High Visceral Fat in Female Breast Cancer Patients Correlates with the Risk of Progression after Adjuvant Chemotherapy

Abstract

Rationale

Clinical and epidemiological evidence indicate that obesity is associated with the risk and progression of breast cancer. Body mass index (BMI) as a measure of adiposity does not precisely describe individual body composition and adipose tissue distribution. We aimed to investigate the association between body composition and the efficiency of adjuvant chemotherapy as well as post-treatment progress among female breast cancer patients.

Methods

Participants included 199 females with stage I-III breast cancer. Body composition, including body fat mass, visceral fat level, and skeletal muscle mass, was assessed based on the bioelectrical impedance analysis (BIA). The Kaplan-Meier survival curves, log-rank test, and Cox proportional-hazards model were used to estimate the effects of body composition as prognostic factors on survival.

Results

Postmenopausal women had a higher proportion of visceral fat compared to premenopausal women (64% vs. 33.87%, P < 0.001). Compared with those with normal visceral fat level, patients with high visceral fat level were older (P < 0.001), had higher body fat mass (p < 0.001), skeletal muscle mass (P = 0.013), minerals (P = 0.011), protein (P = 0.036), triglycerides (P = 0.038), cholesterol (P = 0.022), and low-density lipoprotein cholesterol (LDL-C) (P = 0.015). A more prolonged disease-free survival (DFS) was noted in patients with a normal visceral fat level as compared to patients with a high visceral fat level (hazard ratio [HR] 1.9, 95% CI 1-3.5; adjusted HR 1.77, 95% CI 0.932-3.36).

Conclusions

A high visceral fat level in female patients with breast cancer is associated with a shorter DFS after adjuvant chemotherapy. Body composition alongside BIA provides a quick and noninvasive approach to identify breast cancer patients with a higher risk of cancer progression.

Author Contributions

Cui JW designed the research; Data acquisition was performed by Wang WJ and Gao YY; Wang WJ performed the data analyses; Cui JW and Wang WJ drafted the manuscript; Cui JW, Wang WJ, and Gao YY revised and edited the paper; All authors approved the final version.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Data Availability Statements

The data used to support the findings of this study are available from the corresponding author upon request.

Additional information

Funding

Research on Chronic Noncommunicable Diseases Prevention and Control of the National Ministry of Science and Technology (2016YFC1303804); Jilin Province Finance Department (2018SCZWSZX-010); Jilin Provincial Science and Technology Department (20180101009JC and 20190303146SF).