Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Inflammation Research
Published in: Inflammation Research 2/2024

12-12-2023 | Obesity | Original Research Paper

Association of systemic inflammation with the obesity paradox in cancer: results from multi-cohort studies

Authors: Hailun Xie, Lishuang Wei, Heyang Zhang, Guotian Ruan, Xiaoyue Liu, Shiqi Lin, Jinyu Shi, Chenan Liu, Xin Zheng, Yue Chen, Hanping Shi

Published in: Inflammation Research | Issue 2/2024

Login to get access

Abstract

Aims

This study aimed to explore whether the obesity paradox exists in overall and specific cancers and to investigate the role of systemic inflammation in the obesity paradox.

Methods

The Cox proportional hazard model was used to explore the relationship between body mass index (BMI) and all-cause mortality. The mediated effect was used to investigate the proportion of systemic inflammation mediating the relationship between BMI and cancer survival risk.

Results

The survival probability showed a step-like increase with an increase in BMI regardless of pathological stage. Approximately 10.8%–24.0% of the overall association between BMI and all-cause mortality in cancer was mediated by inflammation. In the internal validation, we found evidence of the obesity paradox in all body composition obtained using BIA, with inflammation remaining an important mediating factor. Furthermore, we also validated the existence of the obesity paradox of cancer in NHANES. Systemic inflammation remains an important factor in mediating the association between BMI and prognosis in cancer patients.

