P < 0.001), and DXA trunk %fat (r = 0.661, P < 0.001). Additionally, RFM was a significant predictor of DXA whole body %fat (P < 0.001) and accounted for 63.5% of model variance. From baseline to 12 months, a significant reduction in RFM was observed among participants in the exercise only and exercise + energy restriction groups (P = 0.020, P < 0.001, respectively). Magnitude of RFM change did not differ among groups. Notably, changes in RFM were significantly correlated with changes in DXA whole body %fat (r = 0.279, P = 0.001) and DXA trunk %fat (r = 0.276, P = 0.001). Conclusions Results support use of RFM as an estimate of whole body %fat, as well as an indicator of its sensitivity to change in fat mass over 12 months in older adults. Incorporation of RFM in cardiometabolic research may provide meaningful information not reflected in conventional body composition measures such as body mass index. Funding Sources NIH

Project description:BackgroundRace and sex differences in adolescents' body fat are demonstrated in cross-sectional cohorts, yet a longitudinal design would better identify patterns of fat distribution over time.ObjectivesThe aim was to examine race and sex differences in adiposity between black and white adolescents over 2 y.MethodsA cohort of adolescents aged 10-16 y (38% black; 52% girls; 15% overweight, 34% with obesity) underwent body composition measurements at baseline (n = 309) and 2 y later (n = 236), using DXA to quantify whole-body fat mass (FM) and MRI for abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) volumes. General linear models were used to examine race and sex differences in log-transformed FM, SAT, and VAT, adjusting for age, sexual maturation, extended BMI percentile, and race-by-sex interaction. SAT and VAT models in addition controlled for baseline FM and change in FM (for change models).ResultsMean (95% CI) baseline FM (kg) was higher among white [18.5 (17.9, 19.2) than among black adolescents [17.4 (16.6, 18.2), P = 0.03] and girls [19.5 (18.8, 20.3) than boys [16.5 (15.8, 17.2), P < 0.0001]. Mean (95% CI) baseline SAT (L) was higher among girls [4.4 (4.2, 4.6)] than among boys [3.9 (3.7, 4.1), P < 0.0001]. Mean (95% CI) baseline VAT (L) was higher among white [0.5 (0.5, 0.6)] than among black [0.3 (0.3, 0.4)] adolescents (P < 0.0001) and boys [0.5 (0.4, 0.5)] than girls [0.4 (0.4, 0.4), P = 0.04]. Over 2 y mean (95% CI) FM change (kg) was higher among white [3.7 (2.9, 4.5)] than among black adolescents [2.3 (1.3, 3.3), P = 0.04] and girls [4.0 (3.0, 4.9)] than boys [2.0 (1.1, 3.0), P = 0.007], but SAT change (L) did not differ by race or sex. VAT change (L) was higher among white [0.1 (0.1, 0.1)] than among black adolescents [0.0 (0.0, 0.1), P = 0.003] and boys [0.1 (0.1, 0.1)] than girls [0.0 (0.0, 0.1), P = 0.034].ConclusionsSex and race differences in the deposition and accumulation of excess fat are important considerations for understanding obesity prevalence and obesity-related disease risk among adolescents.This trial was registered at clinicaltrials.gov as NCT02784509.

Project description:Objective: We aimed to assess the role of adipose tissue distribution in cardiometabolic risk (in particular insulin sensitivity) in a population of children and adolescents with obesity. Methods: In this cross-sectional study, participants were 479 children and adolescents with obesity (322 boys and 157 girls) aged 3 to 18 years attending the Children's Hospital at Zhejiang University School of Medicine (Hangzhou, China). Clinical assessments included anthropometry, body composition (DXA scans), carotid artery ultrasounds, and OGTT. Insulin sensitivity was assessed using the Matsuda index. Participants were stratified into groups by sex and pubertal stage. Key predictors were DXA-derived android-to-gynoid-fat ratio (A/G) and total body fat percentage (TBF%). Results: Irrespective of sex and pubertal stage, there was a strong association between increasing A/G (i.e., greater abdominal adiposity) and lower insulin sensitivity. In multivariable models, every 0.1 increase in A/G was associated with a reduction in insulin sensitivity in prepubertal boys [-29% (95% CI -36%, -20%); p < 0.0001], pubertal boys [-13% (95% CI -21%, -6%); p = 0.001], and pubertal girls [-16% (95% CI -24%, -6%); p = 0.002]. In contrast, TBF% was not associated with insulin sensitivity when A/G was adjusted for, irrespective of pubertal stage or sex. In addition, every 0.1 increase in A/G was associated with increased likelihood of dyslipidemia in prepubertal boys [adjusted odds ratio (aOR) 1.62 (95% CI 1.05, 2.49)], impaired glucose tolerance in pubertal boys [aOR 1.64 (95% CI 1.07, 2.51)] and pubertal girls [aOR 1.81 (95% CI 1.10, 2.98)], and odds of NAFLD in both prepubertal [aOR 2.57 (95% CI 1.56, 4.21)] and pubertal [aOR 1.69 (95% CI 1.18, 2.40)] boys. In contrast, higher TBF% was only associated with higher fasting insulin and ALT in pubertal boys, being also predictive of NAFLD in this group [aOR 1.15 per percentage point (95% CI 1.06, 1.26)], but was not associated with the likelihood of other cardiometabolic outcomes assessed in any group. Conclusions: A/G is a much stronger independent predictor of cardiometabolic risk factors in children and adolescents with obesity in China, particularly glucose metabolism.

Dataset Information

Association of Abdominal Visceral Adiposity and Total Fat Mass with Cancer Incidence and Mortality in White and Black Adults.

Background

Methods

Results

Conclusions

Impact

Publications

Association of Abdominal Visceral Adiposity and Total Fat Mass with Cancer Incidence and Mortality in White and Black Adults.

Similar Datasets

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