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An Analysis of Individual Body Fat Depots and Risk of Developing Cancer

Insights From the Dallas Heart Study



      To examine the association between specific adipose tissue depots and the risk of incident cancer in the Dallas Heart Study.

      Patients and Methods

      Individuals without prevalent cancer in the Dallas Heart Study underwent quantification of adipose depots: visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue, and liver fat by magnetic resonance imaging, and subcutaneous lower-body fat (LBF) by dual-energy X-ray absorptiometry from January 1, 2000, through December 31, 2002, and were observed for the development of cancer for up to 12 years. Multivariable Cox proportional hazards modeling was performed to examine the association between fat depots and cancer.


      Of 2627 participants (median age, 43 years; 69% nonwhite race), 167 (6.4%) developed cancer. The most common primary sites of cancer were the breast (in women) and the prostate (in men). In multivariable models adjusted for age, sex, race, smoking, alcohol use, family history of malignancy, and body mass index, a 1-SD increase in VAT was not associated with increased risk of cancer (hazard ratio [HR], 0.94; 95% CI, 0.77-1.14). In contrast, each 1-SD increase in LBF was associated with a reduced incidence of cancer (HR, 0.69; 95% CI, 0.52-0.92) in the fully adjusted model.


      In this study, adiposity-associated cancer risk was heterogeneous and varied by fat depot: VAT was not independently associated with incident cancer, and LBF seemed to protect against cancer development. Further studies of the adiposity-cancer relationship, including serial assessments, are needed to better elucidate this relationship.

      Abbreviations and Acronyms:

      BMI (body mass index), DHS (Dallas Heart Study), HC (hip circumference), HR (hazard ratio), IQR (interquartile range), LBF (lower-body fat), LF (liver fat), MET (metabolic equivalent of task), SAT (subcutaneous adipose tissue), TCR (Texas Cancer Registry), VAT (visceral adipose tissue), WC (waist circumference), WHR (waist-hip ratio)
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