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1
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Zhang H, Yang W, Zhang B, Wu J, Zhang W, Wang Z, Cui J. Non-alcoholic fatty liver disease increases the risk of biochemical recurrence in high-grade metastatic prostate cancer patients. Asia Pac J Clin Oncol 2024; 20:707-713. [PMID: 38970310 DOI: 10.1111/ajco.14094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/21/2024] [Accepted: 05/22/2024] [Indexed: 07/08/2024]
Abstract
INTRODUCTION Non-alcoholic fatty liver disease (NAFLD) has been reported to be helpful to identify high-risk individuals of developing prostate cancer. Our aim is to investigate the relationship between NAFLD and biochemical recurrence in metastatic prostate cancer patients. METHODS We retrospectively investigated 602 patients with metastatic prostate cancer receiving the androgen deprivation therapy. Liver fat was estimated with liver-to-spleen ratio by computed tomography (CT) scans. The relationship between NAFLD and biochemical recurrence was investigated with Cox models. The model for biochemical recurrence was adjusted for multiple variables. RESULTS NAFLD was significantly associated with biochemical recurrence in patients with Gleason score ≥4+3 when adjusting for each of body mass index (hazards ratio [HR] = 1.38; 95% confidence interval [CI] = 1.08-1.77; p = 0.01), visceral adipose tissue (HR = 1.36; 95% CI = 1.07-1.74; p = 0.01), hypertension (HR = 1.41; 95% CI = 1.10-1.80; p = 0.01), and diabetes mellitus (HR = 1.42; 95% CI = 1.11-1.82; p = 0.01), using age and prostate-specific antigen level as potential confounder. The 2-year biochemical recurrence rate in the Gleason score ≥4+3 patients with and without NAFLD was 84.0% (100/119) and 72.2% (130/180), respectively (p = 0.018). The median biochemical recurrence free survival of the Gleason score ≥4+3 patients with and without NAFLD were 17 and 21 months, respectively (p = 0.005). CONCLUSIONS NAFLD is an independent risk factor for biochemical recurrence in patients with high-grade metastatic prostate cancer. If validated in prospective studies, future research should test whether treatment of NAFLD can lead to better prognosis.
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Affiliation(s)
- Hongyi Zhang
- Department of Urology, The First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Wenbo Yang
- Department of Oncology, The First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Bin Zhang
- Department of Oncology, The First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jiahui Wu
- Department of Oncology, The First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Wei Zhang
- Department of Urology, The Second Affiliated Hospital, Air Forth Medical University, Xi'an, Shaanxi, China
| | - Zhenlong Wang
- Department of Urology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jie Cui
- Department of General Practice, The First Affiliated Hospital, Xi'an Medical University, Xi'an, Shaanxi, China
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2
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Li YD, Ren ZJ, Gao L, Ma JH, Gou YQ, Tan W, Liu C. Cholelithiasis increased prostate cancer risk: evidence from a case-control study and a meta-analysis. BMC Urol 2022; 22:160. [PMID: 36192737 PMCID: PMC9528176 DOI: 10.1186/s12894-022-01110-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/19/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Cholelithiasis represents a known risk factor for digestive system neoplasm. Few studies reported the association between cholelithiasis and the risk of prostate cancer (PCa), and the results were controversial. Methods We reviewed the medical records of the Second Affiliated Hospital of Chongqing Medical University Hospital to perform a retrospective matched case–control study, which included newly diagnosed 221 PCa patients and 219 matched controls. Logistic regression was applied to compare cholelithiasis exposure and adjusted for confounding factors. Additionally, we conducted a meta-analysis pooling this and published studies further to evaluate the association between cholelithiasis and PCa risk. Related ratio (RR) and 95% confidence interval (95%CI) were used to assess the strength of associations. Results Our case–control study showed that cholelithiasis was associated with a higher incidence of PCa (OR = 1.87, 95% CI: 1.06–3.31) after multivariable adjustment for covariates. The incidence of PCa was increased in patients with gallstones but not cholecystectomy. 7 studies involving 80,403 individuals were included in the meta-analysis. Similarly, the results demonstrated that cholelithiasis was associated with an increased risk of PCa (RR = 1.35, 95%CI: 1.17–1.56) with moderate-quality evidence. Cholelithiasis patients with low BMI increased the PCa incidence. Moreover, Subgroup analysis based on region showed that cholelithiasis was associated with PCa in Europe (RR = 1.24, 95%CI 1.03–1.51) and Asia (RR = 1.32, 95%CI 1.24–1.41). Conclusions The results suggested an association between cholelithiasis and the risk of PCa. There was no significant relationship between cholecystectomy therapy and PCa risk. Further cohort studies should be conducted to demonstrate the results better.
