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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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Wu S, Zou Q, Li C, Huang H, Xiong Z. Predicted body fat percentage, fat mass and lean body mass in relation to risk of prostate cancer: Results from the NHANES 1999 to 2010. Medicine (Baltimore) 2024; 103:e38422. [PMID: 38847698 PMCID: PMC11155590 DOI: 10.1097/md.0000000000038422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/09/2024] [Indexed: 06/10/2024] Open
Abstract
The purpose of this study is to examine the relationship between fat mass (FM), body fat percentage (BF%), lean body mass (LM), and prostate cancer (PCa), and evaluate their potential impact on the risk of PCa. Data from the National Health and Nutrition Examination Survey (NHANES) of the United States were utilized. Adult male participants from 6 survey cycles between 1999 and 2010 were selected as the study sample. Multivariable logistic regression analysis was conducted to explore the association between BF%, LM, and PCa, while controlling for potential confounding variables. Among the 8440 participants, 359 cases of PCa were diagnosed. The relationship between BF%, LM, and PCa was nonlinear. In the multivariable logistic regression analysis, there was an independent association between BF% and PCa risk (OR: 1.04, 95% CI: 1.02-1.06), suggesting that higher BF% levels are associated with an increased risk of PCa. Conversely, higher LM levels were associated with a decreased risk of PCa (OR: 0.96, 95% CI: 0.95-0.98). The findings of this study demonstrate a correlation between BF% and LM with PCa, but do not provide direct evidence of a causal relationship. Higher BF% levels are associated with an increased risk of PCa, while higher LM levels are associated with a decreased risk. These results provide valuable insights for understanding and potentially preventing PCa, although further research is needed to fully comprehend the underlying mechanisms.
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Affiliation(s)
- Shuai Wu
- Department of Urology, The First People’s Hospital of Fuzhou City, Fuzhou, Jiangxi Province, China
| | - Qi Zou
- Department of Urology, The First People’s Hospital of Fuzhou City, Fuzhou, Jiangxi Province, China
| | - Chen Li
- Department of Urology, The First People’s Hospital of Fuzhou City, Fuzhou, Jiangxi Province, China
| | - Huibing Huang
- Department of Urology, The First People’s Hospital of Fuzhou City, Fuzhou, Jiangxi Province, China
| | - Zhiyong Xiong
- Department of Urology, The First People’s Hospital of Fuzhou City, Fuzhou, Jiangxi Province, China
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Lee H, Chung HS, Kim YJ, Choi MK, Roh YK, Yu JM, Oh CM, Kim J, Moon S. Association between body composition and the risk of mortality in the obese population in the United States. Front Endocrinol (Lausanne) 2023; 14:1257902. [PMID: 38089609 PMCID: PMC10711108 DOI: 10.3389/fendo.2023.1257902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
Background Recent studies have presented the concept of the obesity paradox, suggesting that individuals with obesity have a lower risk of death than those without obesity. This paradox may arise because body mass index (BMI) alone is insufficient to understand body composition accurately. This study investigated the relationship between fat and muscle mass and the risk of mortality in individuals with overweight/obesity. Methods We used data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2006 and 2011 to 2018, which were linked to mortality information obtained from the National Death Index. Multiple Cox regression analyses were performed to estimate mortality risk. Subgroup analysis was conducted using propensity score-matched (PSM) data for age, sex, and race/ethnicity. Results This study included 16,555 participants who were overweight/obese (BMI≥25 kg/m2). An increase in appendicular skeletal muscle mass index was associated with a lower mortality risk (hazard ratio [HR]: 0.856; 95% confidence interval [CI]: 0.802-0.915). This finding was consistent with the subgroup analysis of the PSM data. Contrastingly, a high fat mass index was associated with an increased risk of mortality. Sarcopenic overweight/obesity was significantly associated with high mortality compared to obesity without sarcopenia (HR: 1.612, 95%CI: 1.328-1.957). This elevated risk was significant in both age- and sex-based subgroups. This finding was consistent with the subgroup analysis using PSM data. Conclusion In contrast to the obesity paradox, a simple increase in BMI does not protect against mortality. Instead, low body fat and high muscle mass reduce mortality risk.
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Affiliation(s)
- Heeso Lee
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Yoon Jung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Min Kyu Choi
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Yong Kyun Roh
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jae Myung Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Chang-Myung Oh
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - Joon Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - Shinje Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
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Tzenios N, Tazanios ME, Chahine M. The impact of body mass index on prostate cancer: An updated systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e30191. [PMID: 36397423 PMCID: PMC9666096 DOI: 10.1097/md.0000000000030191] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Increasing evidence suggested obesity was associated with the risk of prostate cancer. Also, the association between prostate cancer risk and obesity has received much attention in recent years, but the results are still unclear. Therefore, the current systematic review and meta-analysis aimed to evaluate the impact of body mass index (BMI) on prostate cancer. METHODS We systematically searched PubMed, Google Scholar, Scopus and Cochrane databases with the appropriate key terms to identify the eligible articles related to the impact of BMI on prostate cancer. The Newcastle-Ottawa checklist was used for the quality assessment of studies, and the meta-analysis was carried out using Review Manager 5.3. RESULTS The present review includes 23 studies that fulfilled the criteria for inclusion. In the meta-analysis, a significant difference was observed between the obese and normal weight (P < .001) and 54% of obese has a risk compared to normal weight. Heterogeneity between the fifteen studies was high (I2 = 100%). Test for overall effect: Z = 8.77 (P < .001) (odds ratio [OR] = 0.32 confidence interval [CI]: 0.25-0.42). However, there was no significant difference observed between the overweight and normal weight (P = .75). Heterogeneity between the fifteen studies is high (I2 = 100%). CONCLUSION Prostate cancer is a common malignancy that poses a threat to the health of men. Obesity is associated with a higher risk of death from prostate cancer based on the findings of the included studies. Furthermore, wherever possible, the impact of weight change on prostate cancer patient mortality should be investigated.
