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Tian HY, Yang M, Xie HL, Ruan GT, Ge YZ, Zhang XW, Zhang HY, Liu CA, Liu T, Shi HP. The effect of hyperlipidemia on overall survival in patients with cancer was differentiated by BMI and hyperlipidemia type. Nutr Metab (Lond) 2024; 21:37. [PMID: 38914993 PMCID: PMC11197256 DOI: 10.1186/s12986-024-00811-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND AND AIMS The impact of lipids on the overall survival (OS) of patients with malignancy has not yet been clarified. This study aimed to evaluate the effect of hyperlipidemia on the OS among Chinese patients based on Body Mass Index (BMI) stratifications and hyperlipidemia types. METHOD The patients in this study were derived from the Investigation of the Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) trial. Kaplan-Meier was used to draw the survival curve, and the log-rank test was used to estimate the survival rates between each group. Cox proportional hazards regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI). RESULTS A total of 9054 patients were included in the final study, with a median age of 59 years, and 55.3% (5004) of them were males. Regarding types of hyperlipidemia, only low high-density lipoprotein was an independent risk factor for the prognosis of all patients (HR = 1.35, 95% CI: 1.25-1.45, P < 0.001), while high total cholesterol (HR = 1.01, 95% CI: 0.90-1.15, P = 0.839) and high low-density lipoprotein (HR = 1.03, 95%CI: 0.91-1.16, P = 0.680) were not. In terms of BMI stratification, the effect of triglycerides on prognosis varied; high triglycerides were an independent risk factor for the prognosis of underweight patients (HR = 1.56, 95% CI:1.05-2.32, P = 0.027) and a protective factor for overweight patients (HR = 0.75, 95% CI: 0.63-0.89, P = 0.001). However, for normal-weight patients, there was no significant statistical difference (HR = 0.88, 95%CI: 0.75-1.03, P = 0.108). CONCLUSIONS The impact of hyperlipidemia on the OS among patients with cancer varied by different BMI and hyperlipidemia types. BMI and hyperlipidemia type ought to be considered in combination to estimate the prognosis of patients with malignancy.
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Affiliation(s)
- Hai-Ying Tian
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ming Yang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Hai-Lun Xie
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Yi-Zhong Ge
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Xiao-Wei Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - He-Yang Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Chen-An Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Tong Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China.
- National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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Pagano AP, da Silva BR, Vieira FT, Meira Filho LF, Purcell SA, Lewis JD, Mackenzie ML, Robson PJ, Vena JE, Silva FM, Prado CM. Association Between Diabetes and Risk of Prostate Cancer: A Systematic Review and Meta-Analysis of Observational Studies. World J Mens Health 2024; 42:42.e64. [PMID: 39028128 DOI: 10.5534/wjmh.240022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/26/2024] [Accepted: 04/09/2024] [Indexed: 07/20/2024] Open
Abstract
PURPOSE Metabolic diseases such as diabetes mellitus may play a role in the development and progression of prostate cancer (PC); however, this association remains to be explored in the context of specific PC stages. The objective of this study was to systematically review the evidence for an association between diabetes and overall, early, or advanced PC risk. MATERIALS AND METHODS A systematic review with meta-analysis was performed (MEDLINE, EMBASE, and CINAHL) from inception until September 2023. Cohort and case-control studies that assessed PC risk in adult males (≥18 years) associated with type 2 diabetes mellitus or diabetes (if there was no distinction between diabetes type) were included. The Newcastle-Ottawa Scale (NOS) was used to assess study bias; those with NOS<7 were excluded. Evidence certainty was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method. RESULTS Thirty-four studies (n=26 cohorts and n=8 case-controls) were included. Of these, 32 assessed diabetes and all PC stages combined, 12 included early PC stages, and 15 included advanced PC stages. Our meta-analysis showed diabetes had a protective effect against early PC development (n=11, risk ratio [RR]=0.71; 95% confidence interval [CI]=0.61-0.83, I²=84%) but no association was found for combined (n=21, RR=0.95; 95% CI=0.79-1.13, I²=99%) or advanced PC stages (n=15, RR=0.96; 95% CI=0.77-1.18, I²=98%) at diagnosis. According to GRADE, the evidence certainty was very low. CONCLUSIONS Diabetes may be protective against early PC stages, yet evidence linking diabetes to risk across all stages, and advanced PC specifically, is less conclusive. High heterogeneity may partially explain discrepancy in findings and was mostly associated with study design, method used for PC diagnosis, and risk measures. Our results may aid risk stratification of males with diabetes and inform new approaches for PC screening in this group, especially considering the reduced sensitivity of prostate-specific antigen values for those with diabetes.
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Affiliation(s)
- Ana Paula Pagano
- Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Bruna Ramos da Silva
- Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Flávio Teixeira Vieira
- Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Luiz Fernando Meira Filho
- Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Sarah A Purcell
- Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
- Division of Endocrinology, Metabolism, and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John D Lewis
- Department of Experimental Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle L Mackenzie
- Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Paula J Robson
- Cancer Care Alberta and the Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
- Alberta's Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Flávia Moraes Silva
- Nutrition Department and Nutrition Science Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
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Shen T, Zhao J, Li W, Wang X, Gao Y, Wang Z, Hu S, Cai J. Hypertension and hyperglycaemia are positively correlated with local invasion of early cervical cancer. Front Endocrinol (Lausanne) 2023; 14:1280060. [PMID: 38152132 PMCID: PMC10752498 DOI: 10.3389/fendo.2023.1280060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023] Open
Abstract
Background Metabolic disorders are involved in the development of numerous cancers, but their association with the progression of cervical cancer is unclear. This study aims to investigate the association between metabolic disorders and the pathological risk factors and survival in patients with early cervical cancer. Methods Patients with FIGO IB1 (2009) primary cervical cancer who underwent radical hysterectomy and systematic pelvic lymph node dissection at our institution from October 2014 to December 2017 were included retrospectively. Clinical data regarding the metabolic syndrome and surgical pathology of the patient were collected. The correlations between metabolic disorders (hypertension, hyperglycemia, and obesity) and clinicopathological characteristics as well as survival after surgery were analyzed. Results The study included 246 patients with clinical IB1 cervical cancer, 111 (45.1%) of whom had at least one of the comorbidities of hypertension, obesity, or hyperglycemia. Hypertension was positively correlated with parametrial invasion and poorly differentiated histology; hyperglycemia was positively correlated with stromal invasion; obesity was negatively associated with lymph node metastasis; but arbitrary disorder did not show any correlation with pathologic features. Hypertension was an independent risk factor for parametrial invasion (OR=6.54, 95% CI: 1.60-26.69); hyperglycemia was an independent risk factor for stromal invasion (OR=2.05, 95% CI: 1.07-3.95); and obesity was an independent protective factor for lymph node metastasis (OR=0.07, 95% CI: 0.01-0.60). Moreover, the patients with hypertension had a significantly lower 5-year OS rate (70.0% vs. 95.3%, P<0.0001) and a significantly lower 5-year PFS rate than those without hypertension (70.0% vs. 91.2%, P=0.010). Conclusion Hypertension and hyperglycemia are positively associated with local invasion of early cervical cancer, which need to be verified in multi-center, large scale studies.
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Affiliation(s)
| | | | | | | | | | | | - Sha Hu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Cai
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Suarez Arbelaez MC, Nackeeran S, Shah K, Blachman-Braun R, Bronson I, Towe M, Bhat A, Marcovich R, Ramasamy R, Shah HN. Association between body mass index, metabolic syndrome and common urologic conditions: a cross-sectional study using a large multi-institutional database from the United States. Ann Med 2023; 55:2197293. [PMID: 37036830 PMCID: PMC10088970 DOI: 10.1080/07853890.2023.2197293] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/25/2023] [Indexed: 04/11/2023] Open
Abstract
INTRODUCTION The study aims to determine whether body mass index (BMI), metabolic syndrome (MS) or its individual components (primary hypertension, type 2 diabetes mellitus and dyslipidemias) are risk factors for common urological diseases. MATERIALS AND METHODS Cross-sectional study with data collected on February 28, 2022 from the TriNetX Research Network. Patients were divided in cohorts according to their BMI, presence of MS (BMI > 30 kg/m2, type 2 diabetes mellitus, primary hypertension and disorders of lipoprotein metabolism) and its individual components and its association with common urological conditions was determined. For each analysis, odds ratio (OR) with 95% confidence intervals were calculated. Statistical significance was assessed at p < .05. RESULTS BMI > 30 kg/m2 was associated with increased risk of lithiasis, kidney cancer, overactive bladder, male hypogonadism, benign prostatic hyperplasia, and erectile dysfunction (p < .05). On the contrary, BMI was inversely associated with ureteral, bladder and prostate cancer (p < .05). In all urological diseases, MS was the strongest risk factor, with prostate cancer (OR = 2.53) showing the weakest and male hypogonadism the strongest (OR = 13.00) associations. CONCLUSIONS MS and its individual components were significant risk factors for common urological conditions. Hence holistic approaches with lifestyle modification might prevent common urological disease.Key messagesOverall, metabolic syndrome is the strongest risk factor for all the analysed urological diseases.Abnormally high body mass index can be a risk or protective factor depending on the threshold and urological disease that are being evaluated.Metabolic syndrome and increased BMI should be considered important factors associated to the prevalence of common urological diseases.
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Affiliation(s)
| | - Sirpi Nackeeran
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Khushi Shah
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ruben Blachman-Braun
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isaac Bronson
- UMass Chann Medical School, University of Massachusetts, Amherst, MA, USA
| | - Maxwell Towe
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Abhishek Bhat
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Marcovich
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hemendra N. Shah
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Liu H, Shui IM, Keum N, Shen X, Wu K, Clinton SK, Cao Y, Song M, Zhang X, Platz EA, Giovannucci EL. Plasma total cholesterol concentration and risk of higher-grade prostate cancer: A nested case-control study and a dose-response meta-analysis. Int J Cancer 2023; 153:1337-1346. [PMID: 37306155 PMCID: PMC10527248 DOI: 10.1002/ijc.34621] [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: 12/05/2022] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/13/2023]
Abstract
Our previous publication found an increased risk of higher-grade (Gleason sum ≥7) prostate cancer for men with high total cholesterol concentration (≥200 mg/dl) in the Health Professionals Follow-up Study (HPFS). With additional 568 prostate cancer cases, we are now able to investigate this association in more detail. For the nested case-control study, we included 1260 men newly diagnosed with prostate cancer between 1993 and 2004, and 1328 controls. For the meta-analyses, 23 articles studied the relationship between total cholesterol level and prostate cancer incidence were included. Logistic regression models and dose-response meta-analysis were performed. An increased risk of higher-grade (Gleason sum ≥4 + 3) prostate cancer for high vs low quartile of total cholesterol level was observed in the HPFS (ORmultivariable = 1.56; 95% CI = 1.01-2.40). This finding was compatible with the association noted in the meta-analysis of highest vs lowest group of total cholesterol level, which suggested a moderately increased risk of higher-grade prostate cancer (Pooled RR =1.21; 95%CI: 1.11-1.32). Moreover, the dose-response meta-analysis indicated that an increased risk of higher-grade prostate cancer occurred primarily at total cholesterol levels ≥200 mg/dl, where the RR was 1.04 (95%CI: 1.01-1.08) per 20 mg/dl increase in total cholesterol level. However, total cholesterol concentration was not associated with the risk of prostate cancer overall either in the HPFS or in the meta-analysis. Our primary finding, as well as the result of the meta-analysis suggested a modest increased risk of higher-grade prostate cancer, at total cholesterol concentrations exceeding 200 mg/dl.
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Affiliation(s)
- Hui Liu
- Central Lab, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310058, China
- Department of Nutrition, Harvard School of Public Health, Boston, MA, 02115, USA
| | | | - NaNa Keum
- Department of Food Science and Biotechnology, Dongguk University, Goyang, 10326, Korea
| | - Xudan Shen
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Zhejiang University, Hangzhou, China
| | - Kana Wu
- Department of Nutrition, Harvard School of Public Health, Boston, MA, 02115, USA
| | - Steven K. Clinton
- Division of Public Health Sciences, Division of Medical Oncology, The James Cancer Hospital and The Ohio State University Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Yin Cao
- Department of Surgery, Washington University School of Medicine, St Louis, MO, 63110, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Mingyang Song
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Xuehong Zhang
- Department of Nutrition, Harvard School of Public Health, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Elizabeth A. Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, 21205, USA
| | - Edward L. Giovannucci
- Department of Nutrition, Harvard School of Public Health, Boston, MA, 02115, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, 02115, USA
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Marrone MT, Prizment AE, Couper D, Butler KR, Astor BC, Joshu CE, Platz EA, Mondul AM. Total-, LDL-, and HDL-cholesterol, apolipoproteins, and triglycerides with risk of total and fatal prostate cancer in Black and White men in the ARIC study. Prostate 2023. [PMID: 37154584 DOI: 10.1002/pros.24546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/21/2023] [Accepted: 04/21/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Cholesterol reduction is considered a mechanism through which cholesterol-lowering drugs including statins are associated with a reduced aggressive prostate cancer risk. While prior cohort studies found positive associations between total cholesterol and more advanced stage and grade in White men, whether associations for total cholesterol, low (LDL)- and high (HDL)-density lipoprotein cholesterol, apolipoprotein B (LDL particle) and A1 (HDL particle), and triglycerides are similar for fatal prostate cancer and in Black men, who experience a disproportionate burden of total and fatal prostate cancer, is unknown. METHODS We conducted a prospective study of 1553 Black and 5071 White cancer-free men attending visit 1 (1987-1989) of the Atherosclerosis Risk in Communities Study. A total of 885 incident prostate cancer cases were ascertained through 2015, and 128 prostate cancer deaths through 2018. We estimated multivariable-adjusted hazard ratios (HRs) of total and fatal prostate cancer per 1-standard deviation increments and for tertiles (T1-T3) of time-updated lipid biomarkers overall and in Black and White men. RESULTS Greater total cholesterol concentration (HR per-1 SD = 1.25; 95% CI = 1.00-1.58) and LDL cholesterol (HR per-1 SD = 1.26; 95% CI = 0.99-1.60) were associated with higher fatal prostate cancer risk in White men only. Apolipoprotein B was nonlinearly associated with fatal prostate cancer overall (T2 vs. T1: HR = 1.66; 95% CI = 1.05-2.64) and in Black men (HR = 3.59; 95% CI = 1.53-8.40) but not White men (HR = 1.13; 95% CI = 0.65-1.97). Tests for interaction by race were not statistically significant. CONCLUSIONS These findings may improve the understanding of lipid metabolism in prostate carcinogenesis by disease aggressiveness, and by race while emphasizing the importance of cholesterol control.
