Racial differences in adipose tissue distribution and risk of aggressive prostate cancer among men undergoing radiotherapy.
Racial differences in adipose tissue distribution and risk of aggressive prostate cancer among men undergoing radiotherapy.
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DOI：
10.1158/1055-9965.epi-14-0236
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发表时间：
2014-11
期刊：
影响因子：
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通讯作者：
Freedland SJ
中科院分区：
文献类型：
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作者：
Allott EH;Howard LE;Song HJ;Sourbeer KN;Koontz BF;Salama JK;Freedland SJ
虽然体重指数 (BMI) 升高与侵袭性前列腺癌 (PC) 风险增加相关，但脂肪组织分布的重要性尚不清楚。我们研究了整体肥胖和内脏肥胖与侵袭性 PC 风险之间的关联。此外，考虑到脂肪组织分布的种族差异，我们研究了种族是否改变了这些关联。我们对 2005 年至 2011 年达勒姆 VA 内的 308 名接受放射治疗的 PC 患者进行了横断面分析。多变量逻辑回归检查了 BMI 类别和腰围 (WC)、内脏脂肪面积 (VFA) 和前列腺周围脂肪组织面积 (PPAT) 的三分位数与高级别 PC 风险（格里森评分≥7 vs. ≤6）之间的关联。按种族分层的模型检查了黑人和非黑人之间的这些关联是否存在差异。 BMI (p-趋势 = 0.054) 和 WC (p-趋势 = 0.040) 升高均与高级别 PC 风险增加相关，尽管与 BMI 的相关性不具有统计学意义，但不同种族之间的结果相似。相比之下，VFA 升高与黑人男性侵袭性 PC 风险增加相关（p 趋势 = 0.002），但非黑人男性则不然（p 趋势 = 0.831），种族和 VFA 之间存在显着的交互作用（p 交互作用 = 0.035）。尽管 PPAT 也观察到类似的模式，但没有一个具有统计显着性。在接受 PC 放射治疗的男性中，内脏肥胖与侵袭性 PC 风险增加相关，尤其是黑人男性。如果在未来的研究中得到证实，这些结果表明脂肪组织分布差异可能会导致 PC 种族差异。这些发现强调需要阐明导致内脏肥胖和侵袭性 PC 之间关联的种族差异的机制。
While elevated body mass index (BMI) has been associated with increased risk of aggressive prostate cancer (PC), the importance of adipose tissue distribution is not well understood. We examined associations between overall and visceral obesity and aggressive PC risk. Moreover, given racial differences in adipose tissue distribution, we examined whether race modified these associations. We conducted a cross-sectional analysis of 308 radiation-treated PC patients within the Durham VA from 2005–2011. Multivariable logistic regression examined the association between BMI categories and tertiles of waist circumference (WC), visceral fat area (VFA) and periprostatic adipose tissue area (PPAT) with high-grade PC risk (Gleason score ≥7 vs. ≤6). Models stratified by race examined whether these associations differed between black and non-black men. Both elevated BMI (p-trend=0.054) and WC (p-trend=0.040) were associated with increased high-grade PC risk, with similar results between races, although the association with BMI was not statistically significant. In contrast, elevated VFA was associated with increased aggressive PC risk in black men (p-trend=0.002) but not non-black men (p-trend=0.831), with a significant interaction between race and VFA (p-interaction=0.035). Though similar patterns were observed for PPAT, none were statistically significant. Among men undergoing radiation therapy for PC, visceral obesity is associated with increased aggressive PC risk, particularly among black men. If confirmed in future studies, these results suggest adipose tissue distribution differences may contribute to PC racial disparity. These findings highlight the need to elucidate mechanisms contributing to racial differences in the association between visceral obesity and aggressive PC.