Abstract
Direct effects of cancer cells and various cancer treatments can cause bone loss in cancer survivors. The aim of this study was to assess the risk of bone loss in Korean cancer survivors, and the relationship between body composition and bone mineral density (BMD). We hypothesized that cancer survivors would have lower BMD than healthy people, and increased muscle mass has a protective effect on BMD. We measured BMD and body composition in 259 cancer survivors (99 men and 160 women). Subjects were selected from the Korean National Health and Nutrition Survey conducted from 2008 to 2011. Body composition and BMD were measured by dual-energy X-ray absorptiometry. We examined the linear trend of lumbar BMD according to tertiles of lean mass (LM) and fat mass (FM) by linear regression, adjusting for age, alcohol consumption, smoking, exercise, 25-hydroxyvitamin D, height, protein intake, and menopausal status. Cancer survivors under 50 years of age had lower lumbar BMD compared with healthy controls (0.93 ± 0.04 g/cm2 vs. 1.02 ± 0.01 g/cm2, p = 0.032 in males; 0.95 ± 0.02 g/cm2 vs. 0.98 ± 0.01 g/cm2, p = 0.015 in females). Lumbar BMD significantly increased from the lowest to highest tertiles of LM in male (p for trend < 0.001) and marginally significantly increased in female survivors (p for trend = 0.060). In this study of Korean cancer survivors, young survivors were at higher risk of having low lumbar BMD. Higher LM had beneficial effects on BMD in cancer survivors. To prevent osteoporosis and fractures, efforts to increase lean body mass, including bone, are needed for young cancer survivors.
Highlights
Direct effects of cancer cells and various cancer treatments can cause bone loss in cancer survivors
Prevalence of current smoking and heavy alcohol consumption were higher in healthy controls than in cancer survivors, while there were no significant differences in physical inactivity between the two groups
The linear correlation between fat mass (FM) and bone mineral density (BMD) was significant in male cancer survivors (p for trend = 0.019) and healthy women (p for trend < 0.001) after adjustment (Table 4). This nationwide Korean study confirms that Korean cancer survivors aged less than 50 years had lower BMD in the lumbar spine compared with healthy controls
Summary
Direct effects of cancer cells and various cancer treatments can cause bone loss in cancer survivors. The aim of this study was to assess the risk of bone loss in Korean cancer survivors, and the relationship between body composition and bone mineral density (BMD). Few studies have examined the relationship between body composition and bone density in cancer survivors, compared with the healthy population, considering age-related changes in lean mass (LM) and FM. Our aim was to assess the increased risk of bone loss in Korean cancer survivors compared with the healthy general population, and to evaluate the relationship between body composition and bone mineral density (BMD) in cancer survivors. We investigated the complex association between body composition and BMD in both male and female cancer survivors compared with age- and sex-matched healthy www.nature.com/scientificreports individuals who had never been diagnosed with any cancer because age and sex are major risk factors associated with bone loss
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