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Affiliation(s)
- Michael T Marrone
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Anna E Prizment
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota, USA
- University of Minnesota Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - David Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Kenneth R Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Brad C Astor
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
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7
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Lin E, Garmo H, Hagström E, Van Hemelrijck M, Adolfsson J, Stattin P, Zethelius B, Crawley D. Association between atherogenic lipids and GnRH agonists for prostate cancer in men with T2DM: a nationwide, population-based cohort study in Sweden. Br J Cancer 2023; 128:814-824. [PMID: 36522475 PMCID: PMC9977763 DOI: 10.1038/s41416-022-02091-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 11/15/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Gonadotropin-releasing hormone agonists (GnRH) used in prostate cancer (PCa) are associated with atherogenic dyslipidaemia. It can be assumed that GnRH need to be used with greater caution in men with type 2 diabetes mellitus (T2DM). This study investigated association of GnRH with atherogenic lipids (AL) in PCa men with T2DM. METHODS Two cohorts including 38,311 men with 11 years follow-up based on Swedish national registers were defined (PCa-Exposure cohort and GnRH-Exposure cohort). Based on European guidelines on cardiovascular diseases (CVD), primary outcomes were defined as: 1.0 mmol/L increase in AL and lipid-lowering therapy (LLT) intensification. We used Cox proportional-hazards models and Kaplan-Meier curves to assess the association. RESULTS There was an association between GnRH and increased AL (i.e., triglyceride, PCa-Exposure cohort: HR 1.77, 95% CI 1.48-2.10; GnRH-Exposure cohort: HR 1.88, 95% CI 1.38-2.57). There was also an association between PCa diagnosis and increased AL. In contrast, no association between LLT intensification and GnRH was found. CONCLUSION In this large population-based study, men with T2DM on GnRH for PCa had an increased risk of increased atherogenic lipids. These results highlight the need to closely monitor lipids and to be ready to intensify lipid-lowering therapy in men with T2DM on GnRH for PCa.
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Affiliation(s)
- E Lin
- School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), King's College London, London, UK.
| | - Hans Garmo
- School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), King's College London, London, UK.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Emil Hagström
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.,Uppsala Clinical Research Centre, Uppsala, Sweden
| | - Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), King's College London, London, UK
| | - Jan Adolfsson
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Björn Zethelius
- Department of Public Health/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Danielle Crawley
- School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), King's College London, London, UK
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8
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Zheng D, Yang J, Qian J, Jin L, Huang G. Fibrinogen-to-Neutrophil Ratio as a New Predictor of Central Lymph Node Metastasis in Patients with Papillary Thyroid Cancer and Type 2 Diabetes Mellitus. Cancer Manag Res 2022; 14:3493-3505. [PMID: 36573167 PMCID: PMC9789701 DOI: 10.2147/cmar.s366270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/23/2022] [Indexed: 12/24/2022] Open
Abstract
Background Many patients have a higher risk of thyroid cancer if they have both papillary thyroid carcinoma (PTC) and Type 2 diabetes mellitus (T2DM). Meanwhile, the primary reason for local PTC recurrence is cervical lymph node metastasis. Therefore, the prognosis of patients affects how cervical lymph nodes are managed during surgery. Due to surgical complications such as laryngeal nerve palsy and hypocalcemia, it is still debatable whether to prevent central lymph node dissection (CLND). Predicting central lymph node metastasis (CLNM) is crucial to direct CLND. It is unclear how important the fibrinogen-to-neutrophil ratio (FNR) is in thyroid cancer, so we looked into how it might help patients with PTC and T2DM predict CLNM. Patients and methods Wenzhou Medical University's First Affiliated Hospital provided us with 413 patients with PTC and T2DM, randomly divided into a training set (N = 292) and a validation set (N = 121). Univariate and multivariate logistic regression analyses were used to identify independent risk factors. After constructing a nomogram, the validity of the model was evaluated. Results The maximum tumor diameter, high-density lipoprotein, thyroxine, triglyceride, lymphocyte, and FNR were all identified as independent risk factors by multivariate logistic regression analysis. The C index of the training set was 0.775, and the validation set was 0.654. Conclusion In patients with PTC and T2DM, preoperative FNR was an independent risk factor for CLNM.
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Affiliation(s)
- Danni Zheng
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Jiawen Yang
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Jiali Qian
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Lingli Jin
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China,Correspondence: Lingli Jin, Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Nanbaixiang Street, Ouhai District, Wenzhou, Zhejiang, People’s Republic of China, Tel +86 577 5557 8527, Email
| | - Guanli Huang
- Department of Breast and Thyroid Surgery Department, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, People’s Republic of China,Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China,Guanli Huang, Department of Breast and Thyroid Surgery Department, The Quzhou Affiliated Hospital of Wenzhou Medical University Quzhou People’s Hospital, Kecheng District, Minjiang Avenue No. 100, Quzhou, Zhejiang, People’s Republic of China, Tel +86 570 8895 120, Email
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9
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Lavalette C, Cordina-Duverger E, Rébillard X, Lamy PJ, Trétarre B, Cénée S, Menegaux F. Diabetes, metabolic syndrome and prostate cancer risk: Results from the EPICAP case-control study. Cancer Epidemiol 2022; 81:102281. [PMID: 36279644 DOI: 10.1016/j.canep.2022.102281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/30/2022] [Accepted: 10/17/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Diabetes may be associated with decreased prostate cancer (PCa) risk. However, previous studies have not always accounted for time since diabetes diagnosis or antidiabetic drug use. Futhermore, the role of metabolic syndrome (MetS) in PCa risk is still debated. We investigated the role of diabetes and MetS in PCa risk based on data from the Epidemiological study of PCa (EPICAP). METHODS EPICAP is a population-based case-control study that included 819 incident PCa cases in 2012-2013 and 879 controls frequency matched by age. MetS was characterized according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Logistic regression models adjusted for age, family history of PCa and ethnicity, were used to assess odds ratios (ORs) and their 95%conficence intervals (CIs) for the associations between diabetes, MetS and PCa risk. RESULTS Whereas we did not observed an association between diabetes and PCa, a decreased risk of PCa has been highlighted with an increasing treated diabetes duration (p-trend=0.008). No association has been observed between MetS, the number of MetS criteria and the risk of PCa. However, we suggested that NSAIDs use could modify the association between MetS and PCa risk. CONCLUSION Our results suggest an inverse association between the duration of diabetes and PCa risk. The role of metabolic factors, such as MetS and its components, in PCa risk remains unclear and requires further investigations.
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Affiliation(s)
- Céline Lavalette
- Université Paris-Saclay, UVSQ, Inserm, CESP, Exposome and Heredity Team, Villejuif, France
| | | | | | - Pierre-Jean Lamy
- Service Urologie, Clinique Beau Soleil, Montpellier, France; Institut médical d'Analyse Génomique-Imagenome, Labosud, Montpellier, France
| | - Brigitte Trétarre
- Registre des Tumeurs de l'Hérault, EA 2415, ICM, Montpellier, France
| | - Sylvie Cénée
- Université Paris-Saclay, UVSQ, Inserm, CESP, Exposome and Heredity Team, Villejuif, France
| | - Florence Menegaux
- Université Paris-Saclay, UVSQ, Inserm, CESP, Exposome and Heredity Team, Villejuif, France.
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10
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Murdock DJ, Sanchez RJ, Mohammadi KA, Fazio S, Geba GP. Serum cholesterol and the risk of developing hormonally driven cancers: A narrative review. Cancer Med 2022; 12:6722-6767. [PMID: 36444895 PMCID: PMC10067100 DOI: 10.1002/cam4.5463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/18/2022] [Accepted: 11/11/2022] [Indexed: 12/02/2022] Open
Abstract
Although cholesterol has been hypothesized to promote cancer development through several potential pathways, its role in the risk of developing hormonally driven cancer is controversial. This literature review summarizes evidence from the highest quality studies to examine the consistency and strength of the relationship between serum cholesterol parameters and incidence of hormonally driven cancer. Articles were identified using EMBASE. Longitudinal observational studies published between January 2000 and December 2020 were considered for inclusion. The endpoint of interest was incident prostate, ovary, breast, endometrium, and uterine cancers. In total, 2732 reports were identified and screened; 41 studies were included in the review. No associations were found for ovarian cancer. Most endometrial cancer studies were null. The majority (76.9%) of studies reported no association between cholesterol and prostate cancer. Data on breast cancer were conflicting, associations limited, and effect sizes modest. Our results do not provide evidence for a clear association between cholesterol and different types of incident, hormonally driven reproductive cancers. Future studies should investigate the impact of lipid-lowering therapy.
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Affiliation(s)
- Dana J Murdock
- Regeneron Pharmaceuticals, Inc., Tarrytown, New York, USA
| | | | | | - Sergio Fazio
- Regeneron Pharmaceuticals, Inc., Tarrytown, New York, USA
| | - Gregory P Geba
- Regeneron Pharmaceuticals, Inc., Tarrytown, New York, USA
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11
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Connaughton M, Dabagh M. Association of Hypertension and Organ-Specific Cancer: A Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10061074. [PMID: 35742125 PMCID: PMC9222904 DOI: 10.3390/healthcare10061074] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/28/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022] Open
Abstract
Hypertension and cancer are two of the leading global causes of death. Hypertension, known as chronic high blood pressure, affects approximately 45% of the American population and is a growing condition in other parts of the world, particularly in Asia and Europe. On the other hand, cancer resulted in approximately 10 million deaths in 2020 worldwide. Several studies indicate a coexistence of these two conditions, specifically that hypertension, independently, is associated with an increased risk of cancer. In the present study, we conducted a meta-analysis initially to reveal the prevalence of hypertension and cancer comorbidity and then to assess which organ-specific cancers were associated with hypertension by calculating the summary relative risks (RRs) and 95% confidence intervals (CIs). Our analysis shows that hypertension plays a role in cancer initiation. Our extended analysis on how the hypertension-associated angiogenesis factors are linked to cancer demonstrated that matrix metalloproteinases 2 and 9 appear to be two key factors facilitating cancer in hypertensive patients. This work serves as an important step in the current assessment of hypertension-promoted increased risk of 19 different cancers, particularly kidney, renal cell carcinoma, breast, colorectal, endometrial, and bladder. These findings provide new insight into how to treat and prevent cancer in hypertensive patients.
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12
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Perez-Cornago A, Dunneram Y, Watts EL, Key TJ, Travis RC. Adiposity and risk of prostate cancer death: a prospective analysis in UK Biobank and meta-analysis of published studies. BMC Med 2022; 20:143. [PMID: 35509091 PMCID: PMC9069769 DOI: 10.1186/s12916-022-02336-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/14/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The association of adiposity with prostate cancer specific mortality remains unclear. We examined how adiposity relates to fatal prostate cancer and described the cross-sectional associations of commonly used adiposity measurements with adiposity estimated by imaging in UK Biobank. We also conducted a dose-response meta-analysis to integrate the new data with existing prospective evidence. METHODS 218,237 men from UK Biobank who were free from cancer at baseline were included. Body mass index (BMI), total body fat percentage (using bioimpedance), waist circumference (WC) and waist-to-hip ratio (WHR) were collected at recruitment. Risk of dying from prostate cancer (primary cause) by the different adiposity measurements was estimated using multivariable-adjusted Cox proportional hazards models. Results from this and other prospective cohort studies were combined in a dose-response meta-analysis. RESULTS In UK Biobank, 661 men died from prostate cancer over a mean follow-up of 11.6 years. In the subsample of participants with magnetic resonance imaging and dual-energy X-ray absorptiometry, BMI, body fat percentage and WC were strongly associated with imaging estimates of total and central adiposity (e.g. visceral fat, trunk fat). The hazard ratios (HR) for prostate cancer death were 1.07 (95% confidence interval = 0.97-1.17) per 5 kg/m2 higher BMI, 1.00 (0.94-1.08) per 5% increase in total body fat percentage, 1.06 (0.99-1.14) per 10 cm increase in WC and 1.07 (1.01-1.14) per 0.05 increase in WHR. Our meta-analyses of prospective studies included 19,633 prostate cancer deaths for BMI, 670 for body fat percentage, 3181 for WC and 1639 for WHR, and the combined HRs for dying from prostate cancer for the increments above were 1.10 (1.07-1.12), 1.03 (0.96-1.11), 1.07 (1.03-1.11), and 1.06 (1.01-1.10), respectively. CONCLUSION Overall, we found that men with higher total and central adiposity had similarly higher risks of prostate cancer death, which may be biologically driven and/or due to differences in detection. In either case, these findings support the benefit for men of maintaining a healthy body weight.
