Body Composition, Weight, and Colon Cancer Survival

身体成分、体重和结肠癌生存率

• 批准号: 9070643
• 负责人: BETTE J CAAN
• 金额: $ 60.01万
• 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 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9070643
• 关键词: Adipose tissue; Body Composition; Body Weight; Body Weight Changes; Body fat; Body mass index; California; Cancer Prognosis; Cancer Survivor; Cessation of life; Chronic; Clinical; Colon; Colon Carcinoma; Colorectal; Colorectal Cancer; Data; Diabetes Mellitus; Diagnosis; Diagnostic Neoplasm Staging; Diet; Disease; Endocrine; Epidemiology; Equation; Fatty acid glycerol esters; Gender; Health; Height; Hormonal; Hospitalization; Hyperinsulinism; Immune; Incidence; Individual; Inflammation; Insulin Resistance; Intervention; Lead; Measurement; Measures; Methods; 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; Time; Weight; Weight Gain; Weight maintenance regimen; X-Ray Computed Tomography; abdominal CT; advanced disease; cancer recurrence; 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; rectal; reduced muscle mass; response; sarcopenia; sarcopenic obesity; sex; standard measure; tool; treatment site; 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（由申请人提供）：流行病学和科学研究表明，肥胖对患结直肠癌的风险有重大影响。然而，肥胖与大肠癌（CRC）预后之间的关联不那么令人信服。尽管一些研究发现严重的肥胖患者（BMI，E35 kg/m2）的复发风险增加和/或死亡，但大多数研究发现体重指数（BMI）（BMI）或诊断后体重增加和CRC预后之间没有关联。 BMI和结直肠癌终点之间缺乏一致的发现可能部分是由于BMI在疾病背景下可能是人体成分的替代品。脂肪组织和肌肉质量在体内发挥强大但内分泌，免疫和激素影响不同。尽管超重的人倾向于具有更高量的瘦和脂肪质量，但超重或肥胖的人可能存在低水平的肌肉质量。肌肉减少症（肌肉浪费）在癌症幸存者中也很常见，即使存在脂肪增加。因此，我们建议将收集的腹部CT扫描作为诊断和诊断后1 - 2年的常规分期和监视的一部分，以评估脂肪和肌肉质量，并检查人体组成与人群中CRC生存的关系（n = 3546）在2005年至2010年之间，在北加州Kaiser Permanente（KPNC）中诊断为I-III期浸润性结直肠癌（CRC）。具体而言，我们将检查诊断时CRC幸存者中肌肉浪费（Sarcopenia）和多余的脂肪质量（FM）（AIM 1），诊断和CRC生存时FM和肌肉质量之间的关联（AIM 2），是否变化诊断后的诊断和1至2年之间测量的FM和肌肉质量因体重变化而有所不同（AIM 3），以及诊断和诊断后1至2年之间的FM和肌肉质量的变化是否与CRC生存有关（目标4）。这项研究使用一种新颖的，最先进的工具来收集比标准的身高和体重测量的更准确的身体组成量度，并且可以为能量平衡和身体成分在癌症存活中的作用提供重要的见解。这项研究将使CRC患者能够鉴定出肌肉浪费高风险的CRC患者，并可能会提高我们对BMI为什么与事件CRC相关而而不是CRC结局的理解。在临床或流行病学环境中，可以轻松地使用CT扫描来评估脂肪/肌肉质量，从而为BMI增加一项重要的生理方法，以帮助靶向和个性化体重控制策略和其他治疗方法，以防止肌肉质量损失，从而有可能改善生存率。因此，这项研究的结果可能导致临床实践的改变。此外，关于脂肪/肌肉作用的见解 CRC预后的质量可能为未来的研究提供有关能量平衡在癌症存活中的作用的新途径