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Affiliation(s)
- Ya-Dong Li
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Zheng-Ju Ren
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Liang Gao
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jun-Hao Ma
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yuan-Qing Gou
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Wei Tan
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Chuan Liu
- Department of Urology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
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3
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Liu W, Li W, Wang Z, Zhu Y, Ye D, Zhang G. Metabolically Abnormal Obesity Increases the Risk of Advanced Prostate Cancer in Chinese Patients Undergoing Radical Prostatectomy. Cancer Manag Res 2020; 12:1779-1787. [PMID: 32210619 PMCID: PMC7071860 DOI: 10.2147/cmar.s242193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/27/2020] [Indexed: 12/19/2022] Open
Abstract
Background To investigate the pathological risk of prostate cancer (PCa) according to the obesity and metabolic status of Chinese patients undergoing radical prostatectomy. Materials and Methods We performed a retrospective cross-sectional study of 1016 patients with PCa who underwent radical prostatectomy and whose metabolic status and body mass index were examined. Multivariate logistic regression analysis was performed to examine the relationship between different metabolic obesity phenotypes and the pathological outcomes of PCa. Results Among 1016 men, 551 (54.2%), 106 (10.4%), 238 (23.4%), and 121 (11.9%) were assigned to the metabolically healthy and normal weight (MHNW) group, metabolically abnormal but normal weight (MANW) group, metabolically healthy but overweight or obese (MHO) group, and metabolically abnormal and overweight or obese (MAO) group, respectively. Compared with the MHNW group, the MAO group had a significantly greater risk of a higher prostatectomy Gleason score [odds ratio (OR), 1.907; 95% confidence interval (95% CI), 1.144–3.182], pathological stage (OR, 1.606; 95% CI, 1.035–2.493), and seminal vesicle invasion (OR, 1.673; 95% CI, 1.041–2.687). In contrast, the ORs were not increased in the MHO or MANW group. In the context of normal weight, metabolic disorders were associated with lymph node involvement. The metabolic status and body mass index were not associated with extracapsular extension or surgical margins in any of the four groups. Conclusion The MAO phenotype is associated with aggressive PCa, including a higher prostatectomy Gleason score, pathological stage, and seminal vesicle invasion and might also be associated with disease progression. Obesity and metabolic disorders act synergistically to increase the pathological risk of PCa.
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Affiliation(s)
- Wen Liu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Wenxian Li
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Zhankun Wang
- Department of Urology, Qingdao Eighth People's Hospital, Qingdao, People's Republic of China
| | - Yao Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Guiming Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
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4
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Morlacco A, Dal Moro F, Rangel LJ, Carlson RE, Soligo M, Karnes RJ. Impact of metabolic syndrome on functional outcomes and complications of surgical treatment of prostate cancer. J Surg Oncol 2019; 120:1505-1507. [PMID: 31721218 DOI: 10.1002/jso.25762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) has a negative impact on functional recovery and complications after many surgical procedures. AIM To assess the role of Mets on functional outcomes and complications after radical prostatectomy (RP) for prostate cancer. PATIENTS AND METHODS Complete data were collected from 5758 patients, undergoing RP at a single referral centers in a 10-year period and the presence of MetS before surgery was ascertained in 17.7% of them using a modified version of the IDF-AHA/NHLBI criteria. Outcomes included 1-year continence and potency rates, early (≤90 days) and late (>90 days) complications. RESULTS Postoperative continence (no pads) was significantly less likely in MetS patients (75.4% vs 82.6%, P < .01), despite no difference in preoperative continence. Erections with or without therapy were reached in 55.8% of non-MetS and 41.8% of MetS patients (P < .01), in this case a significant difference in preoperative function was seen. No differences in early and late complications, except for wound infections (5.8% vs 3.9%, P < .01) were observed. CONCLUSIONS In the present study RP was safe from the complications standpoint in MetS patients, but the presence of the syndrome was a significant risk factor for post-RP incontinence and impotence.