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Affiliation(s)
- Aurora Perez-Cornago
- Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, OX3 7LF Oxford, UK
| | - Yashvee Dunneram
- Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, OX3 7LF Oxford, UK
| | - Eleanor L. Watts
- Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, OX3 7LF Oxford, UK
| | - Timothy J. Key
- Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, OX3 7LF Oxford, UK
| | - Ruth C. Travis
- Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, OX3 7LF Oxford, UK
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13
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Stikbakke E, Schirmer H, Knutsen T, Støyten M, Wilsgaard T, Giovannucci EL, McTiernan A, Eggen AE, Haugnes HS, Richardsen E, Thune I. Systolic and diastolic blood pressure, prostate cancer risk, treatment, and survival. The PROCA‐
life
study. Cancer Med 2021; 11:1005-1015. [PMID: 34939344 PMCID: PMC8855905 DOI: 10.1002/cam4.4523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022] Open
Abstract
Background Inflammation has been linked to prostate cancer and hypertension, but it remains equivocal whether elevated blood pressure (BP) influence prostate cancer risk and survival. Method Using Cox regression models, we examined the association between prediagnostic BP and prostate cancer risk among 12,271 men participating in the Prostate Cancer throughout life (PROCA‐life) study. Systolic and diastolic BP were measured. A total of 811 men developed prostate cancer, and followed for additional 7.1 years, and we studied the association between prediagnostic BP and overall mortality among patients with prostate cancer. Results Men (>45 years) with a systolic BP >150 mmHg had a 35% increased risk of prostate cancer compared with men with a normal systolic BP (<130 mmHg) (HR 1.35, 95% CI 1.08–1.69). Among patients with prostate cancer, men with systolic BP >150 mmHg had a 49% increased overall mortality compared with men with a normal systolic BP (HR 1.49, 1.06–2.01). Among patients with prostate cancer treated with curative intent, those with a high diastolic BP (>90 mmHg) had a threefold increase in overall mortality risk (HR 3.01, 95% CI 1.40–6.46) compared with patients with a normal diastolic BP (<80 mmHg). Conclusion Our results support that systolic and diastolic BP are important factors when balancing disease management in patients with prostate cancer.
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Affiliation(s)
- Einar Stikbakke
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Oncology University Hospital of North Norway Tromsø Norway
| | - Henrik Schirmer
- Department of Cardiology Akershus University Hospital Lørenskog Norway
- Institute of Clinical Medicine Campus Ahus University of Oslo Oslo Norway
| | - Tore Knutsen
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Urology University Hospital of North Norway Tromsø Norway
| | - Martin Støyten
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Oncology University Hospital of North Norway Tromsø Norway
| | - Tom Wilsgaard
- Department of Community Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
| | - Edward L. Giovannucci
- Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Boston Massachusetts USA
- Departments of Nutrition and Epidemiology Harvard T.H. Chan School of Public Health Boston Massachusetts USA
| | - Anne McTiernan
- Program in Epidemiology Division of Public Health Sciences Fred Hutchinson Cancer Research Center Seattle Washington USA
- Department of Epidemiology School of Public Health, and Department of Medicine, School of Medicine University of Washington Seattle Washington USA
| | - Anne E. Eggen
- Department of Community Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
| | - Hege S. Haugnes
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Oncology University Hospital of North Norway Tromsø Norway
| | - Elin Richardsen
- Department of Medical Biology Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Department of Pathology University Hospital of North Norway Tromsø Norway
| | - Inger Thune
- Department of Clinical Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
- Department of Oncology, The Cancer Centre, Ullevaal Oslo University Hospital Oslo Norway
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14
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Choi JB, Myong JP, Lee Y, Koh JS, Hong SH, Yoon BI, Ha US. Impact of age and metabolic syndrome-like components on prostate cancer development: a nationwide population-based cohort study. Transl Androl Urol 2021; 10:2990-2997. [PMID: 34430402 PMCID: PMC8350233 DOI: 10.21037/tau-21-249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/11/2021] [Indexed: 11/06/2022] Open
Abstract
Background Because of the contradictory results, more epidemiologic data is needed to determine if metabolic syndrome is a risk factor for developing prostate cancer. This study investigated whether metabolic syndrome-like components affect the incidence of prostate cancer in a Korean population. Methods Men over 50 years of age who underwent health examinations in 2009 were followed until December 2015 (n=1,917,430) using National Health Insurance System data. Subjects were divided into three groups according to the number of metabolic syndrome-like components. The predictive accuracy of age for prostate cancer was assessed by the Youden index and multivariate adjusted Cox regression analysis was used to analyze the effect of metabolic syndrome-like components on prostate cancer development. Results The risk of prostate cancer increases with age, and the best cutoff age for prostate cancer detection was 62 years (the maximum value of the Youden index). When stratified by the number of metabolic syndrome-like components, the age with the highest Youden index of each group is still 61 or 62 years. In multivariate adjusted Cox regression analysis, there was no statistically significant difference in the incidence rate among the non-component group, the group with 1 or 2 components, and the group with ≥3 components. Conclusions The current study found that there was no statistically significant association between metabolic syndrome and prostate cancer development in a Korean population. However, results of this study should be interpreted with consideration due to several limitations including the diversity of definitions of metabolic syndrome components.
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Affiliation(s)
- Jin Bong Choi
- Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun-Pyo Myong
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yunhee Lee
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun Sung Koh
- Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung Il Yoon
- Department of Urology, International St Mary's Hospital, The Catholic Kwandong University of Korea, Incheon, Korea
| | - U-Syn Ha
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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15
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Rivera-Izquierdo M, Pérez de Rojas J, Martínez-Ruiz V, Pérez-Gómez B, Sánchez MJ, Khan KS, Jiménez-Moleón JJ. Obesity as a Risk Factor for Prostate Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of 280,199 Patients. Cancers (Basel) 2021; 13:cancers13164169. [PMID: 34439328 PMCID: PMC8392042 DOI: 10.3390/cancers13164169] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Results from individual studies on the association between obesity and prostate cancer mortality remain inconclusive; additionally, several large cohort studies have recently been conducted. We aimed to systematically review all available evidence and synthetize it using meta-analytic techniques. The results of our study showed that obesity was associated with prostate cancer specific mortality and all-cause mortality. The temporal association was consistent with a dose-response relationship. Our results demonstrated that obesity, a potentially modifiable prognostic factor, was associated with higher prostate cancer mortality. This study improved the evidence regarding the potential impact of lifestyle on improving prostate cancer prognosis. Strategies aimed at maintaining normal, or reducing abnormal, body mass index in diagnosed prostate cancer patients might improve survival. These results should guide urologists, oncologists, patients, policy-makers and primary care providers with respect to evidence-based practice and counselling concerning lifestyle changes after prostate cancer diagnosis. Abstract The aim of this study was to systematically review all evidence evaluating obesity as a prognostic factor for PC mortality. Cohort and case-control studies reporting mortality among PC patients stratified by body mass index (BMI) were included. The risk of mortality among obese patients (BMI ≥ 30) was compared with the risk for normal weight (BMI < 25) patients, pooling individual hazard ratios (HR) in random-effects meta-analyses. Reasons for heterogeneity were assessed in subgroup analyses. Dose-response associations for BMI per 5 kg/m2 change were assessed. Among 7278 citations, 59 studies (280,199 patients) met inclusion criteria. Obesity was associated with increased PC-specific mortality (HR: 1.19, 95% CI: 1.10–1.28, I2: 44.4%) and all-cause mortality (HR: 1.09, 95% CI: 1.00–1.18, I2: 43.9%). There was a 9% increase (95% CI: 5–12%, I2: 39.4%) in PC-specific mortality and 3% increase (95% CI: 1–5%, I2: 24.3%) in all-cause mortality per 5 kg/m2 increase in BMI. In analyses restricted to the higher quality subgroup (NOS ≥ 8), obesity was associated with increased PC-specific mortality (HR: 1.24, 95% CI: 1.14–1.35, I2: 0.0%) and maintained the dose-response relationship (HR: 1.11 per 5 kg/m2 increase in BMI, 95% CI: 1.07–1.15, I2: 26.6%). Obesity had a moderate, consistent, temporal, and dose-response association with PC mortality. Weight control programs may have a role in improving PC survival.
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Affiliation(s)
- Mario Rivera-Izquierdo
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Correspondence:
| | - Javier Pérez de Rojas
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
| | - Virginia Martínez-Ruiz
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
| | - Beatriz Pérez-Gómez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- National Centre for Epidemiology, Department of Epidemiology of Chronic Diseases, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María-José Sánchez
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Escuela Andaluza de Salud Pública (EASP), 18011 Granada, Spain
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
| | - José Juan Jiménez-Moleón
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (J.P.d.R.); (V.M.-R.); (M.-J.S.); (K.S.K.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
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16
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Jochems SHJ, Wood AM, Häggström C, Orho-Melander M, Stattin P, Stocks T. Waist circumference and a body shape index and prostate cancer risk and mortality. Cancer Med 2021; 10:2885-2896. [PMID: 33710775 PMCID: PMC8026929 DOI: 10.1002/cam4.3827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/12/2022] Open
Abstract
We recently found a negative association between body mass index (BMI) and the risk of localised prostate cancer (PCa), no association with advanced PCa, and a positive association with PCa‐specific mortality. In a 15% subpopulation of that study, we here investigated the measures of abdominal adiposity including waist circumference (WC) and A Body Shape Index (ABSI) in relation to PCa risk and mortality. We used data from 58,457 men from four Swedish cohorts to assess WC and ABSI in relation to PCa risk according to cancer risk category, including localised asymptomatic and symptomatic PCa and advanced PCa, and PCa‐specific mortality. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). During, on average, 10 years of follow‐up, 3290 men were diagnosed with PCa and 387 died of PCa. WC was negatively associated with the risk of total PCa (HR per 10 cm, 0.95; 95% CI 0.92–0.99), localised PCa (HR per 10 cm, 0.93, 95% CI 0.88–0.96) and localised asymptomatic PCa cases detected through a prostate‐specific antigen (PSA) test (HR per 10 cm, 0.87, 95% CI 0.81–0.94). WC was not associated with the risk of advanced PCa (HR per 10 cm, 1.02, 95% CI 0.93–1.14) or with PCa‐specific mortality (HR per 10 cm, 1.04, 95% CI 0.92–1.19). ABSI showed no associations with the risk of PCa or PCa‐specific mortality. While the negative association between WC and the risk of localised PCa was partially driven by PSA‐detected PCa cases, no association was found between abdominal adiposity and clinically manifest PCa in our population.
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Affiliation(s)
| | - Angela M Wood
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Christel Häggström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Tanja Stocks
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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17
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Monroy-Iglesias MJ, Russell B, Crawley D, Allen NE, Travis RC, Perez-Cornago A, Van Hemelrijck M, Beckmann K. Metabolic syndrome biomarkers and prostate cancer risk in the UK Biobank. Int J Cancer 2021; 148:825-834. [PMID: 33405276 DOI: 10.1002/ijc.33255] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 01/08/2023]
Abstract
We investigated the association between metabolic syndrome (MetS) and its components and risk of prostate cancer (PCa) in a cohort of men enrolled in the UK Biobank. Our study cohort included 220 622 PCa-free men with baseline measurements of triglycerides (TGs), HDL-cholesterol (HDL), glycated hemoglobin (HbA1c), blood pressure (BP), and waist circumference (WC). Multivariable Cox proportional hazards regression was used to analyze associations with PCa for: individual metabolic components (TG, HDL, HbA1c, BP, WC), combinations of two and three components, and MetS overall (three or more components). We conducted mediation analyses to examine potential hormonal and inflammatory pathways (total testosterone [TT], C-reactive protein [CRP], insulin-like growth factor 1 [IGF-1]) through which MetS components may influence PCa risk. A total of 5409 men in the study developed PCa during a median follow-up of 6.9 years. We found no significant association between MetS and PCa risk (hazard ratio [HR] = 0.99, 95% confidence interval [CI] = 0.92-1.06). No associations were found with PCa risk and individual measurements of TG, HDL, BP, or WC. However, an inverse association was observed with elevated HbA1c (≥42 mmol/mol) (HR = 0.89, 95% CI = 0.79-0.98). Consistent inverse associations were observed between HbA1c and risk of PCa. Mediation analysis revealed TT, CRP, and IGF-1 as potential mediating factors for this association contributing 10.2%, 7.1%, and 7.9% to the total effect, respectively. Overall MetS had no association with PCa risk. However, a consistent inverse association with PCa risk was found for HbA1c. This association may be explained in part through hormonal and inflammatory pathways.
