Low muscle mass is associated with a higher risk of all-cause and cardiovascular disease-specific mortality in cancer survivors

Objectives: Individuals with prior cancer diagnosis are more likely to have low muscle mass (LMM) than their cancer-free counterparts. Understanding the effects of LMM on the prognosis of cancer survivors can be clini-cally important. The aim of this study was to investigate whether risks for all-cause and cardiovascular dis-ease (CVD)-specific mortality differ by status of LMM in cancer survivors and a matched cohort without cancer history.Methods: We used cohort data from the 1999-2006 and 2011-2014 National Health and Nutrition Examina-tion Survey. Participants included 946 adults surviving for >= 1 since cancer diagnosis and a matched cohort (by age, sex, and race) without cancer history (N =1857). LMM was defined by appendicular lean mass and body height (men <7.26 kg/m2, women <5.45 kg/m2). Death was ascertained via the National Death Index and cause of death was assessed via International Classification of Diseases, Tenth Revision. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratio (aHR) and 95% confidence interval (CI) of LMM.Results: The mean age of cancer survivors and matched cohort was 60.6 y (SD 15) and 60.2 y (SD 14.9), respectively. The median follow-up was 10.5 y for survivors and 10.9 y for matched cohort. Overall, 22.2% of cancer survivors and 19.7% of the matched cohort had LMM, respectively. In all, 321 survivors (33.9%) and 495 participants (26.7%) in the matched cohort died during follow-up. CVD-specific deaths were identified in 58 survivors (6.1%) and 122 participants in the matched cohort (6.6%). The multivariable Cox model sug-gested that LMM was positively associated with all-cause (aHR, 1.73; 95% CI, 1.31-2.29) and CVD-specific (aHR, 2.13; 95% CI, 1.14-4.00) mortality in cancer survivors. The associations between LMM and risk for all -cause (aHR, 1.24; 95% CI, 0.98-1.56) and CVD-specific (aHR, 1.21; 95% CI, 0.75-1.93) mortality were not sta-tistically significant in the matched cohort.Conclusion: Cancer survivors with LMM have an increased risk for all-cause and CVD-specific mortality. This increase appears to be larger than that in counterparts without cancer history.(c) 2022 Elsevier Inc. All rights reserved.