ASPO Abstracts
METABOLIC HEALTH PHENOTYPE AND RISK OF CANCER IN THE UTAH OBESITY COHORT STUDY
Category: Early Detection & Risk Prediction
Conference Year: 2021
Abstract Body:
Purpose: Body mass index (BMI) may misclassify obesity-related cancer risk since metabolic dysfunction can
exist at any BMI. Whether weight loss improves metabolic health may also be heterogeneous. We measured the
association of metabolic dysfunction, independent of obesity, and metabolic response to surgical weight loss, with
risk of cancer. Methods: In the Utah Obesity Study, a large prospective cohort of gastric bypass (N= 418) and non-
surgical patients with severe obesity (N=737), clinicodemographics and metabolic health parameters were
measured at baseline, 2-years (post-weight loss in the surgery group), 6 and 12-years. We classified participants
into metabolic health phenotype (metabolic syndrome (MetS) ( >=3 Adult Treatment Panel III criteria) per obesity
class (obese I/II (BMI >=30 & <40 kg/m2), III/IV (BMI >= 40 & <50 kg/m2), or V+ (BMI >= 50 kg/m2)), and
measured changes in metabolic syndrome criteria from baseline to 2-years on a continuous scale in the bariatric
surgery group (>=10% improvement, yes/no). We determined their associations with cancer incidence using
logistic regression, adjusting for age, sex, % weight change from baseline, and study group. Results: Participants
were predominantly female, white, middle-aged (45+/-9 years), and morbidly obese (BMI 45.9+/-5 kg/m2; % fat
52+/-3%). All groups with MetS had elevated risk of cancer compared with normal/overweight individuals without
MetS. Although results were non-statistically significant, within obesity classes, those with MetS versus without
MetS had higher cancer risk (e.g., obese I/II without MetS OR=1.15 (0.24, 5.5); obese I/II with MetS 1.61 (0.24,
10). Those who did not improve MetS criteria after surgical weight loss by >=10% had higher risk of cancer
compared with those who did see improvements (OR=1.28, 95% CI 0.18, 5.85 at 6-years; OR=1.59, 95% CI 0.21,
8.27 at 12-years). Wide confidence intervals suggest follow-up in a larger cohort. Conclusions: Metabolic
dysfunction, independent of obesity, and metabolic non-response to surgical weight loss were not associated with
cancer risk. A follow-up study in a larger cohort is ongoing.
Keywords: Metabolic phenotypes, weight-loss non- responders, cancer