Body mass index, waist-to-hip ratio and late outcomes: a report from the Shanghai Breast Cancer Survival Study

Sci Rep. 2017 Aug 1;7(1):6996. doi: 10.1038/s41598-017-07320-7.

Abstract

Obesity has been well studied in relation to breast cancer survival. However, the associations of post-diagnosis obesity and late outcomes (≥5 years after diagnosis) have been much less studied. A total of 4062 5-year disease-free patients were recruited from the Shanghai Breast Cancer Survival Study, a longitudinal study of patients diagnosed during 2002-2006. Cox proportional hazard model with restricted cubic spline were used to evaluate the potential non-linear associations of post-diagnosis body mass index (BMI) and waist-to-hip ratio (WHR) with late all-cause mortality and late recurrence. While no significant association was observed for post-diagnosis BMI or WHR with late recurrence; a U-shaped association was observed for the two measures with late all-cause death. Women with BMI of 25.0 kg/m2 or WHR of 0.83 were at the lowest risk of late all-cause mortality, whereas those with BMI beyond the range of 22.1-28.7 kg/m2 or WHR beyond the range of 0.81-0.86 had a higher risk. ER, stage or menopausal status did not modify the effect of post-diagnosis BMI or WHR on the outcomes. In conclusion, post-diagnosis BMI and WHR, as indicators of overall and central obesity respectively, were associated with late all-cause mortality in U-shaped pattern among long-term breast cancer survivors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Body Mass Index
  • Breast Neoplasms / complications*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Female
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Obesity / complications*
  • Obesity / mortality
  • Recurrence
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome
  • Waist-Hip Ratio