Obesity Is a Significant Risk Factor for Prostate Cancer at the Time of Biopsy
Obesity Is a Significant Risk Factor for Prostate Cancer at the Time of Biopsy
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DOI：
10.1016/j.urology.2008.05.044
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发表时间：
2008-11-01
期刊：
影响因子：
2.1
通讯作者：
Aronson, William J.
中科院分区：
文献类型：
--
作者：
Freedland, Stephen J.;Wen, Joanne;Aronson, William J.
目的研究表明肥胖与前列腺癌风险降低有关。我们假设肥胖在生物学上与风险增加有关，尽管这一点由于前列腺特异性抗原(PSA)的血液稀释和较大的前列腺体积而被掩盖。方法我们回顾研究了1999年至2003年在退伍军人事务部大洛杉矶医疗系统内的两个平等准入中心接受前列腺活检的连续441名男性。我们用Logistic回归分析估计了肥胖(BMI=30 kg/m(2))与活检阳性和Gleason&Gt；=4+3之间的关系。结果共有123名男性(28%)肥胖，149名男性(34%)患有癌症。中位数PSA为5.7 ng/mL，年龄为63.9岁。肥胖男性的PSA浓度显著升高(P=0.02)，前列腺体积显著增大(P=0.04)。肥胖与年龄(P=.19)或种族(P=.37)没有显著关系。在单变量分析中，肥胖与前列腺癌风险无关(优势比[OR]1.13，95%可信区间[CI]0.73-1.75，P=.58)。然而，在调整了多种临床特征后，肥胖与前列腺癌风险显著增加相关(OR 1.98，95%CI 1.17-3.32，P=0.01)。经多因素校正后，肥胖与高级别疾病之间没有显著关联(P=.18)。结论在没有调整临床特征的情况下，在这一平等机会、以临床为基础的人群中，肥胖与前列腺癌风险没有显著关联。然而，在调整较低的PSA水平和较大的前列腺大小后，肥胖与前列腺癌风险增加98%相关。这些发现支持了这样一个事实，即目前的前列腺癌筛查做法可能对肥胖男性有偏见。泌尿外科72：1102-1105,2008。(C)2008年爱思唯尔公司。
OBJECTIVES Studies suggest obesity is associated with decreased prostate cancer risk. We hypothesized obesity is biologically associated with increased risk, although this is obscured owing to hemodilution of prostate-specific antigen (PSA) and larger prostate size.METHODS We retrospectively studied 441 consecutive men undergoing prostate biopsy between 1999 and 2003 at two equal access centers within the Veterans Affairs Greater Los Angeles Healthcare System. We estimated the association between obesity (body mass index >= 30 kg/m(2)) and positive biopsy and Gleason >= 4+3 using logistic regression analysis adjusting for multiple clinical characteristics.RESULTS A total of 123 men (28%) were obese and 149 men (34%) had cancer. Median PSA and age were 5.7 ng/mL and 63.9 years, respectively. Obese men had significantly tower PSA concentrations (P = .02) and larger prostate volumes (P = .04). Obesity was not significantly related to age (P = .19) or race (P = .37). On univariate analysis, obesity was not associated with prostate cancer risk (odds ratio [OR] 1.13, 95% confidence interval [CI] 0.73-1.75, P = .58). However, after adjusting for multiple clinical characteristics, obesity was associated with significantly increased prostate cancer risk (OR 1.98, 95% Cl 1.17-3.32, P = .01). After multivariable adjustment, there was no significant association between obesity and high-grade disease (P = .18).CONCLUSIONS Without adjustment for clinical characteristics, obesity was not significantly associated with prostate cancer risk in this equal-access, clinic-based population. However, after adjusting for the lower PSA levels and the larger prostate size, obesity was associated with a 98% increased prostate cancer risk. These findings support the fact that current prostate cancer screening practices may be biased against obese men. UROLOGY 72: 1102-1105, 2008. (C) 2008 Elsevier Inc.