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Affiliation(s)
- Alessandro Morlacco
- Urology Clinic - Department of Surgical, Oncological and Gastroenterological Sciences, Padova University, Padova, Italy
| | - Fabrizio Dal Moro
- Urology Clinic, University Hospital "Santa Maria della Misericordia", Udine, Italy.,Department of Surgical, Oncological and Gastroenterological Sciences, Padova University, Padova, Italy
| | - Laureano J Rangel
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Rachel E Carlson
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Matteo Soligo
- Urology Clinic - Department of Surgical, Oncological and Gastroenterological Sciences, Padova University, Padova, Italy
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5
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Di Francesco S, Robuffo I, Caruso M, Giambuzzi G, Ferri D, Militello A, Toniato E. Metabolic Alterations, Aggressive Hormone-Naïve Prostate Cancer and Cardiovascular Disease: A Complex Relationship. ACTA ACUST UNITED AC 2019; 55:medicina55030062. [PMID: 30866568 PMCID: PMC6473682 DOI: 10.3390/medicina55030062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/30/2019] [Accepted: 02/27/2019] [Indexed: 02/06/2023]
Abstract
Background: Epidemiological studies suggest a possible relationship between metabolic alterations, cardiovascular disease and aggressive prostate cancer, however, no clear consensus has been reached. Objective: The aim of the study was to analyze the recent literature and summarize our experience on the association between metabolic disorders, aggressive hormone-naïve prostate cancer and cardiovascular disease. Method: We identified relevant papers by searching in electronic databases such as Scopus, Life Science Journals, and Index Medicus/Medline. Moreover, we showed our experience on the reciprocal relationship between metabolic alterations and aggressive prostate cancer, without the influence of hormone therapy, as well the role of coronary and carotid vasculopathy in advanced prostate carcinoma. Results: Prostate cancer cells have an altered metabolic homeostatic control linked to an increased aggressivity and cancer mortality. The absence of discrimination of risk factors as obesity, systemic arterial hypertension, diabetes mellitus, dyslipidemia and inaccurate selection of vascular diseases as coronary and carotid damage at initial diagnosis of prostate cancer could explain the opposite results in the literature. Systemic inflammation and oxidative stress associated with metabolic alterations and cardiovascular disease can also contribute to prostate cancer progression and increased tumor aggressivity. Conclusions: Metabolic alterations and cardiovascular disease influence aggressive and metastatic prostate cancer. Therefore, a careful evaluation of obesity, diabetes mellitus, dyslipidemia, systemic arterial hypertension, together with a careful evaluation of cardiovascular status, in particular coronary and carotid vascular disease, should be carried out after an initial diagnosis of prostatic carcinoma.
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Affiliation(s)
- Simona Di Francesco
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, 87100 Cosenza, Italy.
| | - Iole Robuffo
- Institute of Molecular Genetics, National Research Council, Section of Chieti, 66100 Chieti, Italy.
| | - Marika Caruso
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, 87100 Cosenza, Italy.
| | - Giulia Giambuzzi
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Deborah Ferri
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Andrea Militello
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, 87100 Cosenza, Italy.
- Urology and Andrology Section, Villa Immacolata Hospital, 01100 Viterbo, Italy.
| | - Elena Toniato
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
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6
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Gómez-Gómez E, Carrasco-Valiente J, Campos-Hernández JP, Blanca-Pedregosa AM, Jiménez-Vacas JM, Ruiz-García J, Valero-Rosa J, Luque RM, Requena-Tapia MJ. Clinical association of metabolic syndrome, C-reactive protein and testosterone levels with clinically significant prostate cancer. J Cell Mol Med 2018; 23:934-942. [PMID: 30450757 PMCID: PMC6349154 DOI: 10.1111/jcmm.13994] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/16/2022] Open
Abstract
Recently, the influence that metabolic syndrome (MetS), hormonal alterations and inflammation might have on prostate cancer (PCa) risk has been a subject of controversial debate. Herein, we aimed to investigate the association between MetS‐components, C‐reactive protein (CRP) and testosterone levels, and the risk of clinically significant PCa (Sig‐PCa) at the time of prostate biopsy. For that, men scheduled for transrectal ultrasound guided biopsy of the prostate were studied. Clinical, laboratory parameters and criteria for MetS characterization just before the biopsy were collected. A total of 524 patients were analysed, being 195 (37.2%) subsequently diagnosed with PCa and 240 (45.8%) meet the diagnostic criteria for MetS. Among patients with PCa, MetS‐diagnosis was present in 94 (48.2%). Remarkably, a higher risk of Sig‐PCa was associated to MetS, greater number of MetS‐components and higher CRP levels (odds‐ratio: 1.83, 1.30 and 2.00, respectively; P < 0.05). Moreover, higher circulating CRP levels were also associated with a more aggressive Gleason score in PCa patients. Altogether, our data reveal a clear association between the presence of MetS, a greater number of MetS‐components or CRP levels >2.5 mg/L with an increased Sig‐PCa diagnosis and/or with aggressive features, suggesting that MetS and/or CRP levels might influence PCa pathophysiology.
