Visceral fat accumulation is associated with  different pathological subtypes of renal cell  carcinoma (RCC): a multicentre study in China.
OBJECTIVE
To investigate whether visceral obesity is associated with certain histological subtypes of renal cell carcinoma (RCC) ina multicentre Chinese cohort.


METHODS
A kidney tumour database was created using three tertiary centres in China; 487 patients were enrolled presenting with localised RCC and complete computer tomography(CT)/magnetic resonance imaging (MRI) information. A single-slice CT image was used to measure the area of visceral and subcutaneous adipose tissues in each patient. Statistical methods were used to analyse clear-cell RCC (ccRCC) and non-clear-cell RCC (non-ccRCC) as they relate to visceral fat area (VFA) and other risk factors, such as age, gender, tumour size, diabetes, hypertension, total fat area (TFA) and body mass index (BMI).


RESULTS
In all, 418 patients had a ccRCC subtype and 69 had a non-ccRCC subtype. For all the patients with RCC, the mean VFA was 102 cm2, while mean BMI was 24 kg/m2. The mean VFA was greater in ccRCC than non-ccRCC patients by 25 cm2. There were significant differences in the mean VFA and TFA between patients with ccRCC and those with non-ccRCC.Multivariate analysis showed that the presence ofVFA was more important than the effects of BMI and Type 2 diabetes on pathology prediction. In patients with a normal BMI, those with a higher quartile of VFA were more likely to develop ccRCC than those with a low VFA.


CONCLUSIONS
Increased visceral fat was found to be associated with ccRCC and the significance of VFA outweighed the effects of BMI and Type 2 diabetes for the prediction of RCC pathology in multivariate analyses. As a result, VFA could constitute a primary explanation for the link between obesity and ccRCC.
Hong-Kai
HK
Wang
Xi-Shuang
XS
Song
Yue
Y
Cheng
Yuan-Yuan
YY
Qu
Shi-Lin
SL
Zhang
Bo
B
Dai
Hai-Liang
HL
Zhang
Yi-Jun
YJ
Shen
Yi-Ping
YP
Zhu
Guo-Hai
GH
Shi
Xiao-Jian
XJ
Qin
Chun-Guang
CG
Ma
Guo-Wen
GW
Lin
Wen-Jun
WJ
Xiao
Yao
Y
Zhu
Ding-Wei
DW
Ye
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000473:pathology; D002681:China; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat; D007680:Kidney Neoplasms / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000473:pathology; D050507:Subcutaneous Fat, Abdominal; D055815:Young Adult