Abstract A059: Racial and ethnic variation in obesity rates and body composition and their associations with renal cell carcinoma grade, stage, and histologic subtype
Authors: Batai Ken , Claudio Juan Adrover , Blew Robert M. , Lee Benjamin R. , Tiwari Hina Arif , Wightman Patrick , Liu Qian , Roche Charles L. , Davis Evan W , Cannioto Rikki , Kauffman Eric C. , Bea Jennifer W. 
Published: September 2024

Abstract
Background: Obesity is more prevalent in minoritized groups, including Hispanics, American Indian (AI), and non-Hispanic Black (NHB), and these groups have higher renal cell carcinoma (RCC) incidence and mortality rates than non-Hispanic White (NHW). However, the role of abdominal adiposity in RCC disparities are still unknown. To address this gap, we investigated body composition variation and associations with RCC pathological characteristics accounting for neighborhood characteristics. Methods: Social vulnerability index (SVI) scores were linked to the zip code of patient’s residence. Preoperative CT and MRI scans were obtained. SliceOmatic software was used to measure intermuscular, visceral, and subcutaneous adipose tissue and skeletal muscle areas and were normalized for height to obtain intermuscular, visceral, and subcutaneous adipose tissue index (IMATI, VATI, and SATI) and skeletal muscle index (SMI). Non-parametric tests were used to examine correlations, and logistic regression analyses were performed to obtain odds ratio (OR) and confidence interval (CI). Results: A total of 235 patients, including 70 (29.8%) Hispanic, 17 (7.2%) AI, and 20 (8.5%) NHB, were included. Obesity was more common in Hispanic (58.6%), AI (70.6%), and NHB (60.0%) than NHW (47.9%) patients. Compared to NHW patients, SATI was higher in Hispanic (P&lt;0.001) and AI (P=0.002), and VATI was higher in Hispanic patients (P=0.04). Patients from minoritized racial and ethnic groups were more likely to come from neighborhoods with high SVI. SVI was significantly positively correlated with BMI (P=0.02) and SATI (P&lt;0.001). Among SVI themes, socioeconomic, housing and transportation, and minority and language characteristics were significantly positively correlated with SATI (P&lt;0.01). All body composition measurements were significantly positively correlate with BMI (P&lt;0.001). Patients from minoritized racial and ethnic groups were also more likely to have hypertension and diabetes, and patients with both conditions had higher BMI (P=0.002), IMATI (P&lt;0.001), VATI (P&lt;0.001), and SATI (P=0.01) than patients without either condition. Obesity was associated with reduced odds of high grade RCC (OR 0.53, 95% CI 0.29-0.93). After including comorbidities in the model, association was no longer significant. In the same model, AI patients showed a trend for increased odds of high grade (OR 3.28, 95% CI 0.85-12.62, P=0.08) compared to NHW patients. AI patients also had significantly increased odds of having advanced stage RCC (OR 3.72, 95% CI 1.14-12.19). The highest quartile of IMATI significantly increased odds of advanced stage (OR 4.53, 95% CI 1.43-14.36) and clear cell subtype (OR 5.87, 95% CI 1.17-29.55) compared to the lowest quartile with significant P for trend (0.009 and 0.03 respectively). The third quartile of VATI was also significantly associated with clear cell subtype (OR 13.27, 95% CI 13.27). Conclusion: Obesity rates and body composition vary among racially and ethnically diverse RCC patients and are associated with RCC pathological characteristics.
Citation Format: Ken Batai, Juan Adrover Claudio, Robert M. Blew, Benjamin R. Lee, Hina Arif Tiwari, Patrick Wightman, Qian Liu, Charles L. Roche, Evan W Davis, Rikki Cannioto, Eric C. Kauffman, Jennifer W. Bea. Racial and ethnic variation in obesity rates and body composition and their associations with renal cell carcinoma grade, stage, and histologic subtype [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A059.