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Affiliation(s)
- Enrique Gómez-Gómez
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Urology, Reina Sofia University Hospital, Cordoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Cordoba (UCO), Cordoba, Spain
| | - Julia Carrasco-Valiente
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Urology, Reina Sofia University Hospital, Cordoba, Spain
| | - Juan Pablo Campos-Hernández
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Urology, Reina Sofia University Hospital, Cordoba, Spain
| | | | - Juan Manuel Jiménez-Vacas
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Cordoba (UCO), Cordoba, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Madrid, Spain
| | - Jesus Ruiz-García
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Urology, Reina Sofia University Hospital, Cordoba, Spain
| | - Jose Valero-Rosa
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Urology, Reina Sofia University Hospital, Cordoba, Spain
| | - Raul Miguel Luque
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Cordoba (UCO), Cordoba, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Madrid, Spain
| | - María José Requena-Tapia
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Urology, Reina Sofia University Hospital, Cordoba, Spain
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7
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Morlacco A, Dal Moro F, Rangel LJ, Carlson RE, Schulte PJ, Jeffrey KR. Impact of metabolic syndrome on oncologic outcomes at radical prostatectomy. Urol Oncol 2018; 36:528.e1-528.e6. [PMID: 30446466 DOI: 10.1016/j.urolonc.2018.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/05/2018] [Accepted: 10/01/2018] [Indexed: 11/15/2022]
Abstract
PURPOSE The associations between metabolic syndrome (MetS) and prostate cancer (CaP) outcomes following radical prostatectomy (RP) are not clear. This study aims to understand the role of MetS in influencing oncological outcomes at RP. MATERIALS AND METHODS Patients who underwent RP for CaP at our institution from 2000 to 2010 were identified; MetS prior to RP was ascertained with a modified version of the IDF-AHA/NHLBI using ICD-9 codes. Histopathological outcomes included surgical margins, pathological stage, and Gleason score (GS) upgrading. Long-term outcomes included biochemical recurrence (BCR), local recurrence, systemic progression, and CaP-specific mortality. Multivariable adjusted logistic regression and Cox proportional hazards regression assessed the association between MetS status and histopathological and long-term outcomes, respectively. RESULTS Of 8,504 RP patients, 1,054 (12.4%) had MetS at the time of RP. MetS patients were older, had higher biopsy GS, but lower pre-op prostatic specific antigen (PSA), higher pathological GS, and larger prostate volume. Adjusted logistic regression suggested an association between MetS and positive margins (odds ratio [OR] = 1.22, P = 0.025) and GS upgrading (OR = 1.28, P = 0.002). There was evidence of an increased risk of local recurrence (hazard ratio [HR] = 1.33, P = 0.037) and CaP-specific mortality (HR = 1.58, P < 0.001) for MetS patients. There was no evidence to suggest an association with BCR or systemic progression. CONCLUSION Men with MetS are at higher risk of GS upgrade and positive surgical margins at surgery, local recurrence, and CaP-specific mortality. Pathological stage, BCR, and systemic progression were not associated with MetS. Our data may be useful in patients' counseling, especially when active surveillance is an option.
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Affiliation(s)
- Alessandro Morlacco
- Department of Urology, Mayo Clinic, Rochester, MN; Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Clinica Urologica, Università degli Studi di Padova, Padova, Italy
| | - Fabrizio Dal Moro
- Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Clinica Urologica, Università degli Studi di Padova, Padova, Italy
| | | | - Rachel E Carlson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
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8
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Fuentes-Pastor J, Pellejero P, Ortiz I, Ramírez-Backhaus M, de Gracia A, Marrugo C, Gomez-Ferrer A, Calatrava A, Rubio-Briones J, Rodriguez-Torreblanca C, Solsona-Narbón E. Association between late-onset hypogonadism syndrome plus metabolic syndrome and prostate cancer and its aggressiveness. Actas Urol Esp 2016; 40:440-5. [PMID: 27091367 DOI: 10.1016/j.acuro.2016.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 02/07/2016] [Accepted: 02/08/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess the relationship between prostate cancer (PC) and the presence of metabolic syndrome and late-onset hypogonadism (LOH) syndrome. MATERIAL AND METHOD A retrospective study was conducted on 686 patients who underwent prostate biopsy. We analysed the demographic variables, clinical data and biopsy results. To diagnose metabolic syndrome, we employed the criteria of the American Heart Association. For the diagnosis of LOH syndrome, we employed the Androgen Deficiency in the Aging Male questionnaire and testosterone levels (TT). We evaluated the relationship between free testosterone (FT) and bioavailable testosterone (BT) on one hand and PC and its aggressiveness on the other, as well as the usefulness of the TT to prostate specific antigen (TT/PSA) ratio in the PC diagnosis. RESULTS The patient's median age was 65 years. Metabolic syndrome is not associated with PC (39.4% vs. 35%; P=.1) but is associated with a PC Gleason score >7 (50.4% vs. 29.44%; P=.002). LOH, low FT and low BT are associated with an increased presence of PC (51% vs. 35%, P=.02; 44.86% vs. 33.33%, P=.03; and 46.46% vs. 33.08%, P=.01, respectively) and with an increased probability of a PC Gleason score >7 (61.54% vs. 37.5%, P=.02; 54.17% vs. 34.12%, P=.02; 54.35% vs. 34.48%, P=.02, respectively). Additionally, the median TT/PSA ratio was significantly lower in patients with positive biopsies (P=.022). CONCLUSIONS Metabolic syndrome was not associated with the probability of having PC but was associated with a PC Gleason score >7. Moreover, LOH syndrome had a higher percentage of PC and a greater presence of PC Gleason scores >7, as did low levels of FT and low levels of BT.
