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Predicted lean body mass, fat mass and risk of lung cancer: prospective US cohort study

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Abstract

An inverse association between body mass index (BMI) and risk of lung cancer has been reported. However, the association of body composition such as fat mass (FM) and lean body mass (LBM) with risk of lung cancer has not been fully investigated. Using two large prospective cohort studies (Nurses’ Health Study, 1986–2014; Health Professionals Follow-up Study, 1987–2012) in the United States, we included 100,985 participants who were followed for occurrence of lung cancer. Predicted FM and LBM derived from validated anthropometric prediction equations were categorized by sex-specific deciles. During an average 22.3-year follow-up, 2615 incident lung cancer cases were identified. BMI showed an inverse association with lung cancer risk. Participants in the 10th decile of predicted FM and LBM had a lower risk of lung cancer compared with those in the 1st decile, but when mutually adjusted for each other, predicted FM was not associated with lung cancer risk (adjusted hazard ratio [aHR] = 0.98, 95% confidence interval [CI] 0.72–1.35; P(trend) = 0.97) whereas predicted LBM had an inverse association (aHR = 0.73, 95% CI 0.53–1.00; P(trend) = 0.03), especially among participants who were current smokers or had smoked in the previous 10 years (aHR = 0.55, 95% CI 0.36–0.84; P(trend) = 0.008). In conclusion, BMI was inversely associated with lung cancer risk. Based on anthropometric prediction equations, low LBM rather than low FM accounted for the inverse association between BMI and lung cancer risk.

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Acknowledgment

We would like to thank the participants and staff of the NHS and HPFS for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. The authors assume full responsibility for analyses and interpretation of these data.

Funding

This work was supported by the National Institutes of Health (UM1 CA167552, R01 HL35464, UM1 CA186107, P01 CA87969, and R03 CA223619).

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Author notes

  1. Su-Min Jeong and Dong Hoon Lee have contributed equally to this work.

Authors and Affiliations

  1. Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA

    Su-Min Jeong, Dong Hoon Lee & Edward L. Giovannucci

  2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA

    Edward L. Giovannucci

  3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 02115, USA

    Edward L. Giovannucci

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  1. Su-Min Jeong
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Contributions

DHL and ELG contributed to the study design and conception. S-MJ, DHL and ELG drafted the manuscript and the tables. DHL and ELG contributed to the data acquisition and analysis. DHL contributed to the statistical analysis. S-MJ, DHL and ELG critically revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Edward L. Giovannucci.

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Jeong, SM., Lee, D.H. & Giovannucci, E.L. Predicted lean body mass, fat mass and risk of lung cancer: prospective US cohort study. Eur J Epidemiol 34, 1151–1160 (2019). https://doi.org/10.1007/s10654-019-00587-2

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