Body composition and bone mineral density in breast cancer survivors and non-cancer controls: A 12- to 15-month follow-up

Osteosarcopenic adiposity and its relation to cancer and chronic diseases: Implications for research to delineate mechanisms and improve clinical outcomes

This is the third review in our series examining the connection between osteosarcopenic adiposity/obesity (OSA/OSO) syndrome and health impairments. The objective here was to examine whether there is a causal and/or bidirectional relationship between OSA and some chronic diseases. The search (in PubMed, Scopus, and WoS), screened for articles from their inception to the end of February 2024. Of n=859 articles retrieved, eleven met the eligibility criteria (having all three body composition compartments measured-bone, muscle, adipose tissue and being conducted in adult humans with chronic disease). The selected articles included four assessing OSA and cancers, one each assessing OSA and HIV, Cushing's disease (CD), chronic kidney disease (CKD), pulmonary function, and two for alcohol abuse-caused liver disease, as well as one 6-year study showing the progression to OSA over time. There was a positive relationship between OSA and each of the chronic diseases, as well as a possible bidirectional relationship between OSA and cancers. The evidence linking OSA with HIV, CD, CKD, liver disease, and pulmonary function, was insufficient to derive firm conclusions about their causal/bidirectional relations. This review emphasizes the need for a multidisciplinary approach in the management and treatment of chronic diseases where body composition assessment should get full attention. To close the knowledge gap, more studies about the role of OSA in chronic diseases are needed.

Changes in Body Adiposity in Women Undergoing Breast Cancer Treatment: A Scoping Review

Antineoplastic treatments can negatively affect body composition, leading to metabolic derangements and worse clinical outcomes in breast cancer patients. This scoping review assesses body adiposity changes during breast cancer therapy. We included clinical and observational studies, published until the last search date in any language, with women aged >18 years, after breast cancer diagnosis, at any clinical stage and with any history of breast cancer treatment, who had body adiposity quantified by imaging tools at least twice during follow-up. In total, 17 studies were included (n = 1,009 individuals), six of which found a significant increase in body adiposity during treatment, two found a significant decrease, one presented divergent findings according to the imaging method and the analyzed body adiposity depots, and eight studies found no significant change in the outcome. Selective estrogen receptor modulators were associated with increased body adiposity, whereas aromatase inhibitors were associated with its decrease (n = 3). Chemotherapy was associated with increased body adiposity (n = 1), and monoclonal antibody with reduced brown adipose tissue activity (n = 1). Breast cancer treatment may have different effects on body adiposity, according to its mechanisms and protocols. Further studies are necessary to better elucidate this scenario.

The Relationship between Body Composition and Bone Mineral Density of Female Workers in A Unit of Tai’an

Objective. To explore the relationship between body composition and bone mineral density (BMD) of female workers in a university of Tai’an. Methods. This study randomly selected 90 female employees in a university of Tai’an. The body composition was monitored by body composition analyzer (inbody770), and the lumbar bone mineral density was monitored by dual energy X-ray absorptiometry (BMD model). The data were analyzed by SPSS 22.0 statistical software. Results. With the increasing of body mass index (BMI), BMD of female lumbar spines 1-4 (L1-4) increased gradually. Spearman correlation analysis showed that BMI, skeletal muscle mass, upper limb muscle mass, trunk muscle mass, lower limb muscle mass, and whole-body phase angle were positively correlated with L1-4BMD. Age was negatively correlated with L1-4BMD. Linear regression analysis showed that age was a negative factor of L1-4BMD, and skeletal muscle mass was a protective factor of abnormal bone mass, especially lower limb muscle mass. Conclusions. Lower limb muscle mass is a protective factor of female BMD. Strengthening physical exercise to improve lower limb muscle mass is conducive to the prevention of female osteoporosis.

Osteosarcopenic adiposity syndrome update and the role of associated minerals and vitamins

The objectives are to present an updated synopsis on osteosarcopenic adiposity (OSA) syndrome and evaluate the roles of selected micronutrients in its prevention and management. OSA refers to the concurrent deterioration of bone (osteopenia/osteoporosis), muscle (sarcopenia) and adipose tissue expansion. It portrays the most advanced stage in a continuum of body composition disorders. Although OSA has been widely studied involving the populations of different backgrounds, its prevalence is hard to collate because different methodologies and criteria were used for its diagnosis. Another critical health aspect is the presence of low-grade chronic inflammation (LGCI) which contributes to OSA and vice versa. Nutrition is important in the prevention and management of both OSA and LGCI. Although micronutrients act in numerous metabolic and physiological processes, their roles here are presented in relation to OSA (and its components) and LGCI in general and relevant to the COVID-19 pandemic. These include calcium, magnesium, phosphorus, potassium, sodium and vitamins D and K; their interactions, physiological ratios and synergism/antagonism are discussed as well. In conclusion, calcium, magnesium and vitamin D have a profound impact on OSA and its components, and the latter two also on LGCI. Potassium and vitamin K are vital in bone, muscle functioning and possibly adipose tissue modification. Both, but particularly vitamin D, surfaced as important modulators of immune system with application in COVID-19 infections. While both phosphorus and sodium have important roles in bone, muscle and can impact adiposity, due to their abundance in food, their intake should be curbed to prevent possible damaging effects.