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Affiliation(s)
- J Fuentes-Pastor
- Servicio de Urología, Hospital Universitario de Marqués de Valdecilla (HUMV), Santander, España
| | - P Pellejero
- Servicio de Urología, Hospital Universitario Central de Asturias (HUCA), Oviedo, España
| | - I Ortiz
- Departamento de Matemática Aplicada, Universidad de Almería, Almería, España
| | - M Ramírez-Backhaus
- Servicio de Urología, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España.
| | - A de Gracia
- Servicio de Urología, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España
| | - C Marrugo
- Servicio de Urología, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España
| | - A Gomez-Ferrer
- Servicio de Urología, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España
| | - A Calatrava
- Servicio de Anatomía Patológica, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España
| | - J Rubio-Briones
- Servicio de Urología, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España
| | | | - E Solsona-Narbón
- Servicio de Urología, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España
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9
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Zhang GM, Zhu Y, Dong DH, Han CT, Gu CY, Gu WJ, Qin XJ, Sun LJ, Ye DW. The association between metabolic syndrome and advanced prostate cancer in Chinese patients receiving radical prostatectomy. Asian J Androl 2016; 17:839-44. [PMID: 25652638 PMCID: PMC4577601 DOI: 10.4103/1008-682x.148138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The global incidence of metabolic syndrome (MetS) is dramatically increasing. Considerable interest has been devoted to the relationship between MetS and prostate cancer (PCa) risk. However, few studies have examined the association between MetS and PCa progression. This retrospective study consisted of 1016 patients with PCa who received radical prostatectomy. The association between MetS and pathological features was evaluated using logistic regression analysis. Compared with patients without MetS, those with MetS indicated an increased risk of prostatectomy Gleason score (GS) ≥8 (odds ratio [OR] =1.670, 95% confidence interval (CI) 1.096–2.545, P= 0.017), and a 1.5-fold increased risk of pT3–4 disease (OR = 1.583, 95% CI 1.106–2.266, P= 0.012). The presence of MetS was an independent predictor of lymph node involvement (OR = 1.751, 95% CI 1.038–2.955, P= 0.036). Furthermore, as the number of MetS components accumulated, the risk of a GS ≥ 8 increased. The present study indicates a significant association between MetS and advanced PCa. The results need to be evaluated in large-scale prospective cohorts.
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Affiliation(s)
| | | | | | | | | | | | | | - Li-Jiang Sun
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Ding-Wei Ye
- Department of Urology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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10
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Ozbek E, Otunctemur A, Dursun M, Sahin S, Besiroglu H, Koklu I, Erkoc M, Danis E, Bozkurt M. The metabolic syndrome is associated with more aggressive prostate cancer. Asian Pac J Cancer Prev 2016; 15:4029-32. [PMID: 24935591 DOI: 10.7314/apjcp.2014.15.9.4029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The aim of this study was to analyze any association between the metabolic syndrome (MetS) and risk of prostate cancer (PCa) and cancer grade among men undergoing radical prostatectomy for PCa. MATERIALS AND METHODS 50 patients with MetS and 50 patients without MetS who undervent radical prostatectomy (RP) were included in the study. Age at biopsy, height, weight, digital rectal examination (DRE), pre-biopsy PSA levels, prostate volume, histopathologic diagnosis after surgery and Gleason scores were collected data from all patients. Histologic material obtained at biopsy was given a Gleason score; tumours with a Gleason score ≥7 were considered high grade and <7 were considered low grade. RESULTS The mean age at the time of biopsy was 63.7 ± 5.94 in patients with MetS and 61.6 ± 6.14 in patients without MetS. Men with MetS had significantly lower PSA levels (p=0.01) (7.21 ± 2.74 and 8.81 ± 2.72, respectively). Also, the men with MetS had higher RP tumor grade (p=0.04). CONCLUSIONS Men with MetS undergoing RP have lower PSA levels and have significantly higher grade PCa. We must be careful for screening PCa in patients with MetS. Although the patients had lower PSA levels, they may have high grade disease.
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Affiliation(s)
- Emin Ozbek
- Okmeydani Training and Research Hospital, Department of Urology, Istanbul, Turkey E-mail :
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Treviño S, Aguilar-Alonso P, Flores Hernandez JA, Brambila E, Guevara J, Flores G, Lopez-Lopez G, Muñoz-Arenas G, Morales-Medina JC, Toxqui V, Venegas B, Diaz A. A high calorie diet causes memory loss, metabolic syndrome and oxidative stress into hippocampus and temporal cortex of rats. Synapse 2015; 69:421-433. [PMID: 26073877 DOI: 10.1002/syn.21832] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/20/2015] [Accepted: 06/08/2015] [Indexed: 12/04/2024]
Abstract
A high calorie intake can induce the appearance of the metabolic syndrome (MS), which is a serious public health problem because it affects glucose levels and triglycerides in the blood. Recently, it has been suggested that MS can cause complications in the brain, since chronic hyperglycemia and insulin resistance are risk factors for triggering neuronal death by inducing a state of oxidative stress and inflammatory response that affect cognitive processes. This process, however, is not clear. In this study, we evaluated the effect of the consumption of a high-calorie diet (HCD) on both neurodegeneration and spatial memory impairment in rats. Our results demonstrated that HCD (90 day consumption) induces an alteration of the main energy metabolism markers, indicating the development of MS in rats. Moreover, an impairment of spatial memory was observed. Subsequently, the brains of these animals showed activation of an inflammatory response (increase in reactive astrocytes and interleukin1-β as well as tumor necrosis factor-α) and oxidative stress (reactive oxygen species and lipid peroxidation), causing a reduction in the number of neurons in the temporal cortex and hippocampus. Altogether, these results suggest that a HCD promotes the development of MS and contributes to the development of a neurodegenerative process and cognitive failure. In this regard, it is important to understand the relationship between MS and neuronal damage in order to prevent the onset of neurodegenerative disorders.
