Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: A population-based study
Abstract
Background Emerging evidence on body composition suggests that sarcopenic obesity (obesity with depleted muscle mass) might be predictive of morbidity and mortality in non-malignant disease and also of toxicity to chemotherapy. We aimed to assess the prevalence and clinical implications of sarcopenic obesity in patients with cancer. Methods Between Jan 13, 2004, and Jan 19, 2007, 2115 patients with solid tumours of the respiratory or gastrointestinal tract from a cancer treatment centre serving northern Alberta, Canada, were identified. Available lumbar CT images of the obese patients were analysed for total skeletal muscle cross-sectional area; these values were also used to estimate total body fat-free mass (FFM). Findings Of the 2115 patients initially identified, 325 (15%) were classified as obese (body-mass index [BMI] > or =30). Of these obese patients, 250 had CT images that met the criteria for analysis. The remaining 75 patients were recorded as without assessable scans. Obese patients had a wide range of muscle mass. Sex-specific cut-offs that defined a significant association between low muscle mass with mortality were ascertained by optimum stratification analysis: 38 (15%) of 250 patients who had assessable CT images that met the criteria for analysis were below these cut-offs and were classified as having sarcopenia. Sarcopenic obesity was associated with poorer functional status compared with obese patients who did not have sarcopenia (p=0.009), and was an independent predictor of survival (hazard ratio [HR] 4.2 [95% CI 2.4-7.2], p<0.0001). Estimated FFM showed a poor association with body-surface area (r(2)=0.37). Assuming that FFM represents the volume of distribution of many cytotoxic chemotherapy drugs, we estimated that individual variation in FFM could account for up to three-times variation in effective volume of distribution for chemotherapy administered per unit body-surface area, in this population. Interpretation This study provides evidence of the great variability of body composition in patients with cancer and links body composition, especially sarcopenic obesity, to clinical implications such as functional status, survival, and potentially, chemotherapy toxicity.
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Both sarcopenia and sarcopenic obesity are recognized as important nutritional problems that place older adults at higher risk of morbidity and mortality.
“Both sarcopenia and sarcopenic obesity, in which reduced FFM is combined with increased FM, are recognized as important nutritional problems that place older adults at higher risk of morbidity and mortality [2,29].”
From The Utility of Body Composition Assessment in Nutrition and Clinical Practice: An Overview of Current Methodology (2021) · cites this paper as [29]
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- Authors
- Prado, C. M., Lieffers, J. R., McCargar, L. J., Reiman, T., Sawyer, M. B., Martin, L., & Baracos, V. E.
- Affiliations
- University of Alberta (CA)
- Corresponding author
- Baracos, Vickie E
- Venue
- The Lancet Oncology
- Publisher
- Elsevier BV
- Published
- 2008-07
- Volume
- 9
- Issue
- 7
- Pages
- 629-635
- ISSN
- 1470-2045 (ISSN-L)
- OpenAlex
- W2127424726
- Cited by
- 3,238
- References
- 7
- Citations by year
- 2026: 247 · 2025: 256 · 2024: 289 · 2023: 273 · 2022: 300 · 2021: 341 · 2020: 297 · 2019: 248 · 2018: 238 · 2017: 160 · 2016: 146 · 2015: 142 · 2014: 103 · 2013: 59 · 2012: 56
- FWCI
- 17.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- sarcopenic obesity, sarcopenia, body composition, skeletal muscle area, fat-free mass, respiratory cancer, gastrointestinal cancer, solid tumors, obesity, functional status, survival, chemotherapy toxicity, volume of distribution, cancer cachexia
- MeSH terms
- Adult, Aged, Aged, 80 and over, Alberta, Body Composition, Female, Gastrointestinal Neoplasms, Humans, Lung Neoplasms, Male, Middle Aged, Muscular Diseases, Obesity, Cohort Studies, Prevalence, Muscle, Skeletal
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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