Obesity, diabetes, and risk of prostate cancer: Results from the prostate cancer prevention trial
Obesity, diabetes, and risk of prostate cancer: Results from the prostate cancer prevention trial
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DOI：
10.1158/1055-9965.epi-06-0477
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发表时间：
2006-10-01
影响因子：
3.8
通讯作者：
Kristal, Alan R.
中科院分区：
文献类型：
--
作者：
Gong, Zhihong;Neuhouser, Marian L.;Kristal, Alan R.
关于肥胖和前列腺癌发病率之间关系的研究不一致。在某种程度上，这种不一致性可能是由于肥胖对低度和高度癌症的不同影响，或者是由于糖尿病混淆了肥胖与前列腺癌风险的关联。我们调查了肥胖和糖尿病与低度和高度前列腺癌风险的关系。数据来自前列腺癌预防试验中的10，258名参与者（1，936名前列腺癌），他们都通过前列腺活检确定了癌症的存在或不存在。多元逻辑回归用于对总前列腺癌的风险进行建模，多分类逻辑回归用于对低级别和高级别前列腺癌的风险进行建模。与体重指数< 25的男性相比，（体重指数>= 30）发生低度前列腺癌的风险降低18% [比值比（OR），0.82; 95%可信区间（95%CI），0.69-0.98]（Gleason < 7）和29%（OR，1.29; 95% CI，1.01-1.67）高级别前列腺癌风险增加（Gleason >= 7），或者，78%（OR，1.78; 95%CI，1.10-2.87）的风险增加，将高级别癌症定义为Gleason总和8至10。糖尿病与低级别前列腺癌风险降低47%（OR，0.53; 95%CI，0.34-0.83）和高级别前列腺癌风险降低28%（OR，0.72; 95%CI，0.55-0.94）相关。肥胖或糖尿病与癌症风险之间的关联并没有因为相互统计控制而发生实质性改变。肥胖增加了高级别前列腺癌的风险，但降低了低级别前列腺癌的风险，这种关系与糖尿病男性患前列腺癌的风险较低无关。
Studies on the relationship between obesity and prostate cancer incidence are inconsistent. In part, this inconsistency maybe due to a differential effect of obesity on low-grade and high-grade cancer or confounding of the association of obesity with prostate cancer risk by diabetes. We investigated the associations of obesity and diabetes with low-grade and high-grade prostate cancer risk. Data were from 10,258 participants (1,936 prostate cancers) in the Prostate Cancer Prevention Trial who all had cancer presence or absence determined by prostate biopsy. Multiple logistic regression was used to model the risk of total prostate cancer, and polytomous logistic regression was used to model the risk of low-grade and high-grade prostate cancer. Compared with men with body mass index < 25, obese men (body mass index >= 30) had an 18% [odds ratio (OR), 0.82; 95% confidence interval (95% CI), 0.69-0.98] decreased risk of low-grade prostate cancer (Gleason < 7) and a 29% (OR, 1.29; 95% CI, 1.01-1.67) increased risk of high-grade prostate cancer (Gleason >= 7) or, alternatively, a 78% (OR, 1.78; 95% CI, 1.10-2.87) increased risk defining high-grade cancer as Gleason sum 8 to 10. Diabetes was associated with a 47% (OR, 0.53; 95% CI, 0.34-0.83) reduced risk of low-grade prostate cancer and a 28% (OR, 0.72; 95% CI, 0.55-0.94) reduced risk of high-grade prostate cancer. Associations of obesity or diabetes with cancer risk were not substantially changed by mutually statistical controlling for each other. Obesity increases the risk of high-grade but decreases the risk of low-grade prostate cancer, and this relationship is independent of the lower risk for prostate cancer among men with diabetes.