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Affiliation(s)
- Samuel Treviño
- Facultad de Ciencias Químicas, Departamento de Análisis Clínicos, Benemérita Universidad Autónoma de Puebla, CP 72570, Puebla, Mexico
| | - Patrícia Aguilar-Alonso
- Facultad de Ciencias Químicas, Departamento de Bioquímica, Benemérita Universidad Autónoma de Puebla, CP 72570, Puebla, Mexico
| | - Jose Angel Flores Hernandez
- Facultad de Ciencias Químicas, Departamento de Análisis Clínicos, Benemérita Universidad Autónoma de Puebla, CP 72570, Puebla, Mexico
| | - Eduardo Brambila
- Facultad de Ciencias Químicas, Departamento de Análisis Clínicos, Benemérita Universidad Autónoma de Puebla, CP 72570, Puebla, Mexico
| | - Jorge Guevara
- Facultad de Medicina, Departamento de Bioquímica, Universidad Nacional Autónoma de México, CP 04510, DF, Mexico
| | - Gonzalo Flores
- Laboratorio de Neuropsiquiatría, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, CP 72570, Puebla, Mexico
| | - Gustavo Lopez-Lopez
- Facultad de Ciencias Químicas, Departamento de Farmacia, Benemérita Universidad Autónoma de Puebla, CP 72570, Puebla, Mexico
| | - Guadalupe Muñoz-Arenas
- Facultad de Ciencias Químicas, Departamento de Farmacia, Benemérita Universidad Autónoma de Puebla, CP 72570, Puebla, Mexico
| | - Julio Cesar Morales-Medina
- Centro de Investigación en Reproducción Animal, CINVESTAV, Universidad Autónoma de Tlaxcala, Tlaxcala de Xicohténcatl, Mexico
| | - Veronica Toxqui
- Facultad de Ciencias Químicas, Departamento de Análisis Clínicos, Benemérita Universidad Autónoma de Puebla, CP 72570, Puebla, Mexico
- Laboratorio Experimental de Enfermedades Neurodegenerativas, INNN-MVS, CP14269, Mexico DF, Mexico
| | - Berenice Venegas
- Laboratorio de Biologia y Toxicologia de la Reproduccion Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, CP.72570, Puebla, Mexico
| | - Alfonso Diaz
- Facultad de Ciencias Químicas, Departamento de Farmacia, Benemérita Universidad Autónoma de Puebla, CP 72570, Puebla, Mexico
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Sanchís-Bonet A, Ortiz-Vico F, Morales-Palacios N, Sánchez-Chapado M. The association between metabolic syndrome and prostate cancer: Effect on its aggressiveness and progression. Actas Urol Esp 2015; 39:154-60. [PMID: 25454266 DOI: 10.1016/j.acuro.2014.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 09/29/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To evaluate the impact of metabolic syndrome and its individual components on prostate biopsy findings, the radical prostatectomy specimen and on biochemical recurrence. MATERIAL AND METHODS An observational study was conducted of 1319 men who underwent prostate biopsy between January 2007 and December 2011. The impact on the biopsy findings, the radical prostatectomy specimen and biochemical recurrence was evaluated using logistic regression and Cox regression. RESULTS Of the 1319 patients, 275 (21%) had metabolic syndrome, and 517 prostate cancers were diagnosed. A greater percentage of metabolic syndrome was found among patients with prostate cancer than among patients without prostate cancer (25% vs. 18%; P=.002). Poorer results were found in the radical prostatectomy specimens (Gleason score ≥ 7, P<.001; stage ≥ T2c, P<.001; positive surgical margins, P<.001), and there was a greater percentage of biochemical recurrence in patients with metabolic syndrome than in those without metabolic syndrome (24% vs. 13%; P=.003). Metabolic syndrome behaved as an independent predictive factor of finding a Gleason score ≥ 7 for the specimen, as well as for finding a specimen stage ≥ T2c. Metabolic syndrome was also able to independently predict a greater rate of biochemical recurrence (OR: 3.6, P<.001; OR: 3.2, P=.03; HR: 1.7; respectively). CONCLUSIONS Metabolic syndrome is associated with poorer findings in the radical prostatectomy specimens and is an independent prognostic factor of biochemical recurrence.
