Obesity, body composition, and prostate cancer.
Obesity, body composition, and prostate cancer.
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DOI：
10.1186/1471-2407-12-23
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发表时间：
2012-01-18
期刊：
影响因子：
3.8
通讯作者：
Barocas DA
中科院分区：
文献类型：
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作者：
Fowke JH;Motley SS;Concepcion RS;Penson DF;Barocas DA
已知的前列腺癌危险因素尚未转化为有效的预防或辅助护理策略。多项流行病学研究表明，身体肥胖程度较高可能是高级别（Gleason 7、Gleason 8-10）前列腺癌和前列腺癌死亡率的一个可改变的危险因素。然而，BMI 仅近似身体肥胖程度，并且可能会因老年男性的集中脂肪沉积或去脂体重而混淆。我们的目标是使用生物电阻抗分析 (BIA) 来测量身体成分，并确定前列腺癌与全身脂肪量 (FM)、去脂体重 (FFM) 和体脂百分比 (%BF) 之间的关联，以及哪种身体成分测量介导 BMI 或腰围 (WC) 与前列腺癌之间的关联。该研究采用多中心招募方案，针对计划进行前列腺活检的男性。活检时未患前列腺癌的男性作为对照 (n = 1057)。前列腺癌病例被分类为格里森 6 级 (n = 402)、格里森 7 级 (n = 272) 或格里森 8-10 (n = 135) 癌症。 BIA 和体型测量由经过培训的工作人员在诊断前确定，并通过图表审查确定临床和合并症状态。分析利用多变量线性和逻辑回归。体型和成分测量与低度（Gleason 6）前列腺癌没有显着相关性。相反，BMI、WC、FM 和 FFM 与 Gleason 7 和 Gleason 8-10 前列腺癌风险增加相关。此外，BMI 和 WC 不再与 Gleason 8-10（ORBMI = 1.039 (1.000, 1.081)、ORWC = 1.016 (0.999, 1.033)，连续量表）相关，并以全身 FFM 为对照（ORBMI = 0.998 (0.946, 1.052)，ORWC = 0.995 (0.974, 1.017))。此外，在控制 FM 后，增加的 FFM 仍与 Gleason 7 (ORFFM = 1.030 (1.008, 1.052)) 和 Gleason 8-10 (ORFFM = 1.044 (1.014, 1.074)) 显着相关。我们的结果表明，BMI 和 WC 与高级别前列腺癌之间的关联是通过全身 FFM 的测量来介导的。 FFM 不太可能导致前列腺癌，而是提供了睾酮或 IGF1 活性的标志物，这些活性与随着男性年龄的增长而保持瘦体重有关。
Established risk factors for prostate cancer have not translated to effective prevention or adjuvant care strategies. Several epidemiologic studies suggest greater body adiposity may be a modifiable risk factor for high-grade (Gleason 7, Gleason 8-10) prostate cancer and prostate cancer mortality. However, BMI only approximates body adiposity, and may be confounded by centralized fat deposition or lean body mass in older men. Our objective was to use bioelectric impedance analysis (BIA) to measure body composition and determine the association between prostate cancer and total body fat mass (FM) fat-free mass (FFM), and percent body fat (%BF), and which body composition measure mediated the association between BMI or waist circumference (WC) with prostate cancer. The study used a multi-centered recruitment protocol targeting men scheduled for prostate biopsy. Men without prostate cancer at biopsy served as controls (n = 1057). Prostate cancer cases were classified as having Gleason 6 (n = 402), Gleason 7 (n = 272), or Gleason 8-10 (n = 135) cancer. BIA and body size measures were ascertained by trained staff prior to diagnosis, and clinical and comorbidity status were determined by chart review. Analyses utilized multivariable linear and logistic regression. Body size and composition measures were not significantly associated with low-grade (Gleason 6) prostate cancer. In contrast, BMI, WC, FM, and FFM were associated with an increased risk of Gleason 7 and Gleason 8-10 prostate cancer. Furthermore, BMI and WC were no longer associated with Gleason 8-10 (ORBMI = 1.039 (1.000, 1.081), ORWC = 1.016 (0.999, 1.033), continuous scales) with control for total body FFM (ORBMI = 0.998 (0.946, 1.052), ORWC = 0.995 (0.974, 1.017)). Furthermore, increasing FFM remained significantly associated with Gleason 7 (ORFFM = 1.030 (1.008, 1.052)) and Gleason 8-10 (ORFFM = 1.044 (1.014, 1.074)) after controlling for FM. Our results suggest that associations between BMI and WC with high-grade prostate cancer are mediated through the measurement of total body FFM. It is unlikely that FFM causes prostate cancer, but instead provides a marker of testosterone or IGF1 activities involved with retaining lean mass as men age.
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作者：
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