Renal cell carcinoma survival and body mass index

a dose-response meta-analysis reveals another potential paradox within a paradox

M Bagheri, J R Speakman, F Shemirani, K Djafarian

Research output: Contribution to journalReview article

14 Citations (Scopus)

Abstract

BACKGROUND: In healthy subjects increasing body mass index (BMI) leads to greater mortality from a range of causes. Following onset of specific diseases, however, the reverse is often found: called the 'obesity paradox'. But we recently observed the phenomenon called the 'paradox within the paradox' for stroke patients.

OBJECTIVE: The objective of our study was to examine the effect of each unit increase in BMI on renal cancer-specific survival (CSS), cancer-specific mortality, overall survival (OS) and overall mortality.

DESIGN: Random-effects generalized least squares models for trend estimation were used to analyze the data. Eight studies, comprising of 8699 survivals of 10 512 renal cell carcinoma (RCC) patients met the inclusion criteria, including 5 on CSS and 3 on OS.

RESULTS: The association of BMI with CSS and OS was non-linear (P<0.0001, P=0.004, respectively). We observed that CSS increased in relation to BMI, indicating that there was the obesity paradox in RCC. However, each unit increase in BMI over 25 was associated with decreased OS, indicating that RCC may also exhibit a paradox within the paradox.

CONCLUSIONS: Inconsistent effects of increases in BMI on CSS and OS, as previously observed for stroke, creates a paradox (different directions of mortality for different causes) within the obesity paradox.

Original languageEnglish
Pages (from-to)1817-1822
Number of pages6
JournalInternational Journal of Obesity
Volume40
Issue number12
Early online date16 Nov 2016
DOIs
Publication statusPublished - Dec 2016

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Renal Cell Carcinoma
Meta-Analysis
Cell Survival
Body Mass Index
Survival
Mortality
Obesity
Neoplasms
Cell Body
Stroke
Kidney Neoplasms
Least-Squares Analysis
Healthy Volunteers

Cite this

Renal cell carcinoma survival and body mass index : a dose-response meta-analysis reveals another potential paradox within a paradox. / Bagheri, M; Speakman, J R; Shemirani, F; Djafarian, K.

In: International Journal of Obesity, Vol. 40, No. 12, 12.2016, p. 1817-1822.

Research output: Contribution to journalReview article

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title = "Renal cell carcinoma survival and body mass index: a dose-response meta-analysis reveals another potential paradox within a paradox",
abstract = "BACKGROUND: In healthy subjects increasing body mass index (BMI) leads to greater mortality from a range of causes. Following onset of specific diseases, however, the reverse is often found: called the 'obesity paradox'. But we recently observed the phenomenon called the 'paradox within the paradox' for stroke patients.OBJECTIVE: The objective of our study was to examine the effect of each unit increase in BMI on renal cancer-specific survival (CSS), cancer-specific mortality, overall survival (OS) and overall mortality.DESIGN: Random-effects generalized least squares models for trend estimation were used to analyze the data. Eight studies, comprising of 8699 survivals of 10 512 renal cell carcinoma (RCC) patients met the inclusion criteria, including 5 on CSS and 3 on OS.RESULTS: The association of BMI with CSS and OS was non-linear (P<0.0001, P=0.004, respectively). We observed that CSS increased in relation to BMI, indicating that there was the obesity paradox in RCC. However, each unit increase in BMI over 25 was associated with decreased OS, indicating that RCC may also exhibit a paradox within the paradox.CONCLUSIONS: Inconsistent effects of increases in BMI on CSS and OS, as previously observed for stroke, creates a paradox (different directions of mortality for different causes) within the obesity paradox.",
author = "M Bagheri and Speakman, {J R} and F Shemirani and K Djafarian",
note = "The study was supported by Tehran University of Medical Sciences. We gratefully thank Dr Peter Lee for providing us with technical assistance.",
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T2 - a dose-response meta-analysis reveals another potential paradox within a paradox

AU - Bagheri, M

AU - Speakman, J R

AU - Shemirani, F

AU - Djafarian, K

N1 - The study was supported by Tehran University of Medical Sciences. We gratefully thank Dr Peter Lee for providing us with technical assistance.

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N2 - BACKGROUND: In healthy subjects increasing body mass index (BMI) leads to greater mortality from a range of causes. Following onset of specific diseases, however, the reverse is often found: called the 'obesity paradox'. But we recently observed the phenomenon called the 'paradox within the paradox' for stroke patients.OBJECTIVE: The objective of our study was to examine the effect of each unit increase in BMI on renal cancer-specific survival (CSS), cancer-specific mortality, overall survival (OS) and overall mortality.DESIGN: Random-effects generalized least squares models for trend estimation were used to analyze the data. Eight studies, comprising of 8699 survivals of 10 512 renal cell carcinoma (RCC) patients met the inclusion criteria, including 5 on CSS and 3 on OS.RESULTS: The association of BMI with CSS and OS was non-linear (P<0.0001, P=0.004, respectively). We observed that CSS increased in relation to BMI, indicating that there was the obesity paradox in RCC. However, each unit increase in BMI over 25 was associated with decreased OS, indicating that RCC may also exhibit a paradox within the paradox.CONCLUSIONS: Inconsistent effects of increases in BMI on CSS and OS, as previously observed for stroke, creates a paradox (different directions of mortality for different causes) within the obesity paradox.

AB - BACKGROUND: In healthy subjects increasing body mass index (BMI) leads to greater mortality from a range of causes. Following onset of specific diseases, however, the reverse is often found: called the 'obesity paradox'. But we recently observed the phenomenon called the 'paradox within the paradox' for stroke patients.OBJECTIVE: The objective of our study was to examine the effect of each unit increase in BMI on renal cancer-specific survival (CSS), cancer-specific mortality, overall survival (OS) and overall mortality.DESIGN: Random-effects generalized least squares models for trend estimation were used to analyze the data. Eight studies, comprising of 8699 survivals of 10 512 renal cell carcinoma (RCC) patients met the inclusion criteria, including 5 on CSS and 3 on OS.RESULTS: The association of BMI with CSS and OS was non-linear (P<0.0001, P=0.004, respectively). We observed that CSS increased in relation to BMI, indicating that there was the obesity paradox in RCC. However, each unit increase in BMI over 25 was associated with decreased OS, indicating that RCC may also exhibit a paradox within the paradox.CONCLUSIONS: Inconsistent effects of increases in BMI on CSS and OS, as previously observed for stroke, creates a paradox (different directions of mortality for different causes) within the obesity paradox.

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JO - International Journal of Obesity

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