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Telli O, Sarici H, Ekici M, Ozgur BC, Doluoglu OG, Eroglu M, Telli TA. Does metabolic syndrome or its components associate with prostate cancer when diagnosed on biopsy? Ther Adv Med Oncol 2015; 7:63-7. [PMID: 25755679 DOI: 10.1177/1758834014560158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To investigate the association between metabolic syndrome and prostate cancer risk in Turkish men. METHODS We examined data from 220 patients with prostate cancer and 234 men in a control group with benign biopsy results, who had a serum prostate-specific antigen (PSA) level ⩾ 4 ng/ml, or an abnormal digital rectal examination finding and who underwent transrectal ultrasound-guided prostate biopsy at two main training and research hospitals between February 2009 and April 2013. Metabolic syndrome was diagnosed according to The Society of Endocrinology and Metabolism of Turkey metabolic-syndrome criteria. Age, total PSA, waist circumference, body mass index, lipid profiles, fasting blood sugar level, blood pressure level and metabolic syndrome were considered for analysis. RESULTS A total of 454 patients were enrolled: 85 cases in group 1 (38.6% of 220 prostate cancer cases) and 104 control subjects in group 2 (40.4% of 234 controls) were diagnosed with metabolic syndrome. Higher ages and lower high-density lipoprotein-cholesterol were two parameters that were significant only in the prostate cancer group with metabolic syndrome. There was no significant predictor factor for prostate cancer alone; however, higher triglycerides (odds ratio [OR], 1.286; 95% confidence interval [CI] 1.09-1.82 and 1.142; 95% CI 1.06-1.62) and fasting glucose levels (OR, 1.222; 95% CI 1.08-1.61 and 1.024; 95% CI 1.07-1.82) were significant predictors in both the prostate cancer group and control group. CONCLUSIONS We found little evidence to support the hypothesis that increased incidence of metabolic syndrome (or its components) contributes to increased incidence of prostate cancer. A larger, prospective, multicentre investigation is mandatory to confirm if there is any relationship between metabolic syndrome and prostate cancer.
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Affiliation(s)
- Onur Telli
- Ankara University, School of Medicine, Department of Urology Sihhiye 06100 Ankara, Turkey
| | - Hasmet Sarici
- Ankara Training and Research Hospital, Urology Clinic, Ankara, Turkey
| | - Musa Ekici
- Diskapi Yildirim Bayezit Training and Research Hospital, Urology Clinic, Ankara, Turkey
| | - Berat Cem Ozgur
- Ankara Training and Research Hospital, Urology Clinic, Ankara, Turkey
| | | | - Muzaffer Eroglu
- Ankara Training and Research Hospital, Urology Clinic, Ankara, Turkey
| | - Tugba Akin Telli
- Hacettepe Univercity, School of Medicine, Department of Internal Medicine, Ankara, Turkey
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Strine AC, Rice KR, Masterson TA. Metabolic syndrome in the development and progression of prostate cancer. World J Clin Urol 2014; 3:168-183. [DOI: 10.5410/wjcu.v3.i3.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 06/12/2014] [Accepted: 07/14/2014] [Indexed: 02/06/2023] Open
Abstract
Prostate cancer (PCa) is the most common noncutaneous malignancy and second leading cause of cancer-specific mortality for men in the United States. There is a wide spectrum of aggressiveness ranging from biologically significant to indolent disease, which has led to an interest in the identification of risk factors for its development and progression. Emerging evidence has suggested an association between metabolic syndrome (MetS) and PCa. MetS represents a cluster of metabolic derangements that confer an increased risk of cardiovascular disease and type 2 diabetes mellitus. Its individual components include obesity, dyslipidemias, high blood pressure, and high fasting glucose levels. MetS has become pervasive and is currently associated with a high socioeconomic cost in both industrialized and developing countries throughout the world. The relationship between MetS and PCa is complex and yet to be fully defined. A better understanding of this relationship will facilitate the development of novel therapeutic targets for the prevention of PCa and improvement of outcomes among diagnosed men in the future. In this review, we evaluate the current evidence on the role of MetS in the development and progression of PCa. We also discuss the clinical implications on the management of PCa and consider the future direction of this subject.
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Obesity affects the biopsy-mediated detection of prostate cancer, particularly high-grade prostate cancer: a dose-response meta-analysis of 29,464 patients. PLoS One 2014; 9:e106677. [PMID: 25184215 PMCID: PMC4153672 DOI: 10.1371/journal.pone.0106677] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 07/31/2014] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVES In previous studies, obesity (measured according to the body mass index) has correlated inconsistently with the risk of biopsy-measured prostate cancer, and specifically high-grade prostate cancer. This meta-analysis aimed to clarify these correlations. METHODS A comprehensive literature search of the MEDLINE and EMBASE databases was conducted for relevant studies published through January 2014. The pooled estimates of odds ratios (OR) and confidence intervals (CI) were computed, and the meta-analysis was performed with the STATA software according to a random effects approach. RESULTS A total of 11 studies that included 29,464 individuals were identified. A 5-kg/m2 increase in body mass index was associated with a 15% (OR, 1.15; 95% CI, 0.98-1.34) higher risk of prostate cancer detection and a 37% (OR, 1.37; 95% CI, 1.19-1.57) higher risk of high-grade prostate cancer detection at biopsy. There were no differences among the results of studies conducted in the USA, Europe or Asia. We also found that studies that had adjusted for prostate-specific antigen levels, digital rectal examination results, and prostate volumes obtained positive significant outcomes (OR, 1.27; 95% CI, 1.12-1.44), whereas studies that did not adjust for the above-mentioned confounding variables obtained negative results (OR, 0.92; 95% CI, 0.68-1.25). Moreover, the positive correlation between body mass index and the detection of both prostate cancer and high-grade diseases tended to be stronger as the number of biopsy cores increased. CONCLUSION The present meta-analysis demonstrated that a high body mass index correlated positively with prostate cancer detection, especially high-grade prostate cancer detection. The adoption of a modified and possibly more aggressive biopsy strategy was suggested for obese populations.