Effect of Functional Impact Training on Body Composition, Bone Mineral Density, and Strength in Breast Cancer Survivors

PURPOSE

The purpose of this study was to examine the effects of 24 wk of functional impact training (FIT) that consisted of resistance and high-impact exercises in comparison with yin yoga on body composition, bone mineral density (BMD), blood biomarkers for bone metabolism, and strength in breast cancer survivors (BCS).

METHODS

Forty-four BCS (60.3 ± 8.3 yr) were randomly assigned to the FIT or yin yoga group. Body composition and BMD were measured via dual energy x-ray absorptiometry. Blood biomarkers for bone metabolism were analyzed via enzyme-linked immunosorbent assays. Upper and lower body strength was assessed using a one-repetition maximum chest press and isokinetic knee extension/flexion using the Biodex System 3, respectively. Participants completed 45-min FIT or yin yoga sessions twice weekly for 24 wk. Changes in dependent variables over time were analyzed using repeated-measures ANOVA. Significance was accepted at P ≤ 0.05.

RESULTS

There were no group-time effects for body composition, BMD, or blood biomarkers. Main effects were observed for left femoral neck (0.883 ± 0.138 to 0.870 ± 0.131 g·cm) and left forearm (0.465 ± 0.078 to 0.457 ± 0.069 g·cm) BMD. The FIT group improved upper body strength (73.2 ± 18.1 to 83.2 ± 22.3 kg), whereas the yin yoga group did not (59.8 ± 14.8 to 59.3 ± 15.6 kg). Main time effects were observed for peak isokinetic knee extension and flexion at all speeds with an average improvement of 13.2% and 16.2%, respectively.

CONCLUSION

Both FIT and yin yoga may be beneficial exercise modes for improving lower body strength, although only FIT improved upper body strength. Additional research is needed to examine the effectiveness of FIT programs of longer duration and/or higher intensity on body composition and BMD in BCS.

Visceral Adiposity Index in Breast Cancer Survivors: A Case-Control Study

BACKGROUND

Breast cancer (BC) is the first cause of cancer morbidity and mortality in women. This disease has been linked to obesity; however, it is not clear how fat accumulation affects women who survive breast cancer. Although the visceral adiposity index (VAI) is a marker of cardiometabolic risk and adipose tissue dysfunction, it is not clear how it changes in breast cancer survivors. The aim of this investigation was to compare VAI in women with and without breast cancer.

METHODS

A case-control cross-sectional study was conducted on women who were BC survivors and women without the history of BC (control group). Body composition was assessed using electrical bioimpedance while VAI by means of waist circumference (WC), body mass index (BMI), triacylglycerols (TG), and high-density lipoprotein cholesterol (HDL-C).

RESULTS

49 women in the BC survivor group and 50 in the control group. WC was wider in the survivor group as regards control (93.65 ± 10.48 vs. 88.52 ± 9.61 cm) (p=0.025); at once, TG and VAI were significantly higher for the survivor group (243.55 ± 199.84 vs. 159.84 ± 75.77) (p=0.007) and (11.03 ± 11.15 vs. 6.41 ± 3.66) (p < 0.005), respectively. Body composition parameters were similar in both groups.

CONCLUSIONS

VAI is higher in women who are BC survivors in comparison with controls matched by age and bodyweight.

Young cancer survivors have lower bone mineral density compared with healthy controls: a nationwide population-based study in Korea

Direct effects of cancer cells and various cancer treatments can cause bone loss in cancer survivors. The aim of this study was to assess the risk of bone loss in Korean cancer survivors, and the relationship between body composition and bone mineral density (BMD). We hypothesized that cancer survivors would have lower BMD than healthy people, and increased muscle mass has a protective effect on BMD. We measured BMD and body composition in 259 cancer survivors (99 men and 160 women). Subjects were selected from the Korean National Health and Nutrition Survey conducted from 2008 to 2011. Body composition and BMD were measured by dual-energy X-ray absorptiometry. We examined the linear trend of lumbar BMD according to tertiles of lean mass (LM) and fat mass (FM) by linear regression, adjusting for age, alcohol consumption, smoking, exercise, 25-hydroxyvitamin D, height, protein intake, and menopausal status. Cancer survivors under 50 years of age had lower lumbar BMD compared with healthy controls (0.93 ± 0.04 g/cm² vs. 1.02 ± 0.01 g/cm², p = 0.032 in males; 0.95 ± 0.02 g/cm² vs. 0.98 ± 0.01 g/cm², p = 0.015 in females). Lumbar BMD significantly increased from the lowest to highest tertiles of LM in male (p for trend < 0.001) and marginally significantly increased in female survivors (p for trend = 0.060). In this study of Korean cancer survivors, young survivors were at higher risk of having low lumbar BMD. Higher LM had beneficial effects on BMD in cancer survivors. To prevent osteoporosis and fractures, efforts to increase lean body mass, including bone, are needed for young cancer survivors.