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Affiliation(s)
- Maria J Monroy-Iglesias
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Danielle Crawley
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Kerri Beckmann
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
- Cancer Research Institute, University of South Australia, Adelaide, Australia
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18
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Abstract
BACKGROUND Cardio-oncology aims to mitigate adverse cardiovascular manifestations in cancer survivors, but treatment-induced hypertension or aggravated hypertension has received less attention in these high cardiovascular risk patients. METHODS In this systematic review, we searched literature for contemporary data on the prevalence, pathophysiologic mechanisms, treatment implications and preventive strategies of hypertension in patients under antineoplastic therapy. RESULTS Several classes of antineoplastic drugs, including mainly vascular endothelial growth factor inhibitors, proteasome inhibitors, cisplatin derivatives, corticosteroids or radiation therapy were consistently associated with increased odds for new-onset hypertension or labile hypertensive status in previous controlled patients. Moreover, hypertension constitutes a major risk factor for chemotherapy-induced cardiotoxicity, which is the most serious cardiovascular adverse effect of antineoplastic therapy. Despite the heterogeneity of pooled studies, the pro-hypertensive profile of examined drug classes could be attributed to common structural and functional disorders. Importantly, certain antihypertensive drugs are considered to be more effective in the management of hypertension in this population and may partially attenuate indirect complications of cancer treatment, such as progressive development of cardiomyopathy and/or cardiovascular death. Nonpharmacological approaches to alleviate hypertension in cancer patients are also described, albeit adjudicated as less effective in general. CONCLUSION A growing body of evidence suggests that multiple antineoplastic agents increase the rate of progression of hypertension. Physicians need to balance the life-saving cancer treatment and the inflated risk of adverse cardiovascular events due to suboptimal management of hypertension in order to achieve improved clinical outcomes and sustained survival for their patients.
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19
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Traughber CA, Opoku E, Brubaker G, Major J, Lu H, Lorkowski SW, Neumann C, Hardaway A, Chung YM, Gulshan K, Sharifi N, Brown JM, Smith JD. Uptake of high-density lipoprotein by scavenger receptor class B type 1 is associated with prostate cancer proliferation and tumor progression in mice. J Biol Chem 2020; 295:8252-8261. [PMID: 32358065 PMCID: PMC7294086 DOI: 10.1074/jbc.ra120.013694] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/28/2020] [Indexed: 12/30/2022] Open
Abstract
High-density lipoprotein (HDL) metabolism is facilitated in part by scavenger receptor class B, type 1 (SR-B1) that mediates HDL uptake into cells. Higher levels of HDL have been associated with protection in other diseases, however, its role in prostate cancer is not definitive. SR-B1 is up-regulated in prostate cancer tissue, suggesting a possible role of this receptor in tumor progression. Here, we report that knockout (KO) of SR-B1 in both human and mouse prostate cancer cell lines through CRISPR/Cas9-mediated genome editing reduces HDL uptake into the prostate cancer cells and reduces their proliferation in response to HDL. In vivo studies using syngeneic SR-B1 WT (SR-B1+/+) and SR-B1 KO (SR-B1-/-) prostate cancer cells in WT and apolipoprotein-AI KO (apoA1-KO) C57BL/6J mice revealed that WT hosts, containing higher levels of total and HDL-cholesterol, grew larger tumors than apoA1-KO hosts with lower levels of total and HDL-cholesterol. Furthermore, SR-B1-/- prostate cancer cells formed smaller tumors in WT hosts than SR-B1+/+ cells in the same host model. Increased tumor volume was overall associated with reduced survival. We conclude that knocking out SR-B1 in prostate cancer tumors reduces HDL-associated increases in prostate cancer cell proliferation and disease progression.
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Affiliation(s)
- C Alicia Traughber
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Emmanuel Opoku
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
| | - Gregory Brubaker
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
| | - Jennifer Major
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
| | - Hanxu Lu
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
| | - Shuhui Wang Lorkowski
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
| | - Chase Neumann
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Aimalie Hardaway
- Department of Cancer Biology, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
| | - Yoon-Mi Chung
- Department of Cancer Biology, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
| | - Kailash Gulshan
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
| | - Nima Sharifi
- Department of Cancer Biology, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
| | - J Mark Brown
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
- Center for Microbiome and Human Health, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Jonathan D Smith
- Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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20
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Genkinger JM, Wu K, Wang M, Albanes D, Black A, van den Brandt PA, Burke KA, Cook MB, Gapstur SM, Giles GG, Giovannucci E, Goodman GG, Goodman PJ, Håkansson N, Key TJ, Männistö S, Le Marchand L, Liao LM, MacInnis RJ, Neuhouser ML, Platz EA, Sawada N, Schenk JM, Stevens VL, Travis RC, Tsugane S, Visvanathan K, Wilkens LR, Wolk A, Smith-Warner SA. Measures of body fatness and height in early and mid-to-late adulthood and prostate cancer: risk and mortality in The Pooling Project of Prospective Studies of Diet and Cancer. Ann Oncol 2020; 31:103-114. [PMID: 31912782 PMCID: PMC8195110 DOI: 10.1016/j.annonc.2019.09.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 07/24/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Advanced prostate cancer etiology is poorly understood. Few studies have examined associations of anthropometric factors (e.g. early adulthood obesity) with advanced prostate cancer risk. PATIENTS AND METHODS We carried out pooled analyses to examine associations between body fatness, height, and prostate cancer risk. Among 830 772 men, 51 734 incident prostate cancer cases were identified, including 4762 advanced (T4/N1/M1 or prostate cancer deaths) cases, 2915 advanced restricted (same as advanced, but excluding localized cancers that resulted in death) cases, 9489 high-grade cases, and 3027 prostate cancer deaths. Cox proportional hazards models were used to calculate study-specific hazard ratios (HR) and 95% confidence intervals (CI); results were pooled using random effects models. RESULTS No statistically significant associations were observed for body mass index (BMI) in early adulthood for advanced, advanced restricted, and high-grade prostate cancer, and prostate cancer mortality. Positive associations were shown for BMI at baseline with advanced prostate cancer (HR = 1.30, 95% CI = 0.95-1.78) and prostate cancer mortality (HR = 1.52, 95% CI = 1.12-2.07) comparing BMI ≥35.0 kg/m2 with 21-22.9 kg/m2. When considering early adulthood and baseline BMI together, a 27% higher prostate cancer mortality risk (95% CI = 9% to 49%) was observed for men with BMI <25.0 kg/m2 in early adulthood and BMI ≥30.0 kg/m2 at baseline compared with BMI <25.0 kg/m2 in early adulthood and BMI <30.0 kg/m2 at baseline. Baseline waist circumference, comparing ≥110 cm with <90 cm, and waist-to-hip ratio, comparing ≥1.00 with <0.90, were associated with significant 14%-16% increases in high-grade prostate cancer risk and suggestive or significant 20%-39% increases in prostate cancer mortality risk. Height was associated with suggestive or significant 33%-56% risks of advanced or advanced restricted prostate cancer and prostate cancer mortality, comparing ≥1.90 m with <1.65 m. CONCLUSION Our findings suggest that height and total and central adiposity in mid-to-later adulthood, but not early adulthood adiposity, are associated with risk of advanced forms of prostate cancer. Thus, maintenance of healthy weight may help prevent advanced prostate cancer.
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Affiliation(s)
- J M Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, USA; Cancer Epidemiology Program, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA.
| | - K Wu
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - M Wang
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, USA; Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, USA; Department of Medicine, Harvard Medical School, Boston, USA
| | - D Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - A Black
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - P A van den Brandt
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - K A Burke
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, USA
| | - M B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - S M Gapstur
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, USA
| | - G G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - E Giovannucci
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, USA; Department of Medicine, Harvard Medical School, Boston, USA
| | - G G Goodman
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, USA
| | | | - N Håkansson
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - S Männistö
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - L Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
| | - L M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - R J MacInnis
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - M L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - E A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - N Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - J M Schenk
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - V L Stevens
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, USA
| | - R C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - S Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - K Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - L R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
| | - A Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - S A Smith-Warner
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, USA
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21
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Li D, Zhou L, Ma C, Chen W, Zhang Y, Yu S, Wang D, Zou Y, Wu J, Qiu L. Comparative analysis of the serum proteome profiles of thyroid cancer: An initial focus on the lipid profile. Oncol Lett 2019; 18:3349-3357. [PMID: 31452814 DOI: 10.3892/ol.2019.10655] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/13/2019] [Indexed: 01/17/2023] Open
Abstract
The serum lipid profile and clinical outcomes of cancer patients are commonly correlated in a wide range of carcinomas. However, few studies have investigated the serum lipid profile of patients with thyroid cancer (TC). The present study therefore aimed to analyze the lipid profiles of patients with TC. The serum proteomes of 31 participants with stage I-IV TC were screened using Orbitrap Q Exactive Plus. Analytical data collected between November 1, 2013 and November 11, 2018 from the laboratory information system included the total cholesterol (CHO), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), lipoprotein (a) and apolipoprotein B (ApoB) levels that were used to validate the screening results. A total of 3875 outpatients were enrolled in this study. A number of 17 differentially expressed proteins were identified. An Ingenuity pathway analysis identified activation of the liver X receptor/retinoid X receptor (LXR/RXR) activation, which is a crucial pathway involved in lipid metabolism. The results demonstrated that the total CHO levels were significantly different between patients with TC and control groups, both in men and women. In women, the levels of TG, HDL-C, Apo A1 and LDL-C/HDL-C were significantly different between patients with TC and control groups (all P<0.05). Higher concentrations of TG and LDL-C/HDL-C were observed in the cancer group compared with the control group. However, lower levels of Apo A1 and HDL-C were observed in women from the cancer group compared with the control group. The results from the present study revealed the presence of a disordered lipid profile in patients with TC. The molecular mechanism underlying the association between lipid metabolism and cancer requires further investigation and may be used to develop novel diagnostic biomarkers and therapeutic targets in human cancers.
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Affiliation(s)
- Dandan Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China
| | - Liangrui Zhou
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China
| | - Chaochao Ma
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China
| | - Wenhu Chen
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Yimin Zhang
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Songlin Yu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China
| | - Danchen Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China
| | - Yutong Zou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China
| | - Jie Wu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China
| | - Ling Qiu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China
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22
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Orho-Melander M, Hindy G, Borgquist S, Schulz CA, Manjer J, Melander O, Stocks T. Blood lipid genetic scores, the HMGCR gene and cancer risk: a Mendelian randomization study. Int J Epidemiol 2019; 47:495-505. [PMID: 29165714 DOI: 10.1093/ije/dyx237] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2017] [Indexed: 12/17/2022] Open
Abstract
Background It is unclear whether there are causal associations between blood lipids, statin use and cancer risks. Under certain assumptions, Mendelian randomization analysis of a genetic marker for an exposure eliminates reverse causation and confounding. Methods We applied Mendelian randomization analysis to genetic scores, comprising 26-41 single-nucleotide polymorphisms (SNPs), as instrumental variables (IVs) for triglycerides and low- and high-density lipoprotein cholesterol (LDLC, HDLC), using a prospective cohort of 26 904 individuals in which there were 6607 incident cancers. We also investigated cancer risk for a SNP (rs12916) in the gene encoding hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), the targeted enzyme in statin treatment. We used logistic regression and SNP pleiotropy-adjusted analyses to estimate the odds ratio per standard deviation (OR). Results The OR for the triglyceride IV as a predictor of any cancer was 0.91 [95% confidence interval (CI): 0.80-1.03] unadjusted, and 0.87 (95% CI: 0.78-0.95) from the pleiotropy-adjusted analysis. For the HMGCR rs12916 per LDLC-lowering T-allele, the OR was 1.09 (95% CI: 1.01-1.18) for prostate cancer and 0.89 (95% CI: 0.82-0.96) for breast cancer. The LDLC IV was not associated with prostate cancer or breast cancer. There were no associations between IVs and cancers of the lung, colon or bladder. Conclusions Under the assumptions of Mendelian randomization, there is a causal and negative association between serum triglycerides and risk of any cancer. Further, the HMGCR genetic variant might be associated with risks of prostate and breast cancers but the biological mechanisms behind these findings are unclear, as the LDLC IV was not associated with these cancers.
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Affiliation(s)
| | - George Hindy
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.,Program in Medical and Population Genetics, The Broad Institute, Cambridge, MA, USA
| | - Signe Borgquist
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Department of Oncology, Skåne University Hospital, Lund, Sweden
| | | | - Jonas Manjer
- Department of Plastic Surgery, Lund University, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Tanja Stocks
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
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23
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Arthur R, Møller H, Garmo H, Häggström C, Holmberg L, Stattin P, Malmström H, Lambe M, Hammar N, Walldius G, Robinson D, Jungner I, Van Hemelrijck M. Serum glucose, triglycerides, and cholesterol in relation to prostate cancer death in the Swedish AMORIS study. Cancer Causes Control 2018; 30:195-206. [PMID: 30421156 DOI: 10.1007/s10552-018-1093-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 10/29/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Lifestyle-related conditions such as obesity are associated with prostate cancer progression, but the associations with hyperglycemia and dyslipidemia are unclear. This study, therefore, aims to examine the association of glucose, triglycerides, and total cholesterol with prostate cancer death. METHODS From the Swedish AMORIS cohort, we selected 14,150 men diagnosed with prostate cancer between 1996 and 2011 who had prediagnostic measurements of serum glucose, triglycerides, and total cholesterol. Multivariable Cox proportional hazards regression models were used to determine the hazard ratios for death in relation to the aforementioned metabolic markers. RESULTS Using clinical cut-off points, a non-significant positive association was observed between glucose and prostate cancer death. When compared to those with glucose in the lowest quartile, those in the highest quartile had greater risk of prostate cancer death (HR 1.19; 95% CI 1.02-1.39). However, neither total cholesterol nor triglycerides were associated with prostate cancer death. Glucose and triglycerides were positively associated with overall, cardiovascular, and other deaths. Hypercholesterolemia was only associated with risk of CVD death. CONCLUSION Our results suggest that glucose levels may influence prostate cancer survival, but further studies using repeated measurements are needed to further elucidate how glucose levels may influence prostate cancer progression.
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Affiliation(s)
- Rhonda Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, USA.
- Translational Oncology & Urology Research, Kings College London, London, UK.
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park, Bronx, NY, USA.
| | - Henrik Møller
- Translational Oncology & Urology Research, Kings College London, London, UK
| | - Hans Garmo
- Translational Oncology & Urology Research, Kings College London, London, UK
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Christel Häggström
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
- Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Lars Holmberg
- Translational Oncology & Urology Research, Kings College London, London, UK
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Håkan Malmström
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Biostatistics, Data Management and Medical Writing, Research & Development, Swedish Orphan Biovitrum (Sobi), Stockholm, Sweden
| | - Mats Lambe
- Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Niklas Hammar
- Medical Evidence & Observational Research, Global Medicines Development, AstraZeneca, Mölndal, Sweden
| | - Göran Walldius
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - David Robinson
- Department of Urology, Ryhov Hospital, Jönköping, Sweden
| | - Ingmar Jungner
- Department of Clinical Epidemiology, Karolinska Institutet and CALAB Research, Stockholm, Sweden
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24
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Snekvik I, Nilsen T, Romundstad P, Saunes M. Metabolic syndrome and risk of incident psoriasis: prospective data from the HUNT Study, Norway. Br J Dermatol 2018; 180:94-99. [DOI: 10.1111/bjd.16885] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2018] [Indexed: 02/06/2023]
Affiliation(s)
- I. Snekvik
- Department of Public Health and Nursing Faculty of Medicine and Health Sciences Norwegian University of Science and Technology Trondheim Norway
- Department of Dermatology St Olav's Hospital Trondheim University Hospital Trondheim Norway
| | - T.I.L. Nilsen
- Department of Public Health and Nursing Faculty of Medicine and Health Sciences Norwegian University of Science and Technology Trondheim Norway
- Clinic of Anaesthesia and Intensive Care St Olav's Hospital Trondheim University Hospital Trondheim Norway
| | - P.R. Romundstad
- Department of Public Health and Nursing Faculty of Medicine and Health Sciences Norwegian University of Science and Technology Trondheim Norway
| | - M. Saunes
- Department of Dermatology St Olav's Hospital Trondheim University Hospital Trondheim Norway
- Department of Cancer Research and Molecular Medicine Faculty of Medicine and Health Sciences Norwegian University of Science and Technology Trondheim Norway
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25
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Murtola TJ, Kasurinen TVJ, Talala K, Taari K, Tammela TLJ, Auvinen A. Serum cholesterol and prostate cancer risk in the Finnish randomized study of screening for prostate cancer. Prostate Cancer Prostatic Dis 2018; 22:66-76. [PMID: 30214034 DOI: 10.1038/s41391-018-0087-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/26/2018] [Accepted: 05/16/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Hypercholesterolemia has been associated with advanced stage prostate cancer (PCa), but the role of lipid parameters such as HDL and triglycerides is unclear. We examined PCa risk by lipid parameters in a population nested within the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC). METHODS Cholesterol measurements were available on 17,696 men. During the 17-year median follow-up, 2404 PCa cases were diagnosed. Cox regression model was used to estimate hazard ratios (HR) and their 95% confidence intervals (95% CI) for overall PCa risk and stratified by Gleason grade and tumor stage. We compared normolipidemic and hyperlipidemic men on four cholesterol parameters total cholesterol (TC), HDL, LDL, and triglycerides (TG), analyzed as time-dependent variables. RESULTS TC in the highest tertile (above 5.1 mmol/l) and LDL above 3 mmol/l were associated with increased risk of Gleason 8-10 cancer (HR 1.42, 95% CI 1.04-1.95 and HR 1.38, 95% CI 1.02-1.86, respectively). Further, overall PCa risk was elevated in the 3-year lag time analysis by TC in the highest two tertiles (HR 1.27, 95% CI 1.05-1.54 for TC above 4.4 mmol/l, and HR 1.26, 95% CI 1.05-1.51 for TC above 5.1 mmol/l) and HDL in the highest tertile (HR 1.33, 95% CI 1.08-1.64) and above 1 mmol/l (HR 1.29, 95% CI 1.01-1.65). In contrast, TC in the highest tertile was associated with a decreased risk of PCa with 20-year lag time. The risk associations for overall PCa grew stronger with added lag time but were observed only in the FinRSPC control arm. Statin use did not modify the risk association. CONCLUSIONS Hypercholesterolemia may increase overall PCa risk in short-term, inverse risk association was observed with 20-years' time lag. Similar risk increase of overall PCa was also observed for elevated HDL, conflicting with previous findings on the subject.
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Affiliation(s)
- Teemu J Murtola
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland. .,Department of Urology, Tampere University Hospital, Tampere, Finland.
| | - Tatu V J Kasurinen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | | | - Kimmo Taari
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teuvo L J Tammela
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.,Department of Urology, Tampere University Hospital, Tampere, Finland
| | - Anssi Auvinen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
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26
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Pirro M, Ricciuti B, Rader DJ, Catapano AL, Sahebkar A, Banach M. High density lipoprotein cholesterol and cancer: Marker or causative? Prog Lipid Res 2018; 71:54-69. [DOI: 10.1016/j.plipres.2018.06.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 05/15/2018] [Accepted: 06/02/2018] [Indexed: 12/11/2022]
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27
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Hellevik AI, Johnsen MB, Langhammer A, Baste V, Furnes O, Storheim K, Zwart JA, Flugsrud GB, Nordsletten L. Metabolic syndrome as a risk factor for total hip or knee replacement due to primary osteoarthritis: a prospective cohort study (the HUNT study and the Norwegian Arthroplasty Register). Clin Epidemiol 2018; 10:83-96. [PMID: 29391831 PMCID: PMC5768432 DOI: 10.2147/clep.s145823] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective Biochemical changes associated with obesity may accelerate osteoarthritis beyond the effect of mechanical factors. This study investigated whether metabolic syndrome and its components (visceral obesity, hypertension, dyslipidemia and insulin resistance) were risk factors for subsequent total hip replacement (THR) or total knee replacement (TKR) due to primary osteoarthritis. Design In this prospective cohort study, data from the second survey of the Nord-Trøndelag Health Study 2 (HUNT2) were linked to the Norwegian Arthroplasty Register for identification of the outcome of THR or TKR. The analyses were stratified by age (<50, 50–69.9 and ≥70 years) and adjusted for gender, body mass index, smoking, physical activity and education. Results Of the 62,661 participants, 12,593 (20.1%) were identified as having metabolic syndrome, and we recorded 1,840 (2.9%) THRs and 1,111 (1.8%) TKRs during a mean follow-up time of 15.4 years. Cox regression analyses did not show any association between full metabolic syndrome and THR or TKR, except in persons <50 years with metabolic syndrome who had a decreased risk of THR (hazard ratio [HR] 0.58, 95% CI 0.40–0.83). However, when including only participants whose exposure status did not change during follow-up, this protective association was no longer significant. Increased waist circumference was associated with increased risk of TKR in participants <50 years (HR 1.62, 95% CI 1.10–2.39) and 50–69.9 years (HR 1.43, 95% CI 1.14–1.80). Hypertension significantly increased the risk of TKR in participants <50 years (HR 1.38, 95% CI 1.05–1.81), and this risk was greater for men. Conclusion This study found an increased risk of TKR in men <50 years with hypertension and persons <70 years with increased waist circumference. Apart from this, neither metabolic syndrome nor its components were associated with increased risk of THR or TKR due to primary osteoarthritis.
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Affiliation(s)
- Alf Inge Hellevik
- The HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Levanger.,Division of Orthopaedic Surgery, Oslo University Hospital, Oslo
| | - Marianne Bakke Johnsen
- Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo University Hospital, Oslo.,Faculty of Medicine, University of Oslo, Oslo
| | - Arnulf Langhammer
- The HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Levanger
| | | | - Ove Furnes
- The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen.,Department of Clinical Medicine, Institute of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Kjersti Storheim
- Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo University Hospital, Oslo.,Faculty of Medicine, University of Oslo, Oslo
| | - John Anker Zwart
- Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo University Hospital, Oslo.,Faculty of Medicine, University of Oslo, Oslo
| | | | - Lars Nordsletten
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo.,Faculty of Medicine, University of Oslo, Oslo
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28
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Dickerman BA, Torfadottir JE, Valdimarsdottir UA, Wilson KM, Steingrimsdottir L, Aspelund T, Batista JL, Fall K, Giovannucci E, Sigurdardottir LG, Tryggvadottir L, Gudnason V, Markt SC, Mucci LA. Midlife metabolic factors and prostate cancer risk in later life. Int J Cancer 2017; 142:1166-1173. [PMID: 29114858 DOI: 10.1002/ijc.31142] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/12/2017] [Accepted: 10/17/2017] [Indexed: 12/18/2022]
Abstract
Metabolic syndrome is associated with several cancers, but evidence for aggressive prostate cancer is sparse. We prospectively investigated the influence of metabolic syndrome and its components on risk of total prostate cancer and measures of aggressive disease in a cohort of Icelandic men. Men in the Reykjavik Study (n = 9,097, enrolled 1967-1987) were followed for incident (n = 1,084 total; n = 378 advanced; n = 148 high-grade) and fatal (n = 340) prostate cancer until 2014. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for (1) measured metabolic factors at cohort entry (body mass index (BMI), blood pressure, triglycerides, fasting blood glucose) and (2) a metabolic syndrome score (range 0-4) combining the risk factors: BMI ≥30 kg/m2 ; systolic blood pressure (SBP) ≥130 or diastolic blood pressure (DBP) ≥85 mm Hg or taking antihypertensives; triglycerides ≥150 mg/dl; fasting blood glucose ≥100 mg/dl or self-reported type 2 diabetes. Hypertension and type 2 diabetes were associated with a higher risk of total, advanced, high-grade, and fatal prostate cancer, independent of BMI. Neither BMI nor triglycerides were associated with prostate cancer risk. Higher metabolic syndrome score (3-4 vs 0) was associated with a higher risk of fatal prostate cancer (HR 1.55; 95% CI: 0.89, 2.69; p trend = 0.08), although this finding was not statistically significant. Our findings suggest a positive association between midlife hypertension and diabetes and risk of total and aggressive prostate cancer. Further, metabolic syndrome as a combination of factors was associated with an increased risk of fatal prostate cancer.
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Affiliation(s)
- Barbra A Dickerman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Unnur A Valdimarsdottir
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kathryn M Wilson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Laufey Steingrimsdottir
- Unit for Nutrition Research, University Hospital & the Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Thor Aspelund
- Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland.,The Icelandic Heart Association, Kopavogur, Iceland
| | - Julie L Batista
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Katja Fall
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Clinical Epidemiology and Biostatistics, Örebro University Hospital, Örebro, Sweden
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lara G Sigurdardottir
- Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Education and Prevention, The Icelandic Cancer Society, Reykjavik, Iceland
| | | | - Vilmundur Gudnason
- The Icelandic Heart Association, Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Sarah C Markt
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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29
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BMI and serum lipid parameters predict increasing risk and aggressive prostate cancer in Chinese people. Oncotarget 2017; 8:66051-66060. [PMID: 29029491 PMCID: PMC5630391 DOI: 10.18632/oncotarget.19790] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 06/29/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To determine if obesity and serum lipid parameters are associated with increased risk and more aggressive prostate cancer in Chinese population. MATERIALS AND METHODS We conducted a retrospective cohort analysis including 3102 patients. Kruskal-Wallis test for continuous variables and the chi-squared tests for categorical variables were used for univariate comparison of the differences in patient characteristics across BMI categories between different groups. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for the association between prostate cancer and the various patient characteristics. Multivariable Cox proportional hazards regression was performed to assess the risk of prostate cancer recurrence. RESULTS 974 consecutive men were diagnosed as prostate cancer and 700 patients subsequently received radical prostatectomy immediately, and 1031 patients were pathologically diagnosed as biopsy negative. The level of low-density-lipoprotein cholesterol (LDL-c) and total cholesterol was significantly higher and the high-density-lipoprotein cholesterol (HDL-c) level is much lower in prostate cancer patients. Patients with low level of HDL-c, who subsequently received radical prostatectomy, had increased risk of high risk disease. In addition, patients with normal weight were less likely to develop a biochemical recurrence. Combined analysis revealed that obese patients had significantly higher rates of PSA recurrence over time than nonobese patients. CONCLUSIONS In our study, lipid parameters are supposed to be associated with prostate cancer risk and aggressiveness. Obese men are at increased risk of PSA recurrence after radical prostatectomy.
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30
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Meta-analysis of metabolic syndrome and prostate cancer. Prostate Cancer Prostatic Dis 2017; 20:146-155. [DOI: 10.1038/pcan.2017.1] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/31/2016] [Accepted: 11/29/2016] [Indexed: 12/20/2022]
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31
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Kim H, Kalchman I, Santiago-Jiménez M, Lehrer J, Guo J, Hermann G, Yamoah K, Alshalalfa M, Huang HC, Ross AE, Schaeffer EM, Davicioni E, Erho N, Yousefi K, Den RB. Transcriptome evaluation of the relation between body mass index and prostate cancer outcomes. Cancer 2017; 123:2240-2247. [PMID: 28140459 DOI: 10.1002/cncr.30580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/30/2016] [Accepted: 01/05/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Large epidemiological studies indicate that an increased body mass index (BMI) is associated with increased prostate cancer (PCa) mortality. Data indicate that there is no association between elevated metabolic pathway proteins and PCa mortality. There are no published studies evaluating the relation between BMI and metabolic pathways with respect to PCa outcomes with a genomics approach. METHODS The Decipher Genomic Resource Information Database was queried for patients who had undergone prostatectomy and had BMI information available. These patients came from Thomas Jefferson University (TJU) and Johns Hopkins Medical Institution (JHMI); the latter provided 2 cohorts (I and II). A high-BMI group (≥30 kg/m2 ) and a low-BMI group (<25 kg/m2 ) were identified, and genomic data were interrogated for differentially expressed genes with an interquartile range filter and a Wilcoxon test. P values were adjusted for multiple testing with the Benjamini-Hochberg false-discovery rate method. RESULTS A total of 477 patients with a median follow-up of 108 months had BMI information available. Two genes were found to interact with BMI in both the JHMI I cohort and the TJU cohort, but there was no statistical significance after adjustments for multiple comparisons. Aberrant metabolic gene expression was significantly correlated with distant metastases (P < .05). No relation was found between BMI and metastases or overall survival (both P values > .05). CONCLUSIONS In a genomic analysis of prostatectomy specimens, metabolic gene expression, but not BMI, was associated with PCa metastases. Cancer 2017;123:2240-2247. © 2017 American Cancer Society.
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Affiliation(s)
- Hyun Kim
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ingrid Kalchman
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | | | - Jenny Guo
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Gretchen Hermann
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kosj Yamoah
- Department of Radiation Oncology and Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | | | - Ashley E Ross
- James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, Maryland
| | | | - Elai Davicioni
- GenomeDx Biosciences, Vancouver, British Columbia, Canada
| | - Nicholas Erho
- GenomeDx Biosciences, Vancouver, British Columbia, Canada
| | - Kasra Yousefi
- GenomeDx Biosciences, Vancouver, British Columbia, Canada
| | - Robert B Den
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
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32
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Shiota M, Takeuchi A, Sugimoto M, Kashiwagi E, Dejima T, Kiyoshima K, Inokuchi J, Tatsugami K, Yokomizo A, Eto M. The Differential Impact of Body Mass Index and the Feature of Metabolic Syndrome on Oncological Outcomes Following Different Surgical Procedures in Japanese Men with Prostate Cancer. Ann Surg Oncol 2016; 24:1443-1450. [DOI: 10.1245/s10434-016-5705-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Indexed: 12/22/2022]
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33
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Ma HQ, Cui LH, Li CC, Yu Z, Piao JM. Effects of Serum Triglycerides on Prostate Cancer and Breast Cancer Risk: A Meta-Analysis of Prospective Studies. Nutr Cancer 2016; 68:1073-82. [PMID: 27618148 DOI: 10.1080/01635581.2016.1206582] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Epidemiological studies show conflicting results regarding the link between serum triglyceride and the risk of prostate cancer and breast cancer. Therefore, we performed a meta-analysis of prospective studies to clarify this association. We searched PubMed, EMBASE, the Chinese Biomedical Database (CBM), and the China National Knowledge Infrastructure (CNKI) database to identify relevant prospective studies of the relationship between serum triglyceride and prostate cancer and breast cancer risk. Study-specific estimates adjusting for potential confounders were combined to evaluate a summary relative risks (RRs) and 95% confidence intervals (95% CIs) using a fixed- or random-effects model. A total of 11 prospective studies (619,410 subjects and 15,691 incident prostate cancer patients) and 8 prospective studies (590,878 subjects and 12,177 incident breast cancer patients) were respectively included in our meta-analysis to assess the associations of serum triglyceride with prostate cancer and breast cancer risk. The pooled adjusted RR estimates for prostate cancer and breast cancer for the highest versus the lowest exposure levels of serum triglycerides were 0.95 (95% CI: 0.87-1.04) and 0.94 (95% CI: 0.87-1.00), respectively. Additionally, a dose-response analysis revealed that serum levels of triglycerides were not associated with the risk of prostate cancer and breast cancer. We found that serum triglyceride was not related to the risk of prostate cancer and breast cancer.
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Affiliation(s)
- Hong-Qun Ma
- a Department of Public Health , Qingdao University Medical College , Qingdao , China
| | - Lian-Hua Cui
- b The Affiliated Hospital of Qingdao University , Department of Oncology , Qingdao , Shandong , China
| | - Cheng-Cheng Li
- a Department of Public Health , Qingdao University Medical College , Qingdao , China
| | - Zhuang Yu
- b The Affiliated Hospital of Qingdao University , Department of Oncology , Qingdao , Shandong , China
| | - Jin-Mei Piao
- a Department of Public Health , Qingdao University Medical College , Qingdao , China
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34
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Liu BZ, Tao L, Chen YZ, Li XZ, Dong YL, Ma YJ, Li SG, Li F, Zhang WJ. Preoperative Body Mass Index, Blood Albumin and Triglycerides Predict Survival for Patients with Gastric Cancer. PLoS One 2016; 11:e0157401. [PMID: 27309531 PMCID: PMC4911005 DOI: 10.1371/journal.pone.0157401] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/27/2016] [Indexed: 02/07/2023] Open
Abstract
Background Gastric cancer (GC) is common and its prognosis is often poor due to difficulties in early diagnosis and optimal treatment strategies. TNM staging system is useful in predicting prognosis but only possible after surgery. Therefore, it is desirable to investigate prognostic factors/markers that may predict prognosis before surgery by which helps appropriate management decisions preoperatively. Methods A total of 320 GC patients were consecutively recruited from 2004 to 2013 and followed up for 127 months (10.6 years) after surgery. These patients’ were examined for body mass index (BMI) and blood levels of albumin, triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C). Kaplan-Meier method and log rank test were used to analyze long-term survival using the above potential risk markers. We first employed medians of these variables to reveal maximal potentials of the above prognostic predictors. Results Three major findings were obtained: (1) Preoperative BMI was positively correlated with albumin (r = 0.144, P<0.05) and triglyceride (r = 0.365, P<0.01), but negatively correlated with TNM staging (r = -0.265, P<0.05). Preoperative albumin levels were positively correlated with triglyceride (r = 0.173, P<0.05) but again, negatively correlated with TNM staging (r = -0.137, P<0.05); (2) Poor survival was observed in GC patients with lower levels of BMI (P = 0.028), albumin (P = 0.004), and triglyceride (P = 0.043), respectively. Receiver operating characteristic (ROC) curve analyses suggested BMI, albumin and triglyceride to have survival-predictor powers similar to TNM system; and (3) Cox multi-factorial analyses demonstrated that age (P = 0.049), BMI (P = 0.016), cell differentiation (P = 0.001), and TNM staging (P = 0.011) were independent overall survival-predictors for GC patients. Conclusions Preoperative BMI, albumin, and triglyceride levels are capable of predicting survival for GC patients superior to postoperative TNM system in terms of timing for management. As potential survival-predictors, preoperative tests of BMI, albumin and triglyceride, combined with clinical imaging, may help personalized management for GC patients including planning surgical strategy, optimal radio-chemotherapy and appropriate follow-up intervals after surgery.
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Affiliation(s)
- Bin Zheng Liu
- Department of Pathology, the First Affiliated University Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Lin Tao
- Department of Pathology, the First Affiliated University Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Yun Zhao Chen
- Department of Pathology, the First Affiliated University Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Xu Zhe Li
- Department of Pathology, the First Affiliated University Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Yu Ling Dong
- Department of Pathology, the First Affiliated University Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Ya Jing Ma
- Clinical Laboratory, the First Affiliated University Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Shu Gang Li
- Department of Preventive Medicine, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Feng Li
- Department of Pathology, the First Affiliated University Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Wen Jie Zhang
- Department of Pathology, the First Affiliated University Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- The Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- * E-mail:
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35
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Arthur R, Møller H, Garmo H, Holmberg L, Stattin P, Malmstrom H, Lambe M, Hammar N, Walldius G, Robinson D, Jungner I, Hemelrijck M. Association between baseline serum glucose, triglycerides and total cholesterol, and prostate cancer risk categories. Cancer Med 2016; 5:1307-18. [PMID: 26923095 PMCID: PMC4924389 DOI: 10.1002/cam4.665] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/10/2015] [Accepted: 01/11/2016] [Indexed: 01/13/2023] Open
Abstract
Lifestyle-related risk factors such as hyperglycemia and dyslipidemia have been associated with several cancers. However, studies exploring their link with prostate cancer (PCa) clinicopathological characteristics are sparse and inconclusive. Here, we investigated the associations between serum metabolic markers and PCa clinicopathological characteristics. The study comprised 14,294 men from the Swedish Apolipoprotein MOrtality RISk (AMORIS) cohort who were diagnosed with PCa between 1996 and 2011. Univariate and multivariable logistic regression were used to investigate the relation between glucose, triglycerides and total cholesterol and PCa risk categories, PSA, Gleason score, and T-stage. Mean age at time of PCa diagnosis was 69 years. Men with glucose levels >6.9 mmol/L tend to have PSA<4 μg/L, while those with glucose levels of 5.6-6.9 mmol/L had a greater odds of PSA>20 μg/L compared to PSA 4.0-9.9 μg/L. Hypertriglyceridemia was also positively associated with PSA>20 μg/L. Hyperglycemic men had a greater odds of intermediate- and high-grade PCa and advanced stage or metastatic PCa. Similarly, hypertriglyceridemia was positively associated with high-grade PCa. There was also a trend toward an increased odds of intermediate risk localized PCa and advanced stage PCa among men with hypertriglyceridemia. Total cholesterol did not have any statistically significant association with any of the outcomes studied. Our findings suggest that high serum levels of glucose and triglycerides may influence PCa aggressiveness and severity. Further investigation on the role of markers of glucose and lipid metabolism in influencing PCa aggressiveness and severity is needed as this may help define important targets for intervention.
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Affiliation(s)
- Rhonda Arthur
- Division of Cancer StudiesCancer Epidemiology GroupKing's College LondonLondonUnited Kingdom
| | - Henrik Møller
- Division of Cancer StudiesCancer Epidemiology GroupKing's College LondonLondonUnited Kingdom
| | - Hans Garmo
- Division of Cancer StudiesCancer Epidemiology GroupKing's College LondonLondonUnited Kingdom
- Regional Cancer CentreUppsalaSweden
| | - Lars Holmberg
- Division of Cancer StudiesCancer Epidemiology GroupKing's College LondonLondonUnited Kingdom
- Regional Cancer CentreUppsalaSweden
- Department of Surgical SciencesUppsala University HospitalUppsalaSweden
| | - Pår Stattin
- Departments of Surgical and Perioperative SciencesUrology and AndrologyUmeå UniversityFaculty of MedicineUppsalaSweden
| | - Håkan Malmstrom
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - Mats Lambe
- Department of Surgical SciencesUppsala University HospitalUppsalaSweden
- Departments of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Niklas Hammar
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
- AstraZeneca SverigeSödertaljeSweden
| | - Göran Walldius
- Department of Cardiovascular EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - David Robinson
- Departments of Surgical and Perioperative SciencesUrology and AndrologyUmeå UniversityFaculty of MedicineUppsalaSweden
| | - Ingmar Jungner
- Department of Clinical Epidemiological UnitKarolinska Institutet and CALAB ResearchStockholmSweden
| | - Mieke Van Hemelrijck
- Division of Cancer StudiesCancer Epidemiology GroupKing's College LondonLondonUnited Kingdom
- Unit of EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
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36
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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: 1.6] [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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37
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Allott EH, Hursting SD. Obesity and cancer: mechanistic insights from transdisciplinary studies. Endocr Relat Cancer 2015; 22:R365-86. [PMID: 26373570 PMCID: PMC4631382 DOI: 10.1530/erc-15-0400] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2015] [Indexed: 12/11/2022]
Abstract
Obesity is associated with a range of health outcomes that are of clinical and public health significance, including cancer. Herein, we summarize epidemiologic and preclinical evidence for an association between obesity and increased risk of breast and prostate cancer incidence and mortality. Moreover, we describe data from observational studies of weight change in humans and from calorie-restriction studies in mouse models that support a potential role for weight loss in counteracting tumor-promoting properties of obesity in breast and prostate cancers. Given that weight loss is challenging to achieve and maintain, we also consider evidence linking treatments for obesity-associated co-morbidities, including metformin, statins and non-steroidal anti-inflammatory drugs, with reduced breast and prostate cancer incidence and mortality. Finally, we highlight several challenges that should be considered when conducting epidemiologic and preclinical research in the area of obesity and cancer, including the measurement of obesity in population-based studies, the timing of obesity and weight change in relation to tumor latency and cancer diagnosis, and the heterogeneous nature of obesity and its associated co-morbidities. Given that obesity is a complex trait, comprised of behavioral, epidemiologic and molecular/metabolic factors, we argue that a transdisciplinary approach is the key to understanding the mechanisms linking obesity and cancer. As such, this review highlights the critical need to integrate evidence from both epidemiologic and preclinical studies to gain insight into both biologic and non-biologic mechanisms contributing to the obesity-cancer link.
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Affiliation(s)
- Emma H Allott
- Department of EpidemiologyCB 7435, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USADepartment of NutritionUniversity of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USA Department of EpidemiologyCB 7435, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USADepartment of NutritionUniversity of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USA
| | - Stephen D Hursting
- Department of EpidemiologyCB 7435, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USADepartment of NutritionUniversity of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USA Department of EpidemiologyCB 7435, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USALineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USADepartment of NutritionUniversity of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, North Carolina 27599, USA
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38
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De Nunzio C, Truscelli G, Trucchi A, Petta S, Tubaro M, Gacci M, Gaudio C, Presicce F, Tubaro A. Metabolic abnormalities linked to an increased cardiovascular risk are associated with high-grade prostate cancer: a single biopsy cohort analysis. Prostate Cancer Prostatic Dis 2015; 19:35-9. [PMID: 26439746 DOI: 10.1038/pcan.2015.45] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 07/20/2015] [Accepted: 08/17/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Smoking, hypertension, abdominal obesity and metabolic abnormalities have been considered individual factors involved in prostate cancer (PCa) pathogenesis. All of these factors are used to define the individual cardiovascular risk (CVR). The aim of our study was to evaluate the association between CVR and PCa diagnosis and grade among a consecutive series of men undergoing prostate biopsy. METHODS From 2010 onwards, consecutive patients undergoing 12-core prostate biopsy were enrolled. Body mass index was measured before the biopsy. Blood samples were collected and tested for: PSA, fasting glucose, triglycerides and high-density lipoproteins. Blood pressure was also recorded. Metabolic syndrome was defined according to the Adult Treatment Panel III and CVR according to the European Association of Cardiologist Guidelines. We evaluated the association between CVR and PCa biopsy Gleason score using logistic regression analyses. RESULTS Five hundred and eighty-four patients were enrolled. Four hundred and six patients (70%) presented a moderate/high CVR. Two hundred and thirty-seven (40.6%) patients had cancer on biopsy; 157 with moderate/high CVR and 80 with low/no CVR (P=0.11). Out of the 237 patients with PCa, 113 had a Gleason score 6 and 124 a Gleason score ⩾7. Out of them, 92/124 (75%) presented a moderate/high CVR (P=0.004). Moderate/high CVR was not associated with an increased risk of PCa (odds ratio (OR): 0.741, confidence interval (CI): 0.474-1.156; P=0.186) but with an increased risk of Gleason score ⩾7 (OR: 2.154, CI: 1.076-4.314; P=0.030). CONCLUSIONS In our study, a moderate/high CVR is associated with an increased risk of a high-grade Gleason score when PCa is diagnosed on biopsy. Although these results should be confirmed in multicentre studies, patients with moderate/high CVR should be carefully evaluated for PCa diagnosis.
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Affiliation(s)
- C De Nunzio
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
| | - G Truscelli
- Department of Heart and Great Vessels 'A. Reale', Policlinico Umberto I, ' Sapienza' University of Rome, Rome, Italy
| | - A Trucchi
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
| | - S Petta
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
| | - M Tubaro
- ICCU, Cardiovascular Department, Ospedale San Filippo Neri, Rome, Italy
| | - M Gacci
- Department of Urology, Ospedale Careggi, University of Florence, Florence, Italy
| | - C Gaudio
- Department of Heart and Great Vessels 'A. Reale', Policlinico Umberto I, ' Sapienza' University of Rome, Rome, Italy
| | - F Presicce
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
| | - A Tubaro
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
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Blanc-Lapierre A, Spence A, Karakiewicz PI, Aprikian A, Saad F, Parent MÉ. Metabolic syndrome and prostate cancer risk in a population-based case-control study in Montreal, Canada. BMC Public Health 2015; 15:913. [PMID: 26385727 PMCID: PMC4574395 DOI: 10.1186/s12889-015-2260-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/11/2015] [Indexed: 11/23/2022] Open
Abstract
Background The role of metabolic syndrome (MetS) in prostate cancer risk is still debated. We investigated it in a large population-based case–control study. Methods Cases were 1937 men with incident prostate cancer, aged ≤75 years, diagnosed across French hospitals in the Montreal area between 2005 and 2009. Concurrently, 1995 population controls from the same residential area and age distribution were randomly selected from electoral list of French-speaking men. Detailed lifestyle and medical histories, and anthropometric measures, were collected during in-person interviews. Prevalence of MetS components (type 2 diabetes, high blood pressure, dyslipidemia and abdominal obesity) was estimated at 2 years before diagnosis for cases/ interview for controls, and at ages 20, 40, 50 and 60. Logistic regression was used to estimate odds ratios (OR) and 95 % confidence intervals for the association between MetS and prostate cancer risk. Results A history of MetS (≥3 components vs <3) was associated with a reduced risk of prostate cancer (OR = 0.70 [0.60, 0.82]) after considering potential confounders. The negative association was particularly pronounced with a young age (≤40 years) at MetS onset (OR = 0.38 [0.16-0.89]), did not vary according to prostate cancer aggressiveness, and was only partly explained by the presence of type 2 diabetes. A risk decrease was observed with the number of MetS components, suggesting a synergistic interaction of the components. Discussion The observed negative association, consistent with results from other North American populations undergoing regular prostate cancer screening, underlines the importance of considering PSA-testing when studying the MetS-prostate cancer association. Conclusions Findings from this study are consistent with an inverse association between MetS and prostate cancer risk.
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Affiliation(s)
- Audrey Blanc-Lapierre
- Epidemiology and Biostatistics Unit, Institut national de la recherche scientifique-Institut Armand-Frappier, University of Quebec, 531 Boul. des Prairies, Laval, QC, H7V 1B7, Canada.
| | - Andrea Spence
- Epidemiology and Biostatistics Unit, Institut national de la recherche scientifique-Institut Armand-Frappier, University of Quebec, 531 Boul. des Prairies, Laval, QC, H7V 1B7, Canada.
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, 1058, rue St-Denis, Montreal, QC, H2X 3 J4, Canada. .,Department of Surgery, Division of Urology, Centre Hospitalier de l'Université de Montréal, 1058, rue St-Denis, Montreal, QC, H2X 3 J4, Canada.
| | - Armen Aprikian
- Department of Surgery (Urology), McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada.
| | - Fred Saad
- Department of Surgery, Division of Urology, Centre Hospitalier de l'Université de Montréal, 1058, rue St-Denis, Montreal, QC, H2X 3 J4, Canada.
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, Institut national de la recherche scientifique-Institut Armand-Frappier, University of Quebec, 531 Boul. des Prairies, Laval, QC, H7V 1B7, Canada. .,Department of Social and Preventive Medicine, University of Montreal, 7101 Avenue du Parc, Montreal, QC, Canada.
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Abstract
Several epidemiologic studies in Western countries have examined the association between asthma and prostate cancer risk, but the results have been inconclusive. We investigated this association in a large, nationwide, population-based case-cohort study. Using the Taiwan National Health Insurance Research Database from 1997 to 2008, we collected data from 12,372 men, including 4124 with asthma and 8248 age-, residence-, and insurance premium-matched control subjects, who were never diagnosed with asthma. Competing risk-adjusted Cox proportional hazards regression was used to calculate the hazard ratios (HRs) and 95% confidence interval (CI) for determining the association between prostate cancer and asthma. During a mean follow-up of 5.05 years (standard deviation, 2.10), there were 74 cases of prostate cancer. The incidence of prostate cancer was 163.0/100,000 person-years (95% CI: 113.0-228.0) in the asthma patients. Asthma was significantly associated with prostate cancer (HR: 2.36; 95% CI: 1.22-4.57; P = 0.011) after adjusting for age, residential area, insurance premium, hypertriglyceridemia, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, duration of hospitalization, and mortality. In the subgroup analysis, independent risk factors for prostate cancer among men with asthma were age (HR: 1.09; 95% CI: 1.05-1.21; P < 0.001) and hypertension (HR: 2.75; 95% CI: 1.24-7.80; P = 0.047). The results of our study suggest that men with asthma have an increased risk of prostate cancer.
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Affiliation(s)
- Yu-Li Su
- From the Division of Hematology-Oncology (Y-LS, K-MR), Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Division of Rheumatology, Allergy, and Immunology (C-LC), Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung; College of Medicine (K-MR), Chang Gung University, Taoyuan; Department of Public Health (CT-CL), Kaohsiung Medical University, Kaohsiung; and Department of Health Promotion and Health Education (CT-CL), National Taiwan Normal University, Taipei, Taiwan
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Theophilou G, Lima KMG, Briggs M, Martin-Hirsch PL, Stringfellow HF, Martin FL. A biospectroscopic analysis of human prostate tissue obtained from different time periods points to a trans-generational alteration in spectral phenotype. Sci Rep 2015; 5:13465. [PMID: 26310632 PMCID: PMC4550877 DOI: 10.1038/srep13465] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/28/2015] [Indexed: 02/04/2023] Open
Abstract
Prostate cancer is the most commonly-diagnosed malignancy in males worldwide; however, there is marked geographic variation in incidence that may be associated with a Westernised lifestyle. We set out to determine whether attenuated total reflection Fourier-transform infrared (ATR-FTIR) or Raman spectroscopy combined with principal component analysis-linear discriminant analysis or variable selection techniques employing genetic algorithm or successive projection algorithm could be utilised to explore differences between prostate tissues from differing years. In total, 156 prostate tissues from transurethral resection of the prostate procedures for benign prostatic hyperplasia from 1983 to 2013 were collected. These were distributed to form seven categories: 1983–1984 (n = 20), 1988–1989 (n = 25), 1993–1994 (n = 21), 1998–1999 (n = 21), 2003–2004 (n = 21), 2008–2009 (n = 20) and 2012–2013 (n = 21). Ten-μm-thick tissue sections were floated onto Low-E (IR-reflective) slides for ATR-FTIR or Raman spectroscopy. The prostate tissue spectral phenotype altered in a temporal fashion. Examination of the two categories that are at least one generation (30 years) apart indicated highly-significant segregation, especially in spectral regions containing DNA and RNA bands (≈1,000–1,490 cm−1). This may point towards alterations that have occurred through genotoxicity or through epigenetic modifications. Immunohistochemical studies for global DNA methylation supported this. This study points to a trans-generational phenotypic change in human prostate.
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Affiliation(s)
- Georgios Theophilou
- Centre for Biophotonics, LEC, Lancaster University, Lancaster LA1 4YQ, UK.,Department of Obstetrics and Gynaecology, Central Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Kássio M G Lima
- Centre for Biophotonics, LEC, Lancaster University, Lancaster LA1 4YQ, UK.,Institute of Chemistry, Biological Chemistry and Chemometrics, Federal University of Rio Grande do Norte, Natal 59072-970, RN-Brazil
| | - Matthew Briggs
- Department of Obstetrics and Gynaecology, Central Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Pierre L Martin-Hirsch
- Centre for Biophotonics, LEC, Lancaster University, Lancaster LA1 4YQ, UK.,Department of Obstetrics and Gynaecology, Central Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Helen F Stringfellow
- Department of Obstetrics and Gynaecology, Central Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Francis L Martin
- Centre for Biophotonics, LEC, Lancaster University, Lancaster LA1 4YQ, UK
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Zhang JQ, Geng H, Ma M, Nan XY, Sheng BW. Metabolic Syndrome Components are Associated with Increased Prostate Cancer Risk. Med Sci Monit 2015; 21:2387-96. [PMID: 26275075 PMCID: PMC4548704 DOI: 10.12659/msm.893442] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Our study investigated the associations of metabolic syndrome (MS) and metabolic indicators with prostate cancer (PCa) risk in the Chinese Han ethnic population. Material/Methods We studied 101 PCa patients (without/with MS) and 120 healthy controls. Clinical data, including waist circumference, BMI, TG, FINS, FBG, and PCa-related indicators, were collected. The correlations between MS and PCa were analyzed. Results Compared to PCa, PV and Gleason scores increased and PSA levels decreased in PCa with MS group (all P<0.001). PV was positively correlated with BMI, FINS, and HOMA-IR (r=0.459, P<0.001; r=0.421, P=0.001; r=0.490, P=0.003, respectively), and was negatively correlated with HDL-C (r=−0.378, P<0.001). PSA level in MS patients was negatively correlated with BMI (r=−0.125, P<0.001), TG (r=−0.256, P<0.001) and FBG (r=−0.183, P<0.001). Large PV, high TG, low HDL-C, high LDL-C, and high FBG were associated with an increased risk of PCa (P<0.001, OR=1.10, 95%CI: 1.009–3.304; P<0.001, OR=2.91, 95%CI: 1.612–5.241; P<0.001, OR=7.89, 95%CI: 3.908–15.947; P=0.015, OR=1.87, 95%CI: 1.131–3.077; P=0.004, OR=2.17, 95%CI: 1.280–3.686, respectively). MS-related indicators showed a positive relationship with PCa (P<0.001, OR=1.90, 95%CI: 1.107–10.629). Conclusions Our study shows that MS and metabolic indicators are associated with an increased risk of PCa, pointing to a novel therapeutic approach for PCa management.
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Affiliation(s)
- Jian-Qin Zhang
- Department of Nutrition, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Hui Geng
- Health Examination Center, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Mao Ma
- Department of Geriatric Surgery, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Xun-Yi Nan
- Urology Institute, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Bin-Wu Sheng
- Department of Geriatric Surgery, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
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Abstract
Supplemental Digital Content is available in the text. Background: Few previous studies of metabolic aberrations and prostate cancer risk have taken into account the fact that men with metabolic aberrations have an increased risk of death from causes other than prostate cancer. The aim of this study was to calculate, in a real-life scenario, the risk of prostate cancer diagnosis, prostate cancer death, and death from other causes. Methods: In the Metabolic Syndrome and Cancer Project, prospective data on body mass index, blood pressure, glucose, cholesterol, and triglycerides were collected from 285,040 men. Risks of prostate cancer diagnosis, prostate cancer death, and death from other causes were calculated by use of competing risk analysis for men with normal (bottom 84%) and high (top 16%) levels of each factor, and a composite score. Results: During a mean follow-up period of 12 years, 5,893 men were diagnosed with prostate cancer, 1,013 died of prostate cancer, and 26,328 died of other causes. After 1996, when prostate-specific antigen testing was introduced, men up to age 80 years with normal metabolic levels had 13% risk of prostate cancer, 2% risk of prostate cancer death, and 30% risk of death from other causes, whereas men with metabolic aberrations had corresponding risks of 11%, 2%, and 44%. Conclusions: In contrast to recent studies using conventional survival analysis, in a real-world scenario taking risk of competing events into account, men with metabolic aberrations had lower risk of prostate cancer diagnosis, similar risk of prostate cancer death, and substantially higher risk of death from other causes compared with men who had normal metabolic levels.
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YuPeng L, YuXue Z, PengFei L, Cheng C, YaShuang Z, DaPeng L, Chen D. Cholesterol Levels in Blood and the Risk of Prostate Cancer: A Meta-analysis of 14 Prospective Studies. Cancer Epidemiol Biomarkers Prev 2015; 24:1086-93. [PMID: 25953767 DOI: 10.1158/1055-9965.epi-14-1329] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/09/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND As a neutral lipid and prominent component of the Western diet, cholesterol levels might be a risk factor for prostate cancer. However, current evidence has been inconsistent. This meta-analysis aimed to evaluate the association between blood cholesterol levels and the risk of prostate cancer. METHODS An extensive search was performed in MEDLINE and EMBASE for prospective studies that have reported the association between total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL) levels in blood and risk of prostate cancer. Random-effects models were used to summarize the study-specific results. RESULTS Fourteen studies were included in this meta-analysis. In the meta-analysis, the summarized risk ratios (RR) for the highest to lowest cholesterol levels were as follows: 1.05 [95% confidence interval (CI), 0.97-1.14; P = 0.21] for TC, 0.93 (95% CI, 0.80-1.10; P = 0.40) for HDL, and 1.17 (95% CI, 0.88-1.55; P = 0.51) for LDL. When restricting to high-grade prostate cancer, the pooled RR was 1.32 (95% CI, 0.93-1.87; P = 0.13) for TC. In dose-response analyses, a 1 mmol/L increment in blood TC, HDL, and LDL level conferred an RR of 1.01 (95% CI, 0.99-1.02; P = 0.38), 0.98 (95% CI, 0.91-1.07; P = 0.72), and 1.04 (95% CI, 0.98-1.10; P = 0.24), respectively. CONCLUSION In this meta-analysis of 14 large prospective studies, blood TC, HDL, and LDL levels were not associated with the risk of either overall prostate cancer or high-grade prostate cancer. IMPACT Our findings did not appear to support the hypothesis that hypercholesterolemia increases the risk of prostate cancer.
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Affiliation(s)
- Liu YuPeng
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Zhang YuXue
- Department of Preventive Medicine, School of Public Health, Harbin Medical University, Harbin, China
| | - Li PengFei
- Department of Medical Oncology, The third Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Cheng Cheng
- Laboratory Center, Heilongjiang Entry-Exit Inspection and Quarantine Bureau, Harbin, China
| | - Zhao YaShuang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China
| | - Li DaPeng
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, China.
| | - Du Chen
- Department of Urology Oncology, The third Affiliated Hospital, Harbin Medical University, Harbin, China.
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Sun LM, Kuo HT, Jeng LB, Lin CL, Liang JA, Kao CH. Hypertension and subsequent genitourinary and gynecologic cancers risk: a population-based cohort study. Medicine (Baltimore) 2015; 94:e753. [PMID: 25906108 PMCID: PMC4602691 DOI: 10.1097/md.0000000000000753] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Although a relationship between hypertension and the development of renal cancer and other types of cancer have been proposed for decades, the results of epidemiologic studies remain inconclusive. This study was conducted to evaluate the association between hypertension and genitourinary and gynecologic cancers in Taiwan.In this study, we conducted a populated-based retrospective cohort study by using data from the Taiwanese National Health Insurance program. The study period was from 2000 to 2011, and the cohort comprised 111,704 insurants: 57,961 patients with hypertension and 53,743 patients without hypertension. A Cox proportional hazard regression analysis was performed to estimate the effects of hypertension on genitourinary and gynecologic cancers risk.Among the patients with hypertension, the risks of developing renal and uterine corpus cancers were significantly higher in the hypertension group than they were in the nonhypertension group. Further stratified analyses by sex, age, and hypertension duration revealed distinct cancer-specific patterns. Higher cancer risk appears to be more obvious among younger hypertensive patients with longer follow-up time.The results of this study indicate that Taiwanese patients with hypertension have higher risks for some types of cancer, and cancer-specific patterns vary by sex, age, and hypertension duration.
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Affiliation(s)
- Li-Min Sun
- From the Department of Radiation Oncology (L-MS), Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung; School of Medicine (H-TK), China Medical University; Department of Developmental and Behavioral Pediatrics (H-TK), Children's Hospital of China Medical University; Department of Surgery (L-BJ), Organ Transplantation Center, China Medical University Hospital; Graduate Institute of Clinical Medical Science (L-BJ, J-AL, C-HK), School of Medicine, College of Medicine, China Medical University; Management Office for Health Data (C-LL), China Medical University Hospital; College of Medicine (C-LL), China Medical University; Department of Radiation Oncology (J-AL); and Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital, Taichung, Taiwan
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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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Moe B, Augestad LB, Flanders WD, Dalen H, Nilsen TIL. The adverse association of diabetes with risk of first acute myocardial infarction is modified by physical activity and body mass index: prospective data from the HUNT Study, Norway. Diabetologia 2015; 58:59-66. [PMID: 25297571 DOI: 10.1007/s00125-014-3388-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 09/05/2014] [Indexed: 12/30/2022]
Abstract
AIMS/HYPOTHESIS Diabetes increases the risk of acute myocardial infarction (AMI) and effective means for primary prevention are warranted. We prospectively examined the joint association of diabetes and leisure-time physical activity, as well as of diabetes and BMI, with the risk of AMI. METHODS A total of 55,534 men and women in the Norwegian HUNT Study were followed-up for first AMI by hospital admission registries and the Cause of Death Registry. Cox proportional adjusted HRs with 95% CIs were estimated. RESULTS Overall, 1,887 incident AMIs occurred during 12.3 years. Compared with inactive people without diabetes, inactive people with diabetes had an HR of 2.37 (95% CI 1.58, 3.57), whereas the HR among highly active persons with diabetes was 1.04 (95% CI 0.62, 1.74). Normal-weight (BMI 18.5-25 kg/m(2)) persons with diabetes had an HR of 1.60 (95% CI 1.05, 2.44) and obese (BMI > 30 kg/m(2)) persons with diabetes had an HR of 2.55 (95% CI 1.97, 3.29) compared with normal-weight persons without diabetes. The data suggest biological interaction between diabetes and physical activity, with a relative excess risk of inactivity and diabetes of 1.43 (95% CI 0.08, 2.78). For obesity and diabetes, the excess risk due to interaction was smaller (0.67; 95% CI -0.24, 1.58). CONCLUSIONS/INTERPRETATION Body weight and, in particular, physical activity modified the association between diabetes and risk of first AMI. This highlights the potential importance of physical activity and weight maintenance in primary prevention of AMI among people with diabetes.
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Affiliation(s)
- Børge Moe
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, 7491, Trondheim, Norway,
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Jian Gang P, Mo L, Lu Y, Runqi L, Xing Z. Diabetes mellitus and the risk of prostate cancer: an update and cumulative meta-analysis. Endocr Res 2015; 40:54-61. [PMID: 25105463 DOI: 10.3109/07435800.2014.934961] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION To provide further insight into the association between type 2 diabetes mellitus (T2DM) and the pathophysiology of prostate cancer, we conducted an updated, detailed meta-analysis of 56 published case-control and cohort studies. METHODS MEDLINE and EMBASE were used to identify the literature published in April 2012 related to both diabetes mellitus and prostate cancer. A sensitivity analysis was performed, and potential confounding effects were investigated using a stratified meta-analysis. A cumulative meta-analysis was also carried out to evaluate the cumulative effect estimate over time. RESULTS A total of 24 case-control and 32 cohort studies with information on a total of ~8,000,000 subjects and ~140,000 individuals with prostatic cancer showed published estimates of the association between diabetes and prostate cancer malignancy. The pooled effect estimate revealed a relative risk (RR) of 0.88 (95% CI, 0.82-0.93). Interestingly, there was an increased trend for Asians (RR = 1.72, n = 7) but not Americans (RR = 0.82, n = 28) and Europeans (RR = 0.86, n = 21) regarding the association between diabetes mellitus and prostate cancer. The sensitivity analysis, excluding any one study, did not significantly change the pooled RR. The range for the pooled RR when one study was omitted was 0.84-0.89. DISCUSSION The findings of our meta-analysis provide strong evidence of an inverse association between diabetes and prostate cancer. CONCLUSIONS Further research should focus on limitations in the current literature and re-assess the relationship between diabetes and prostate cancer by analyzing the two different diabetes mellitus types separately.
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Affiliation(s)
- Pan Jian Gang
- The Second Affiliated Hospital of Guangzhou Medical University , Guangzhou , China
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Cyrus A, Kabir A, Goodarzi D, Talaei A, Moradi A, Rafiee M, Moghimi M, Shahbazi E, Farmani E. Impact of metabolic syndrome on response to medical treatment of benign prostatic hyperplasia. Korean J Urol 2014; 55:814-20. [PMID: 25512816 PMCID: PMC4265716 DOI: 10.4111/kju.2014.55.12.814] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 10/28/2014] [Indexed: 11/21/2022] Open
Abstract
Purpose To investigate the effect of metabolic syndrome (MetS) on the response to medical therapy of benign prostatic hyperplasia (BPH) after a 3-month period of treatment. Materials and Methods This was a cohort study of 100 patients, 47 with MetS and 53 without MetS, referred to either the primary care unit or referral hospital with BPH who had moderate lower urinary tract symptoms of prostate involvement and were candidates for medical treatment. Our main outcome was response to medical treatment with prazosin 1 mg twice a day and finasteride 5 mg daily in patients with BPH on the basis of International Prostate Symptom Score (IPSS). Multivariate analysis of covariance was used to compare BPH treatment response in patients with and without MetS before and after receiving treatment. Results The mean volume of the prostate was significantly higher in MetS patients than in patients without MetS (57±32.65 mL compared with 46.00±20.19 mL, p=0.036). The control group demonstrated an 11-unit reduction in IPSS, whereas those with MetS showed a reduction in the symptom score of only 6 units (p<0.001). Regarding the components of MetS separately, triglyceride (p<0.001), fasting blood sugar (p=0.001), and waist circumference (p=0.028) significantly affected the clinical progression of BPH. The observational nature of this study may be a limitation in comparison with an interventional study. Conclusions The results of the present study showed that MetS can negatively affect the response to medical treatment of BPH. Therefore, it is necessary to consider MetS in selecting patients with BPH for drug therapy.
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Affiliation(s)
- Ali Cyrus
- Department of Urology, Arak University of Medical Sciences, Arak, Iran
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, and Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Goodarzi
- Department of Urology, Arak University of Medical Sciences, Arak, Iran
| | - Afsaneh Talaei
- Department of Endocrinology, Arak University of Medical Sciences, Arak, Iran
| | - Ali Moradi
- Asadabad Health and Treatment Network, Hamedan University of Medical Sciences, Hamadan, and Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Rafiee
- Department of Statistics, Arak University of Medical Sciences, Arak, Iran
| | - Mehrdad Moghimi
- Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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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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