Association between body mass index and prostate cancer detection rates in Japanese urologic patients.
ABSTRACT To examine whether an association exists between body mass index (BMI) and prostate cancer detection rates or pathologic features of cancer in Japanese urologic patients.
We studied the age, BMI, and biopsy results of 481 patients who underwent transrectal prostate biopsy. They were stratified by BMI into three groups according to the cutoffs recommended for Asian populations: normal, BMI less than 23.0 (n = 248); overweight, BMI 23.0 to 25.0 (n = 116); and obese, BMI greater than 25.0 (n = 117). We then compared the cancer detection rates and pathologic features among the three groups. Multivariate logistic regression analysis was also performed.
No significant differences in the cancer detection rate were found among the three groups (40.2% to 43.1%, P = 0.87) on univariate analysis. Multivariate logistic regression analyses revealed significant associations between the BMI and cancer detection (P = 0.029, 95% confidence interval [CI] 0.85 to 0.99), but no significant associations were observed between BMI and the presence of Gleason components 4 or 5 (P = 0.061, 95% CI 0.79 to 1.01), poor cell differentiation (P = 0.174, 95% CI 0.96 to 1.24), or clinically organ-confined disease (P = 0.45, 95% CI 0.84 to 1.08).
BMI seems to have a significant impact on prostate cancer detection rates, although it seems difficult to apply the BMI directly to the management of patients at risk of prostate cancer in urologic clinics.
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ABSTRACT: The relationship between body mass index (BMI) and prostate cancer risk may be complex because obesity is associated with various hormonal factors and because the influence of BMI may differ according to whether the cancers are hereditary or sporadic. We used data from the Health Professionals Follow-Up Study, in which 2896 incident cases of prostate cancer were reported from February 1, 1986, through January 31, 2000, to determine prospectively whether BMI was associated with the risk of hereditary (men <60 years of age or with a positive family history of prostate cancer) and sporadic (men > or =60 years of age and without such a family history) prostate cancer. The risk of prostate cancer in men with a higher BMI (> or =30 kg/m2) was lower than that in men with a lower BMI (23-24.9 kg/m2) but only if they were younger (<60 years old) (relative risk = 0.52, 95% confidence interval = 0.33 to 0.83; P(trend)<.001) or had a family history of prostate cancer (relative risk = 0.74, 95% confidence interval = 0.45 to 1.19; P(trend) =.01). However, for groups with more sporadic cancers, BMI had a weak, non-statistically significant positive association with prostate cancer. We observed statistically significant interactions between BMI and age (P(interaction)<.001, two-sided Wald test) and between BMI and family history of prostate cancer (P(interaction) =.006, two-sided Wald test). Patterns for BMI and waist circumference were similar. Because obesity is associated with lower circulating concentrations of testosterone, our results suggest the hypothesis that androgens may play a more direct role for early-onset or hereditary prostate cancers than for sporadic prostate cancers.CancerSpectrum Knowledge Environment 08/2003; 95(16):1240-4. · 14.07 Impact Factor
Article: Cholesterol and prostate cancer.[show abstract] [hide abstract]
ABSTRACT: Cholesterol is a neutral lipid that accumulates in liquid-ordered, detergent-resistant membrane domains called lipid rafts. Lipid rafts serve as membrane platforms for signal transduction mechanisms that mediate cell growth, survival, and a variety of other processes relevant to cancer. A number of studies, going back many years, demonstrate that cholesterol accumulates in solid tumors and that cholesterol homeostasis breaks down in the prostate with aging and with the transition to the malignant state. This review summarizes the established links between cholesterol and prostate cancer (PCa), with a focus on how accumulation of cholesterol within the lipid raft component of the plasma membrane may stimulate signaling pathways that promote progression to hormone refractory disease. We propose that increases in cholesterol in prostate tumor cell membranes, resulting from increases in circulating levels or from dysregulation of endogenous synthesis, results in the coalescence of raft domains. This would have the effect of sequestering positive regulators of oncogenic signaling within rafts, while maintaining negative regulators in the liquid-disordered membrane fraction. This approach toward examining the function of lipid rafts in prostate cancer cells may provide insight into the role of circulating cholesterol in malignant growth and on the potential relationship between diet and aggressive disease. Large-scale characterization of proteins that localize to cholesterol-rich domains may help unveil signaling networks and pathways that will lead to identification of new biomarkers for disease progression and potentially to novel targets for therapeutic intervention.Journal of Cellular Biochemistry 02/2004; 91(1):54-69. · 3.06 Impact Factor
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ABSTRACT: Body mass index (BMI), calculated as weight in kg divided by the square of height in m, is used as an indicator of obesity. We assessed the relationship between BMI, and prostate cancer detection rates and biopsy features in a referral based biopsy population. A total of 787 consecutive patients referred for abnormal digital rectal examination and/or prostate specific antigen (PSA) greater than 4 ng/ml underwent systematic prostate biopsy. Three standard categories of BMI were considered, namely normal-less than 25, overweight-25 to 29.9 and obese-30 or greater kg/m. The presence or absence of cancer, percent of core involvement and tumor grade were correlated with BMI. Additional analyses controlled for patient age, PSA and prostate volume. For the entire population detection rates were highest in the normal BMI group compared to the overweight or obese group (52% vs 37% vs 42%, p = 0.0026). When stratified by age, this observation was true for men younger than 70 years (49% vs 32% vs 37%, p = 0.0042) but not for men 70 years or older. When only patients with PSA 10 ng/ml or less were considered, detection rates were highest in the normal BMI group (44% vs 28% vs 36%, p = 0.0061). This observation also persisted in patients younger than 70 years with PSA 10 ng/ml or less, or when only patients younger than 70 years with a total prostate volume of less than 50 cc were included. Of patients with cancer those with a normal BMI had a greater length of needle core involvement on biopsy. Normal BMI correlates with a higher cancer detection rate and larger cancers in men undergoing prostate biopsy.The Journal of Urology 07/2004; 171(6 Pt 1):2199-202. · 3.70 Impact Factor