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. 2017 Mar 17;26(7):1745–1759. doi: 10.1007/s11136-017-1539-z

Table 3.

Mean differences in long-term health-related quality of life outcome scores in colorectal cancer survivors according to tertiles of area of visceral and intermuscular adipose tissue, mean muscle attenuation, and skeletal muscle index (SMI) at colorectal cancer diagnosis

Global quality of life Physical functioning Role functioning Social functioning Disability Fatigue Distress
MD 95% CI MD 95% CI MD 95% CI MD 95% CI MD 95% CI MD 95% CI MD 95% CI
Visceral adipose tissue (cm2, n = 98)a
 T1 Ref Ref Ref Ref Ref Ref Ref
 T2 −7.6 −15.7, 0.6 −4.4 −14.8, 6.0 −2.0 −15.2, 11.2 −2.9 −11.3, 5.5 5.0 −3.0, 13.1 8.0 −5.8, 21.9 1.3 −1.8, 4.5
 T3 −5.0 −15.3, 5.3 −4.2 −17.4, 9.0 1.3 −15.5, 18.1 −4.8 −15.5, 5.9 1.7 −8.5, 11.9 11.8 −5.8, 29.4 2.9 −1.1, 6.9
 P trend 0.33 0.52 0.88 0.37 0.73 0.18 0.16
 Per SD increase −1.2 −5.7, 3.3 2.6 −3.1, 8.2 4.0 −3.2, 11.2 0.8 −3.9, 5.4 −0.3 −4.8, 4.1 0.5 −7.2, 8.2 0.9 −0.8, 2.7
 Visceral obesityb 2.3 −5.4, 10.1 4.0 −5.7, 13.7 8.6 −3.6, 20.8 −0.9 −8.8, 6.9 −2.3 −9.9, 5.2 0.7 −12.4, 13.7 −0.4 −3.4, 2.6
Intermuscular adipose tissue (cm2, n = 96)a
 T1 Ref Ref Ref Ref Ref Ref Ref
 T2 −2.3 −10.0, 5.4 −3.5 −13.2, 6.3 −4.9 −17.1, 7.3 2.0 −5.9, 9.9 5.2 −2.3, 12.7 0.6 −12.4, 13.7 0.8 −2.1, 3.8
 T3 −2.6 −11.5, 6.3 −2.0 −13.2, 9.2 −2.8 −16.9, 11.3 3.3 −5.8, 12.4 3.3 −5.4, 12.0 −1.2 −16.5, 14.1 1.9 −1.5, 5.3
 P trend 0.54 0.69 0.66 0.46 0.40 0.89 0.27
 Per SD increase −0.9 −5.0, 3.1 −1.1 −6.2, 4.0 −1.3 −7.8, 5.1 2.1 −2.1, 6.2 0.1 −3.9, 4.2 0.1 −6.8, 7.1 1.1 −0.5, 2.6
Muscle attenuation (HU, n = 96)a
 T1 Ref Ref Ref Ref Ref Ref Ref
 T2 0.5 −8.1, 9.2 −4.3 −15.1, 6.6 −1.6 −15.4, 12.1 −0.6 −9.4, 8.2 0.4 −8.4, 9.2 3.7 −11.0, 18.3 −0.9 −4.3, 2.5
 T3 −2.4 −11.6, 6.7 1.2 −10.3, 12.7 −2.9 −17.5, 11.6 −4.4 −13.7, 5.0 −1.6 −10.7, 7.6 2.7 −13.1, 18.5 −2.3 −5.9, 1.2
 P trend 0.57 0.76 0.69 0.33 0.71 0.76 0.18
 Per SD increase 0.0 −3.9, 3.9 0.9 −4.0, 5.9 −1.1 −7.4, 5.1 −2.5 −6.5, 1.4 −0.8 −4.7, 3.0 −0.6 −7.6, 6.4 −1.1 −2.6, 0.4
SMI (cm2/m2, n = 96)a
 T1 Ref Ref Ref Ref Ref Ref Ref
 T2 0.6 −7.2, 8.5 3.5 −6.5, 13.4 6.1 −6.4, 18.7 −2.0 −10.1, 6.1 −3.2 −11.1, 4.6 2.2 −11.3, 15.7 −0.3 −3.3, 2.8
 T3 3.7 −5.3, 12.7 4.8 −6.6, 16.1 4.9 −9.4, 19.2 1.2 −8.1, 10.4 −5.9 −15.0, 3.1 −3.5 −18.7, 11.7 −0.4 −3.9, 3.1
 P trend 0.42 0.40 0.48 0.82 0.19 0.65 0.82
 Per SD increase 3.0 −1.5, 7.6 2.8 −2.9, 8.6 3.6 −3.7, 10.8 0.1 −4.6, 4.8 −4.6 −9.1, 0.0 −4.4 −12.1, 3.4 −0.7 −2.4, 1.1
 Sarcopeniac −3.3 −10.4, 3.8 −1.6 −10.4, 7.2 −1.1 −12.0, 9.7 2.3 −4.3, 8.8 2.3 −4.8, 9.4 −1.6 −13.4, 10.2 2.1 −0.6, 4.8

P values in italic indicate a significant level of P < 0.05

CI confidence interval, HU Hounsfield units, MD mean difference, Ref reference category, SD standard deviation

Adjusted for: gender, age at diagnosis (years), body mass index at health-related quality of life assessment (kg/m2), number of comorbidities (0/1/2+), cancer stage (I/II/III), and chemotherapy treatment (yes/no)

Scales are 0–100 (global quality of life, physical, role and social functioning, and disability), 20–140 (fatigue), and 0–21 (distress), with higher scores indicating higher global quality of life, physical, role and social functioning, disability, fatigue, and distress. A total of 3 participants had missing data for disability, 2 for fatigue, and 1 for distress. Predefined minimal important differences for these subscales are global quality of life, 10; physical functioning, 14; role functioning, 19; social functioning, 11; disability, 7.7; fatigue 13.3; and distress, 3.1

All associations of the body composition variables with the HRQoL outcomes that were tested within multivariable linear regression models and are shown in this table were not statistically significant (all P values ≥0.05)

aWith gender-specific tertiles for visceral adipose tissue (men: T1, ≤100.3; T2, 102.7–196.5; T3, ≥199.2; women: T1, ≤58.7; T2, 59.2–131.0; T3, ≥139.1 cm2), intermuscular adipose tissue (men: T1, ≤8.3; T2, 8.8–14.2; T3, ≥14.3; women: T1, ≤9.6; T2, 9.7–17.8; T3, ≥17.9 cm2), and SMI (men: T1, ≤48.6; T2, 48.8–53.8; T3, ≥54.0; women: T1, ≤38.7; T2, 38.7–43.9; T3, ≥44.3 cm2/m2), and overall tertiles for muscle attenuation (T1, ≤33.6; T2, 33.6–41.6; T3, ≥42.0 Hounsfield units)

bDichotomized based on published cutoff for visceral adipose tissue area [46]

cDichotomized based on published cutoff for skeletal muscle index [31]; data missing for 9 participants due to missing data on body mass index at colorectal cancer diagnosis