Body Composition, Weight, and Colon Cancer Survival

身体成分、体重和结肠癌生存率

基本信息

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
项目类别：
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

项目摘要

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，肥胖对患结直肠癌的风险有显着影响。然而，肥胖与结直肠癌（CRC）预后之间的关联尚不那么令人信服。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研究结果可能部分是由于 BMI 可能不能很好地替代疾病情况下的身体成分。脂肪组织和肌肉质量对体内的内分泌、免疫和激素产生强大但不同的影响。尽管超重者的瘦肉量和脂肪量往往较高，但超重或肥胖者的肌肉量可能较低；肌肉减少症（肌肉萎缩）在癌症幸存者中很常见，即使存在脂肪增加也是如此。因此，我们建议使用收集的腹部 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，以评估脂肪和肌肉质量，并检查一组人群中身体成分与 CRC 存活率的关系(n=3546) 于 2005 年至 2010 年间在北加州凯撒医疗机构 (KPNC) 被诊断患有 I-III 期浸润性结直肠癌 (CRC)。具体来说，我们将检查诊断时 CRC 幸存者的肌肉萎缩（肌肉减少症）和多余脂肪量 (FM) 水平（目标 1）、诊断时 FM 和肌肉质量与 CRC 存活率之间的关联（目标 2）、诊断期间和诊断后 1 至 2 年内测量的 FM 和肌肉质量因诊断后体重变化（目标 3）而异，以及诊断之间和诊断后 1 至 2 年内测量的 FM 和肌肉质量的变化是否与诊断后的体重变化有关。与 CRC 存活相关（目标 4）。这项研究使用一种新颖、最先进的工具来收集比标准身高和体重测量更准确的身体成分测量值，并且可以为能量平衡和身体成分在癌症生存中的作用提供重要的见解。这项研究将能够识别肌肉萎缩高风险的 CRC 患者，并可能提高我们对为什么 BMI 与 CRC 发病相关但与 CRC 结果无关的理解。使用 CT 扫描来评估脂肪/肌肉质量可以在临床或流行病学环境中轻松完成，为 BMI 添加重要的生理测量，以帮助确定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，从而有可能提高生存率。因此，这项研究的结果可能会导致临床实践的改变。此外，关于脂肪/肌肉作用的见解结直肠癌预后中的质量可能为未来研究能量平衡在癌症生存中的作用提供新途径