Abstract：
OBJECTIVE: To examine the relationship between the age-adjusted Charlson comorbidity index (A-CCI) with body composition and overall survival in patients newly diagnosed with colorectal cancer (CRC).
METHODS: In this cohort study, patients (≥ 18 years old) with CRC were followed for 36 months. Computed tomography images of the third lumbar were analyzed to determine body composition, including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Phenotypes based on comorbidity burden assessed by A-CCI and body composition parameters were established.
RESULTS: A total of 436 participants were included, 50% male, with a mean age of 61 ± 13.2 years. Approximately half of the patients (50.4%) had no comorbidity, and the A-CCI median score was 4 (interquartile range: 3-6). A higher A-CCI score was a risk factor for 36-month mortality (HR = 3.59, 95% CI = 2.17-5.95). Low SMA and low SMD were associated with a higher A-CCI. All abnormal phenotypes (high A-CCI and low SMA; high A-CCI and low SMD; high A-CCI and high VAT) were independently associated with higher 36-month mortality hazard (adjusted HR 5.12, 95% CI 2.73-9.57; adjusted HR 4.58, 95% CI 2.37-8.85; and adjusted HR 2.36, 95% CI 1.07-5.22, respectively).
CONCLUSIONS: The coexistence of comorbidity burden and abnormal body composition phenotypes, such as alterations in muscle or fat compartments, may pose an additional risk of mortality in patients newly diagnosed with CRC. Early assessment and management of these phenotypes could be crucial in optimizing outcomes in such patients.
METHODS: In this cohort study, patients (≥ 18 years old) with CRC were followed for 36 months. Computed tomography images of the third lumbar were analyzed to determine body composition, including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Phenotypes based on comorbidity burden assessed by A-CCI and body composition parameters were established.
RESULTS: A total of 436 participants were included, 50% male, with a mean age of 61 ± 13.2 years. Approximately half of the patients (50.4%) had no comorbidity, and the A-CCI median score was 4 (interquartile range: 3-6). A higher A-CCI score was a risk factor for 36-month mortality (HR = 3.59, 95% CI = 2.17-5.95). Low SMA and low SMD were associated with a higher A-CCI. All abnormal phenotypes (high A-CCI and low SMA; high A-CCI and low SMD; high A-CCI and high VAT) were independently associated with higher 36-month mortality hazard (adjusted HR 5.12, 95% CI 2.73-9.57; adjusted HR 4.58, 95% CI 2.37-8.85; and adjusted HR 2.36, 95% CI 1.07-5.22, respectively).
CONCLUSIONS: The coexistence of comorbidity burden and abnormal body composition phenotypes, such as alterations in muscle or fat compartments, may pose an additional risk of mortality in patients newly diagnosed with CRC. Early assessment and management of these phenotypes could be crucial in optimizing outcomes in such patients.
摘要：
目的：探讨初诊结直肠癌（CRC）患者年龄校正后的Charlson合并症指数（A-CCI）与身体成分和总生存期之间的关系。
方法：在这项队列研究中，CRC患者(≥18岁)随访36个月.分析第三腰椎的计算机断层扫描图像以确定身体成分，包括骨骼肌面积（SMA），骨骼肌指数（SMI），骨骼肌放射密度（SMD），内脏脂肪组织（VAT），和皮下脂肪组织（SAT）。建立了基于通过A-CCI评估的合并症负担和身体组成参数的表型。
结果：共纳入436名参与者，50%男性,平均年龄为61±13.2岁。大约一半的患者（50.4%）没有合并症，A-CCI中位评分为4分(四分位距:3-6分)。较高的A-CCI评分是36个月死亡率的危险因素（HR=3.59，95％CI=2.17-5.95）。低SMA和低SMD与较高的A-CCI相关。所有异常表型（高A-CCI和低SMA；高A-CCI和低SMD；高A-CCI和高VAT）与较高的36个月死亡率风险独立相关（调整后的HR5.12，95％CI2.73-9.57；调整后的HR4.58，95％CI2.37-8.85；和调整后的HR2.36，95％CI1.07-5.22）。
结论：共病负担和异常身体成分表型并存，如肌肉或脂肪区的改变，在新诊断的CRC患者中可能带来额外的死亡风险.这些表型的早期评估和管理对于优化此类患者的预后至关重要。
方法：在这项队列研究中，CRC患者(≥18岁)随访36个月.分析第三腰椎的计算机断层扫描图像以确定身体成分，包括骨骼肌面积（SMA），骨骼肌指数（SMI），骨骼肌放射密度（SMD），内脏脂肪组织（VAT），和皮下脂肪组织（SAT）。建立了基于通过A-CCI评估的合并症负担和身体组成参数的表型。
结果：共纳入436名参与者，50%男性,平均年龄为61±13.2岁。大约一半的患者（50.4%）没有合并症，A-CCI中位评分为4分(四分位距:3-6分)。较高的A-CCI评分是36个月死亡率的危险因素（HR=3.59，95％CI=2.17-5.95）。低SMA和低SMD与较高的A-CCI相关。所有异常表型（高A-CCI和低SMA；高A-CCI和低SMD；高A-CCI和高VAT）与较高的36个月死亡率风险独立相关（调整后的HR5.12，95％CI2.73-9.57；调整后的HR4.58，95％CI2.37-8.85；和调整后的HR2.36，95％CI1.07-5.22）。
结论：共病负担和异常身体成分表型并存，如肌肉或脂肪区的改变，在新诊断的CRC患者中可能带来额外的死亡风险.这些表型的早期评估和管理对于优化此类患者的预后至关重要。
