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The ESPEN and EASO Criteria for Sarcopenic Obesity in Early Breast Cancer: Association With Physical Function,
Priscila de Ataídes Ferreira1, Thaís Muniz Montalvão Sousa1, Natália Leite Colombelli2
1Department of Nutrition, University of Brasília, Brasília, Brazil.
Background:
Sarcopenic obesity (SO)-excess adiposity with low muscle strength and mass-is a concern in oncology as it may exacerbate functional decline and cancer-related fatigue (CRF). The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recently proposed diagnostic criteria for SO, but these remain untested in breast cancer (BC). We examined associations between SO, CRF, quality of life (QoL), and physical function in women with early BC.
Methods:
Sixty-six patients (48.0 ± 9.9 years; stages I-III) underwent assessments of body mass index (BMI) and composition (DXA), waist circumference (WC), and handgrip strength. Physical function was evaluated using the timed up-and-go (TUG) and the 6-m walk test (6-MWT), while QoL and CRF were assessed using the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC QLQ-C30) and the Cancer Fatigue Scale (B-CFS). The ESPEN-EASO consensus was applied to classify participants as Eutrophic (normal BMI and WC), Obesity (high BMI and/or WC with preserved muscle strength and mass), or SO (high BMI and/or WC with reduced muscle strength and mass).
Results:
Global health/QoL (p = 0.03) was lower in SO (61.6 ± 7.2) and Obesity (60.4 ± 3.7) than Eutrophic (81.1 ± 6.9). Physical functioning scale/QoL was lower in Obesity (84.6 ± 2.2) than Eutrophic (97.0 ± 4.1). Mean physical and overall fatigue in both Obesity (5.3 ± 5.5 and 19.6 ± 9.9) and SO (5.0 ± 4.1 and 18.8 ± 8.6) were not statistically different from Eutrophic (2.0 ± 2.9 and 14.3 ± 7.8). TUG was worse in SO (7.5 ± 0.2 s) than both Eutrophic (6.6 ± 0.2 s) and Obesity (6.8 ± 0.1 s-p < 0.01). Comparisons were adjusted for age, menopausal status, and physical activity. SO-related traits were correlated to physical function and to domains of QoL and CRF.
Conclusions:
Obesity and SO are associated with poorer QoL, while SO is also linked with worse physical function in early BC. Assessing SO traits in clinical settings will improve the management of BC, though confirmation across disease stages is needed.