Conclusions

The obesity paradox is prevalent in most cancers, except for hepatic biliary cancer and breast cancer. Inflammation may be one of the true features of the obesity paradox in cancer.
Appendix
Available only for authorised users
Literature
1.
Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363:2211–9.CrossRefPubMed
2.
3.
Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88.CrossRefPubMedPubMedCentral
4.
5.
Schlesinger S, Siegert S, Koch M, Walter J, Heits N, Hinz S, et al. Postdiagnosis body mass index and risk of mortality in colorectal cancer survivors: a prospective study and meta-analysis. Cancer Causes Control. 2014;25:1407–18.CrossRefPubMed
6.
Tsang NM, Pai PC, Chuang CC, Chuang WC, Tseng CK, Chang KP, et al. Overweight and obesity predict better overall survival rates in cancer patients with distant metastases. Cancer Med. 2016;5:665–75.CrossRefPubMedPubMedCentral
7.
Petrelli F, Cortellini A, Indini A, Tomasello G, Ghidini M, Nigro O, et al. Association of obesity with survival outcomes in patients with cancer: a systematic review and meta-analysis. JAMA Netw Open. 2021;4: e213520.CrossRefPubMedPubMedCentral
8.
Li Y, Li C, Wu G, Yang W, Wang X, Duan L, et al. The obesity paradox in patients with colorectal cancer: a systematic review and meta-analysis. Nutr Rev. 2022;80:1755–68.CrossRefPubMed
9.
Banack HR, Kaufman JS. The obesity paradox: understanding the effect of obesity on mortality among individuals with cardiovascular disease. Prev Med. 2014;62:96–102.CrossRefPubMed
10.
Doehner W, von Haehling S, Anker SD. Protective overweight in cardiovascular disease: moving from “paradox” to “paradigm.” Eur Heart J. 2015;36:2729–32.CrossRefPubMed
11.
12.
13.
Chan DSM, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol. 2014;25:1901–14.CrossRefPubMedPubMedCentral
14.
Wu S, Liu J, Wang X, Li M, Gan Y, Tang Y. Association of obesity and overweight with overall survival in colorectal cancer patients: a meta-analysis of 29 studies. Cancer Causes Control. 2014;25:1489–502.CrossRefPubMed
15.
Protani MM, Nagle CM, Webb PM. Obesity and ovarian cancer survival: a systematic review and meta-analysis. Cancer Prev Res (Phila). 2012;5:901–10.CrossRefPubMed
16.
Banack H, Stokes A. The ‘obesity paradox’may not be a paradox at all. Int J Obes. 2017;41:1162–3.CrossRef
17.
Gonzalez MC, Pastore CA, Orlandi SP, Heymsfield SB. Obesity paradox in cancer: new insights provided by body composition. Am J Clin Nutr. 2014;99:999–1005.CrossRefPubMed
18.
Sanchez A, Furberg H. Obesity paradox in patients with non-small cell lung cancer treated with immunotherapy. JAMA Oncol. 2020;6:940–1.CrossRefPubMed
19.
Ujvari B, Jacqueline C, Misse D, Amar V, Fitzpatrick JC, Jennings G, et al. Obesity paradox in cancer: is bigger really better? Evol Appl. 2019;12:1092–5.CrossRefPubMedPubMedCentral
20.
Laird BJ, Fallon M, Hjermstad MJ, Tuck S, Kaasa S, Klepstad P, et al. Quality of life in patients with advanced cancer: differential association with performance status and systemic inflammatory response. J Clin Oncol. 2016;34:2769–75.CrossRefPubMedPubMedCentral
21.
Abbass T, Dolan RD, Laird BJ, McMillan DC. The relationship between imaging-based body composition analysis and the systemic inflammatory response in patients with cancer: a systematic review. Cancers (Basel). 2019;11:1304.CrossRefPubMedPubMedCentral
22.
Xie H, Ruan G, Ge Y, Zhang Q, Zhang H, Lin S, et al. Inflammatory burden as a prognostic biomarker for cancer. Clin Nutr. 2022;41:1236–43.CrossRefPubMed
23.
Li X, Hu C, Zhang Q, Wang K, Li W, Xu H, et al. Cancer cachexia statistics in China. Precis Nutr***//////. 2022;1:10.
24.
Lv Y, Mao C, Gao X, Ji JS, Kraus VB, Yin Z, et al. The obesity paradox is mostly driven by decreased noncardiovascular disease mortality in the oldest old in China: a 20-year prospective cohort study. Nat Aging. 2022;2:389–96.CrossRefPubMed
25.
Evans DC, Corkins MR, Malone A, Miller S, Mogensen KM, Guenter P, et al. The use of visceral proteins as nutrition markers: an ASPEN position paper. Nutr Clin Pract. 2021;36:22–8.CrossRefPubMed
26.
Li S, Wang Z, Huang J, Fan J, Du H, Liu L, et al. Systematic review of prognostic roles of body mass index for patients undergoing lung cancer surgery: does the “obesity paradox” really exist? Eur J Cardiothorac Surg. 2017;51:817–28.PubMed
27.
Aune D, Sen A, Prasad M, Norat T, Janszky I, Tonstad S, et al. BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 37.4 million deaths among 30.3 million participants. BMJ. 2016;353:2156.CrossRef
28.
29.
Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K. Body fatness and cancer-viewpoint of the IARC working group. N Engl J Med. 2016;375:794–8.CrossRefPubMedPubMedCentral
30.
Marengo A, Rosso C, Bugianesi E. Liver cancer: connections with obesity, fatty liver, and cirrhosis. Annu Rev Med. 2016;67:103–17.CrossRefPubMed
31.
Sohn W, Lee HW, Lee S, Lim JH, Lee MW, Park CH, et al. Obesity and the risk of primary liver cancer: a systematic review and meta-analysis. Clin Mol Hepatol. 2021;27:157–74.CrossRefPubMed
32.
Wang Z, Kim SY, Tu W, Kim J, Xu A, Yang YM, et al. Extracellular vesicles in fatty liver promote a metastatic tumor microenvironment. Cell Metab. 2023;35:1209-1226.e13.CrossRefPubMed
Metadata
Title
Association of systemic inflammation with the obesity paradox in cancer: results from multi-cohort studies
Authors
Hailun Xie
Lishuang Wei
Heyang Zhang
Guotian Ruan
Xiaoyue Liu
Shiqi Lin
Jinyu Shi
Chenan Liu
Xin Zheng
Yue Chen
Hanping Shi
Publication date
12-12-2023
Publisher
Springer International Publishing
Published in
Inflammation Research / Issue 2/2024
Print ISSN: 1023-3830
Electronic ISSN: 1420-908X
DOI
https://doi.org/10.1007/s00011-023-01832-x

Other articles of this Issue 2/2024

Inflammation Research 2/2024 Go to the issue

Review

The NLRP3 inflammasome: a vital player in inflammation and mediating the anti-inflammatory effect of CBD

Original Research Paper

Global evolving patterns and cross-country inequalities of inflammatory bowel disease burden from 1990 to 2019: a worldwide report

Original Research Paper

Prospective study of an adalimumab combined with partial enteral nutrition in the induction period of Crohn’s disease

Original Research Paper

Identification and validation of the association of Janus kinase 2 mutations with the response to immune checkpoint inhibitor therapy

Original Research Paper

Granulocyte macrophage colony stimulating factor exerts dominant effects over macrophage colony stimulating factor during macrophage differentiation in vitro to induce an inflammatory phenotype

Original Research Paper

Sphingosine 1-phosphate (S1P) receptor modulators as an induction and maintenance therapy for ulcerative colitis: a systematic review and meta-analysis of randomized controlled trials
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits