Metabolic syndrome in the development and progression of prostate cancer

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.

Keywords: Diabetes mellitus; Dyslipidemias; Humans; Hyperglycemia; Hypertension; Insulin resistance; Male; Metabolic syndrome X; Obesity; Prostatic neoplasms

Core tip: The current literature is conflicted on the association between metabolic syndrome (MetS) and prostate cancer (PCa), although several studies have demonstrated that men with MetS or its individual components may have an increased risk of more aggressive disease and mortality as well as a poorer outcome after their treatment for PCa. These men may benefit from weight loss, physical activity, and the addition of medications like statins for preventing PCa and improving their outcomes after treatment. A majority of the existing evidence is retrospective or observational in nature, which underscores the need for more randomized controlled trials in the future.