Although an easy-to-use tool in the clinician’s office, metabolic syndrome is not an ideal set of criteria for research. Are you capturing data other than waist circumference, which may not be applicable in this group, to analyze fat mass and muscle mass?

— Kevin C. Oeffinger, MD

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Kevin C. Oeffinger, MD, Director of the Adult Long-Term Follow-up Program at Memorial Sloan Kettering Cancer Center, New York, highlighted the typical fat distribution of this population while noting the limitations of standard criteria for metabolic syndrome, which include waist circumference. “Although many of our cancer patients lose weight and have a normal waist circumference, they are often phenotypically fat,” said Dr. Oeffinger. “In other words, they increase their fat mass while decreasing muscle mass often staying within a normal weight category.”

“Although an easy-to-use tool in the clinician’s office, metabolic syndrome is not an ideal set of criteria for research,” he continued. “It’s simply showing that the clustering of certain conditions is associated with a more-than-additive risk of cardiovascular disease. Are you capturing data other than waist circumference, which may not be applicable in this group, to analyze fat mass and muscle mass?”

“When compared to the body mass index of our controls, survivors are more likely to be overweight or obese, but that increased body mass index is not muscle mass,” Dr. Abu Zaid acknowledged. “I think it has to do with differences in fat distribution… We have computed tomography scans of these patients from when they were diagnosed, out to 5 years. Using these scans, we can easily measure their muscle mass and fat distributions. I think that would be a very nice study to do.” ■

Disclosure: Dr. Oeffinger reported no potential conflicts of interest.