Urologic oncology · 2026
Limitations of body mass index and body fat percentage and waist-to-hip ratio in urologic cancers.
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Kim Soyeoun, Elises Jose Carlo R, Huan Tran Trong, Kwak Cheol, Ku Ja-Hyeon, Yuk Hyeong Dong, Jeong Seung-Hwan, Han Jang Hee, Jeong Chang-Wook
Аннотация
BACKGROUND AND OBJECTIVE: Body mass index (BMI) does not distinguish between adipose and lean mass or capture central adiposity. Patients with urologic malignancies differ in age and body composition, which may influence how BMI reflects true adiposity. We evaluated the concordance between BMI and alternative adiposity measures-body fat percentage (BF%) and waist-to-hip ratio (WHR)-in a cohort of urologic cancers.
METHODS: We analyzed 5,909 patients diagnosed with kidney cancer, prostate cancer, or bladder cancer who underwent surgery between 2017 and 2022 in a prospective registry. Body composition was assessed using multifrequency bioelectrical impedance analysis. Concordance between BMI and BF% or WHR was evaluated using quadratic weighted kappa statistics.
KEY FINDINGS AND LIMITATIONS: Overall, BMI showed moderate agreement with BF% (κ = 0.58) but poor agreement with WHR (κ = 0.25). BMI underestimated adiposity relative to BF% and overestimated it. Notably, BMI failed to identify central obesity as defined by WHR. Concordance varied across cancer types and muscle-mass strata. Limitations include the single-center design and cross-sectional analysis.
CONCLUSIONS: BMI alone may not adequately reflect adiposity in patients with urologic cancers, particularly with respect to central adiposity. Alternative measures such as BF% and WHR may provide complementary information for assessing body composition.
PATIENT SUMMARY: BMI alone may miss important fat patterns, especially abdominal fat. Additional measures such as body fat percentage and waist-to-hip ratio may help better understand body composition in patients with urologic cancers.
METHODS: We analyzed 5,909 patients diagnosed with kidney cancer, prostate cancer, or bladder cancer who underwent surgery between 2017 and 2022 in a prospective registry. Body composition was assessed using multifrequency bioelectrical impedance analysis. Concordance between BMI and BF% or WHR was evaluated using quadratic weighted kappa statistics.
KEY FINDINGS AND LIMITATIONS: Overall, BMI showed moderate agreement with BF% (κ = 0.58) but poor agreement with WHR (κ = 0.25). BMI underestimated adiposity relative to BF% and overestimated it. Notably, BMI failed to identify central obesity as defined by WHR. Concordance varied across cancer types and muscle-mass strata. Limitations include the single-center design and cross-sectional analysis.
CONCLUSIONS: BMI alone may not adequately reflect adiposity in patients with urologic cancers, particularly with respect to central adiposity. Alternative measures such as BF% and WHR may provide complementary information for assessing body composition.
PATIENT SUMMARY: BMI alone may miss important fat patterns, especially abdominal fat. Additional measures such as body fat percentage and waist-to-hip ratio may help better understand body composition in patients with urologic cancers.