Paradoxical relationship between body mass index and bone mineral density in patients with non-small cell lung cancer with brain metastasis

PLoS One. 2019 Jun 21;14(6):e0218825. doi: 10.1371/journal.pone.0218825. eCollection 2019.

Abstract

Background and purpose: Low body mass index (BMI) at presentation has been reported to be associated with higher incidence and mortality of lung cancer, but studies on the relationship between brain metastasis and BMI at presentation are lacking. This study aimed to evaluate the association between brain metastasis and BMI and bone mineral density (BMD) in NSCLC.

Methods: We retrospectively enrolled patients with non-small cell lung cancer who underwent brain magnetic resonance imaging with contrast within 3 months of diagnosis. The BMI was collected, and the BMD was measured in Hounsfield unit (HU) on initial staging computed tomography scans. The independent relationship between BMI and BMD was assessed using multivariable linear regression according to the presence of brain metastasis.

Results: A total of 356 consecutive NSCLC patients were enrolled in the study over a 8-year period in a single institution. Lower BMI with higher BMD was an independent predictive factor for brain metastasis in patients with NSCLC, relative to the other group (HR, 2.03; 95% CI, 1.21 to 3.40; P = 0.007). We also found a significant negative correlation between BMI and BMD among patients with NSCLC with brain metastases (B, -3.343; 95% confidence interval, -6.352 to -0.333; P = 0.030).

Conclusions: Brain metastasis may possibly be associated with lower BMI and higher BMD in NSCLC patients. We expect that these results may facilitate future predictions of brain metastases during the clinical course of NSCLC and enhance our understanding of the underlying mechanisms that link brain metastases and lung cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Bone Density*
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / physiopathology*
  • Brain Neoplasms / secondary
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / physiopathology*
  • Female
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / pathology
  • Lung Neoplasms / physiopathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Tomography, X-Ray Computed

Grants and funding

This work was supported by the research fund of Hanyang University (HY- 201800000002600), http://www.hanyang.ac.kr/web/eng, to HMH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.