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Visceral obesity predicts adverse pathological features in urothelial bladder cancer patients undergoing radical cystectomy: a retrospective cohort study. World J Urol 2013; 32:559-64. [PMID: 23942944 DOI: 10.1007/s00345-013-1147-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 08/03/2013] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To evaluate the pathological characteristics of patients with metabolic syndrome (MetS) undergoing radical cystectomy (RC) for urothelial bladder cancer (BCa). METHODS We retrospectively analyzed 262 consecutive patients with muscle-invasive urothelial BCa or non-muscle-invasive urothelial BCa bacillus Calmette-Guerin refractory undergoing RC with standard pelvic lymphadenectomy. The patients were stratified into those with or without MetS, and a bivariate logistic regression analysis was done to assess MetS and, separately, each single MetS component as independent predictors of higher pathological stage as well as of the presence of lymph vascular invasion (LVI) and lymph node metastasis (LM). RESULTS Metabolic syndrome was found in 36.3 % of patients. At logistic regression analysis, the presence of MetS did not predict the risk of both higher pathological stage and LVI and LM. Investigating the single components of MetS after adjusting for age, gender, and smoking, the risk of higher pathological stage increased with body mass index [BMI (OR 1.307, 95 % CI 1.098-1.555)], waist circumference (OR 1.414, 95 % CI 1.364-1.668), and blood hypertension (OR 2.326, 95 % CI 1.147-4.717). Higher BMI also predicted the presence of LVI (OR 1.432, 95 % CI 1.173-1.748) and LM (OR 1.202, 95 % CI 0.951-1.519), whereas HDL cholesterol was inversely associated with the risk of LVI and LM. CONCLUSIONS Metabolic syndrome does not represent an independent risk factor for worse pathological findings in BCa. Conversely, individual components of MetS could increase the risk of higher stage as well as LM.
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Xiang YZ, Xiong H, Cui ZL, Jiang SB, Xia QH, Zhao Y, Li GB, Jin XB. The association between metabolic syndrome and the risk of prostate cancer, high-grade prostate cancer, advanced prostate cancer, prostate cancer-specific mortality and biochemical recurrence. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2013; 32:9. [PMID: 23406686 PMCID: PMC3598969 DOI: 10.1186/1756-9966-32-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 02/08/2013] [Indexed: 12/21/2022]
Abstract
Background Although a previous meta-analysis reported no association between metabolic syndrome (MetS) and prostate cancer risk, a number of studies suggest that MetS may be associated with the aggressiveness and progression of prostate cancer. However, these results have been inconsistent. This systematic review and meta-analysis investigated the nature of this association. Methods We systematically searched MEDLINE, EMBASE and bibliographies of retrieved studies up to January 2013 using the keywords “metabolic syndrome” and “prostate cancer”. We assessed relative risks (RRs) of the prostate cancer, several parameters of prostate cancer aggressiveness and progression associated with MetS using 95% confidence intervals (95% CIs). Results The literature search produced 547 hits from which 19 papers were extracted for the meta-analysis. In cancer-free population with and without MetS, the combined adjusted RR (95% CI) of prostate cancer risk and prostate cancer-specific mortality in longitudinal cohort studies is 0.96 (0.85 ~ 1.09) and 1.12 (1.02 ~ 1.23) respectively. In the prostate cancer patients with and without MetS, the combined unadjusted OR (95% CI) of high grade Gleason prostate cancer is 1.44 (1.20 ~ 1.72), the OR of advanced prostate cancer is 1.37 (1.12 ~ 1.68) and the OR of biochemical recurrence is 2.06 (1.43 ~ 2.96). Conclusions The overall analyses revealed no association between MetS and prostate cancer risk, although men with MetS appear more likely to have high-grade prostate cancer and more advanced disease, were at greater risk of progression after radical prostatectomy and were more likely to suffer prostate cancer-specific death. Further primary studies with adjustment for appropriate confounders and larger, prospective, multicenter investigations are required.
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Affiliation(s)
- Yu-zhu Xiang
- Minimally Invasive Urology Center, Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China
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