A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and Renal Cell Carcinoma progression
Abstract Increasing evidence supports a role for local fat depots in cancer outcomes. Despite the robust positive association of obesity with renal cell carcinoma (RCCa) diagnosis, increased adiposity is inversely related to RCCa oncological outcomes. Here, we sought to ascertain whether imagiologic...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-24418-9 |
| _version_ | 1811318099801014272 |
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| author | José Preza-Fernandes Pedro Passos Miguel Mendes-Ferreira Adriana R. Rodrigues Alexandra Gouveia Avelino Fraga Rui Medeiros Ricardo Ribeiro |
| author_facet | José Preza-Fernandes Pedro Passos Miguel Mendes-Ferreira Adriana R. Rodrigues Alexandra Gouveia Avelino Fraga Rui Medeiros Ricardo Ribeiro |
| author_sort | José Preza-Fernandes |
| collection | DOAJ |
| description | Abstract Increasing evidence supports a role for local fat depots in cancer outcomes. Despite the robust positive association of obesity with renal cell carcinoma (RCCa) diagnosis, increased adiposity is inversely related to RCCa oncological outcomes. Here, we sought to ascertain whether imagiologically assessed local fat depots associate with RCCa progression and survival and account for this apparent paradox. A retrospective cohort of renal carcinoma patients elective for nephrectomy (n = 137) were included. Beyond baseline clinicopathological characteristics, computed tomography (CT)-scans at the level of renal hilum evaluated areas and densities of different adipose tissue depots (perirenal, subcutaneous, visceral) and skeletal muscle (erector spinae, psoas and quadratus lumborum muscles) were analyzed. Univariate and multivariable Cox proportional hazards models were estimated following empirical analysis using stepwise Cox regression. Age, visceral adipose tissue (VAT) area and body mass index (BMI) predicted tumour-sided perirenal fat area (R 2 = 0.584), which presented upregulated UCP1 expression by 27-fold (P = 0.026) and smaller adipocyte areas, compared with subcutaneous depot. Multivariate analyses revealed that increased area of perirenal adipose tissue (PRAT) on the contralateral and tumour side associate with improved progression-free survival (HR = 0.3, 95CI = 0.1–0.8, P = 0.019) and overall survival (HR = 0.3, 95CI = 0.1–0.7, P = 0.009). PRAT measurements using CT, might become a possible tool, well correlated with other measures of obesity such as VAT and BMI, that will improve determination of obesity and contribute to assess the risk for disease progression and mortality in renal cancer patients. Present data supports the obesity paradox in RCCa, assumed that larger PRAT areas seem to protect from disease progression and death. |
| first_indexed | 2024-04-13T12:20:00Z |
| format | Article |
| id | doaj.art-f683a94b9f4d408fa9b37b8a74472ee3 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-13T12:20:00Z |
| publishDate | 2022-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-f683a94b9f4d408fa9b37b8a74472ee32022-12-22T02:47:15ZengNature PortfolioScientific Reports2045-23222022-11-0112111110.1038/s41598-022-24418-9A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and Renal Cell Carcinoma progressionJosé Preza-Fernandes0Pedro Passos1Miguel Mendes-Ferreira2Adriana R. Rodrigues3Alexandra Gouveia4Avelino Fraga5Rui Medeiros6Ricardo Ribeiro7Urology Department, Hospital Senhora da OliveiraUrology Department, Hospital Senhora da OliveiraTumour and Microenvironment Interactions Group, i3S, Instituto de Investigação e Inovação Em Saúde da Universidade Do PortoAgeing & Stress Group, i3S - Instituto de Investigação e Inovação Em Saúde, University of PortoAgeing & Stress Group, i3S - Instituto de Investigação e Inovação Em Saúde, University of PortoTumour and Microenvironment Interactions Group, i3S, Instituto de Investigação e Inovação Em Saúde da Universidade Do PortoMolecular Oncology Group, Portuguese Institute of OncologyTumour and Microenvironment Interactions Group, i3S, Instituto de Investigação e Inovação Em Saúde da Universidade Do PortoAbstract Increasing evidence supports a role for local fat depots in cancer outcomes. Despite the robust positive association of obesity with renal cell carcinoma (RCCa) diagnosis, increased adiposity is inversely related to RCCa oncological outcomes. Here, we sought to ascertain whether imagiologically assessed local fat depots associate with RCCa progression and survival and account for this apparent paradox. A retrospective cohort of renal carcinoma patients elective for nephrectomy (n = 137) were included. Beyond baseline clinicopathological characteristics, computed tomography (CT)-scans at the level of renal hilum evaluated areas and densities of different adipose tissue depots (perirenal, subcutaneous, visceral) and skeletal muscle (erector spinae, psoas and quadratus lumborum muscles) were analyzed. Univariate and multivariable Cox proportional hazards models were estimated following empirical analysis using stepwise Cox regression. Age, visceral adipose tissue (VAT) area and body mass index (BMI) predicted tumour-sided perirenal fat area (R 2 = 0.584), which presented upregulated UCP1 expression by 27-fold (P = 0.026) and smaller adipocyte areas, compared with subcutaneous depot. Multivariate analyses revealed that increased area of perirenal adipose tissue (PRAT) on the contralateral and tumour side associate with improved progression-free survival (HR = 0.3, 95CI = 0.1–0.8, P = 0.019) and overall survival (HR = 0.3, 95CI = 0.1–0.7, P = 0.009). PRAT measurements using CT, might become a possible tool, well correlated with other measures of obesity such as VAT and BMI, that will improve determination of obesity and contribute to assess the risk for disease progression and mortality in renal cancer patients. Present data supports the obesity paradox in RCCa, assumed that larger PRAT areas seem to protect from disease progression and death.https://doi.org/10.1038/s41598-022-24418-9 |
| spellingShingle | José Preza-Fernandes Pedro Passos Miguel Mendes-Ferreira Adriana R. Rodrigues Alexandra Gouveia Avelino Fraga Rui Medeiros Ricardo Ribeiro A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and Renal Cell Carcinoma progression Scientific Reports |
| title | A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and Renal Cell Carcinoma progression |
| title_full | A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and Renal Cell Carcinoma progression |
| title_fullStr | A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and Renal Cell Carcinoma progression |
| title_full_unstemmed | A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and Renal Cell Carcinoma progression |
| title_short | A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and Renal Cell Carcinoma progression |
| title_sort | hint for the obesity paradox and the link between obesity perirenal adipose tissue and renal cell carcinoma progression |
| url | https://doi.org/10.1038/s41598-022-24418-9 |
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