AUTHOR=Xue Hongmei , Du Hongzhen , Xie Ying , Zhai Yijing , Song Shiming , Luo Bin , Qiu Hong , Wang Kunhua , Cui Jiuwei , Song Chunhua , Xu Hongxia , Li Wei , Shi Hanping , Li Zengning , The Investigation on Nutrition Status and Its Clinical Outcome of Common Cancers (INSCOC) Group , Guo Zengqing , Fu Zhenming , Wang Chang , Weng Min , Cao Jingjing , Zhou Fuxiang , Lin Yuan , Li Suyi , Ba Yi , Yuan Kaitao , Liu Ming , Hu Wen , Zhou Lan , Ma Hu , Yao Qinghua , Cong Minghua , Li Tao , Chen Zihua , Chen Gongyan , Zhao Qingchuan , Feng Changyan , He Ying , Wu Jing , Yang Jiajun , Song Xinxia , Yu Yaying , Ma Wenjun , Luo Suxia , Zheng Jin , Chen Junqiang , Luo Qi , Wang Wei , Qiao Qiuge , Shi Yongmei , Qi Yumei , Feng Yongdong , Jiang Haiping , Guan Wenxian , Chen Jiaxin , Huang He , Yu Zheng , Fang Yu TITLE=Association Between Fat Mass to Lean Body Mass Ratio and All-Cause Mortality Among Middle-Aged and Elderly Cancer Patients Without Obesity: A Multi-Center Observational Study in China JOURNAL=Frontiers in Nutrition VOLUME=Volume 9 - 2022 YEAR=2022 URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.914020 DOI=10.3389/fnut.2022.914020 ISSN=2296-861X ABSTRACT=Objective

We aimed to investigate the association between fat mass to lean body mass ratio (RFL), percentage of body fat (PBF), and fat mass (FM) with mortality among middle-aged and elderly cancer patients without obesity.

Methods

This prospective hospital-based cohort study comprised 3,201 patients with stage I to IV cancer aged 40 years or above (mean age: 58 years for female patients and 61 years for male patients; mean length of follow-up was 1.67 years; the maximal follow-up length was 6.42 years). FM and PBF were measured by bioelectrical impedance analysis (BIA). Cox proportional hazard models were used, and adjusted hazard ratios (HRs) were estimated.

Results

We revealed a significant association between RFL and all-cause mortality among men aged ≥60 years after adjusting for confounders. Compared with those in the lowest tertile of RFL, elderly men in the medium and highest tertile had a 35 and 34% lower hazard of death from any cause, respectively. After additionally adjusted for C-reaction protein (CRP), HRs of medium and high tertile of RFL became short of statistical significance [medium tertile: adjusted HRs (95% CI) = 0.74 (0.46, 1.20); highest tertile: adjusted HRs (95% CI) = 0.84 (0.53, 1.33)]. Among elderly women, RFL was significantly related to all-cause mortality only when the additional adjustment for CRP [medium tertile: adjusted HRs (95% CI) = 2.08 (1.08, 4.01); highest tertile: adjusted HRs (95% CI) = 0.90 (0.45, 1.81)]. No significant association between RFL and all-cause mortality was observed among female participants or male participants aged less than 60 years.

Conclusion

Our findings showed a significant non-linear association between RFL and all-cause mortality, which was observed only in elderly men, and might be attenuated by their inflammation state.