Obesity and prostate cancer: weighing the evidence.
Obesity and prostate cancer: weighing the evidence.
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DOI：
10.1016/j.eururo.2012.11.013
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发表时间：
2013-05
期刊：
影响因子：
23.4
通讯作者：
Freedland, Stephen J.
中科院分区：
文献类型：
--
作者：
Allott, Emma H.;Masko, Elizabeth M.;Freedland, Stephen J.
肥胖和前列腺癌（PCa）影响着西方社会的相当大一部分人。越来越多的证据，流行病学和机械，两者之间的关联是公共卫生的利益。进一步了解这种可改变的危险因素在PCa病因学中的作用对于优化筛查、治疗和预防至关重要。巩固和评估肥胖和前列腺癌之间流行病学联系的证据，除了检查拟议的潜在分子机制。通过结合以下术语对1991年至2012年7月期间发表的相关文章进行PubMed检索：肥胖、BMI、体重指数和前列腺癌风险、前列腺癌发病率、前列腺癌死亡率、根治性前列腺切除术、雄激素剥夺治疗、外射束放射、近距离放射治疗、前列腺癌和生活质量、前列腺癌和主动监测，此外还有肥胖、BMI、体重指数和前列腺癌以及胰岛素、胰岛素样生长因子、雄激素、雌二醇、瘦素、脂联素和IL-6。根据内容、发表日期和相关性选择文章，并检索相关文章的参考文献。越来越多的证据表明，肥胖与侵袭性前列腺癌的发病率升高、根治性前列腺切除术和外照射放射治疗后生化失败的风险增加、雄激素剥夺治疗后并发症的发生率较高以及前列腺癌特异性死亡率增加相关，尽管可能总体前列腺癌发病率较低。这些结果可能部分与检测和治疗肥胖男性的困难有关。然而，多种分子机制也可以解释这些关联。体重减轻减缓了动物模型中的PCa，但尚未在人体试验中进行充分测试。肥胖似乎与侵袭性前列腺癌有关。我们建议临床提示，以更好地诊断和治疗肥胖男性前列腺癌。逆转肥胖是否会减缓PCa的生长目前尚不清楚，尽管这是一个活跃的研究领域。
Obesity and prostate cancer (PCa) affect substantial proportions of Western society. Mounting evidence, both epidemiologic and mechanistic, for an association between the two is of public health interest. An improved understanding of the role of this modifiable risk factor in PCa etiology is imperative to optimize screening, treatment, and prevention. To consolidate and evaluate the evidence for an epidemiologic link between obesity and PCa, in addition to examining the proposed underlying molecular mechanisms. A PubMed search for relevant articles published between 1991 and July 2012 was performed by combining the following terms: obesity, BMI, body mass index and prostate cancer risk, prostate cancer incidence, prostate cancer mortality, radical prostatectomy, androgen-deprivation therapy, external-beam radiation, brachytherapy, prostate cancer and quality of life, prostate cancer and active surveillance, in addition to obesity, BMI, body mass index and prostate cancer and insulin, insulinlike growth factor, androgen, estradiol, leptin, adiponectin, and IL-6. Articles were selected based on content, date of publication, and relevancy, and their references were also searched for relevant articles. Increasing evidence suggests obesity is associated with elevated incidence of aggressive PCa, increased risk of biochemical failure following radical prostatectomy and external-beam radiotherapy, higher frequency of complications following androgen-deprivation therapy, and increased PCa-specific mortality, although perhaps a lower overall PCa incidence. These results may in part relate to difficulties in detecting and treating obese men. However, multiple molecular mechanisms could explain these associations as well. Weight loss slows PCa in animal models but has yet to be fully tested in human trials. Obesity appears to be linked with aggressive PCa. We suggest clinical tips to better diagnose and treat obese men with PCa. Whether reversing obesity slows PCa growth is currently unknown, although it is an active area of research.
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