A cross-sectional study from the National Health and Nutrition Examination Survey reveals the Prognosis and predictors of sarcopenic obesity among cancer patients

Abstract

Abstract Objective Sarcopenic obesity (SO) is a combination of depletion of skeletal muscle mass and obesity, with a high prevalence, undetected onset, challenging diagnosis and poor prognosis. However, studies on SO in cancer settings are limited. We aimed to investigate the association of SO with mortality in cancer patients and the potential predictors involved in the development of SO. Methods 1344 cancer patients' data from the National Health and Nutrition Examination Survey (NHANES) from the years 1999 to 2006 and 2011 to 2014 were examined. Univariable and multivariable Cox proportional hazard models were used to examine the associations of SO with overall mortality, adjusting for potential confounders. Predictive factors of SO were measured using multivariable logistic regression models. Multiple imputation analysis was used to cope with the missing DXA data. Results SO was significantly associated with a higher risk of all-cause mortality (adjusted HR 1.20, 95%CI 1.05–1.37) compared with individuals without SO. Insulin resistance (IR) in cancer patients increased the odds of SO by 2.6 times compared to those without IR (adjusted OR = 2.63, p < 0.0001), and those with hypertriglyceridemia (HTG) were 1.4 times more likely to develop SO compared with those without HTG (adjusted OR = 1.40, p < 0.0001). No significant associations between SO and hypercholesterolemia, high LDL, or low HDL levels were found in cancer patients. Conclusions This study is the first to figure out the puzzle of what precise predictors are associated with the occurrence of SO in cancer patients. We discovered that SO in cancer settings is significantly associated with IR and HTG, rather than hypercholesterolemia, LDL, HDL cholesterol or sex hormone which were commonly considered. The presence of SO in cancer patients increases the risk of all-cause mortality. In clinical practice, SO may be a potential and promising target for cancer treatment strategies.