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Affiliation(s)
- Nikolaos Tzenios
- Public Health and Medical Research, Charisma University, Grace Bay, Turks and Caicos Islands, Train to Teach in Medicine, Department of Postgraduate Medical Education, Harvard Medical School, Boston, Massachusetts. Doctor of Health Sciences Candidate, MCPHS University, Boston, MA, USA
- * Correspondence: Nikolaos Tzenios, Public Health and Medical Research, Charisma University, Grace Bay, Turks and Caicos Islands, Train to Teach in Medicine, Department of Postgraduate Medical Education, Harvard Medical School, Boston, Massachusetts. Doctor of Health Sciences Candidate, MCPHS University, 3 Walham Yard, London SW6 1JA, UK (e-mail: )
| | | | - Mohamed Chahine
- Biological and Chemical Technology, International Medical Institute, Kursk State Medical University, Kursk, Russian Federation
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Duc HN, Oh H, Kim MS. The Effect of Mixture of Heavy Metals on Obesity in Individuals ≥50 Years of Age. Biol Trace Elem Res 2022; 200:3554-3571. [PMID: 34686995 DOI: 10.1007/s12011-021-02972-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
Little is known about the association between a mixture of heavy metals and obesity among individuals ≥50 years of age with comorbidities. Thus, we identified the associations of serum cadmium (Cd), lead (Pb), and mercury (Hg) with obesity using linear regression models; weighted quantile sum (WQS) regression, quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR) were conducted as secondary analyses. Of the 6434 subjects included in the analysis, 13.8% had obesity and 44.6% had abdominal obesity. In the logistic regression model, serum Hg was associated with obesity and abdominal obesity, and significant trends were observed for these heavy metal tertiles (p < 0.001). Serum Hg levels were also associated with body mass index (BMI) and waist circumference (WC). The WQS index was significantly associated with both obesity (OR = 1.43, 95% CI: 1.40-1.46) and abdominal obesity (β = 1.51, 95% CI: 1.48-1.54). The qgcomp index also found a significant association between heavy metals and both obesity (OR = 1.35, 95% CI: 1.12-1.63) and abdominal obesity (OR = 1.34, 95% CI: 1.12-1.60). Serum Hg was the most heavily weighed heavy metal in these models. In BKMR analysis, the overall effect of the mixture was significantly associated with obesity, BMI, and WC. Serum Hg showed positive trends and was observed as the most important factor associated with obesity, BMI, and WC. Our findings were largely robust to secondary analyses that used three novel mixture modeling approaches: WQS, qpcomp, and BKMR. Given increasing exposure to heavy metals, well-characterized cohorts of individuals aged ≥50 years are required to determine the mixed effects of heavy metals on obesity and related diseases.
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Affiliation(s)
- Hai Nguyen Duc
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea
| | - Hojin Oh
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea
| | - Min-Sun Kim
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, Republic of Korea.
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Purcell SA, Oliveira CLP, Mackenzie M, Robson P, Lewis JD, Prado CM. Body Composition and Prostate Cancer Risk: A Systematic Review of Observational Studies. Adv Nutr 2022; 13:1118-1130. [PMID: 34918023 PMCID: PMC9340980 DOI: 10.1093/advances/nmab153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/13/2021] [Accepted: 12/10/2021] [Indexed: 12/24/2022] Open
Abstract
Body composition parameters are not captured by measures of body mass, which may explain inconsistent associations between body weight and prostate cancer (PC) risk. The objective of this systematic review was to characterize the association between fat mass (FM) and fat-free mass (FFM) parameters and PC risk. A search of PubMed, Embase, and Web of Science identified case-control and cohort studies that measured body composition in relation to PC risk. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Thirteen observational studies were included, of which 8 were case-control studies (n = 1572 cases, n = 1937 controls) and 5 were prospective cohort studies (n = 7854 incident cases with PC). The NOS score was 5.9 ± 1.1 for case-control studies and 8.4 ± 1.3 for cohort studies. The most common body composition technique was bioelectrical impedance analysis (n = 9 studies), followed by DXA (n = 2), computed tomography (n = 2), air displacement plethysmography (n = 1), and MRI (n = 1). No case-control studies reported differences in %FM between PC cases and controls and no consistent differences in FM or FFM (in kilograms) were observed. Two out of 5 cohort studies reported that higher %FM was associated with lower PC risk. Conversely, 3 cohort studies reported a greater risk of being diagnosed with advanced/aggressive PC with higher FM (expressed in kilograms, %FM, or fat distribution). Two out of 4 studies (both case-control and cohort) found that higher abdominal adipose tissue was associated with increased PC risk. In conclusion, although results were inconsistent, there is some evidence that FM may be negatively associated with total PC risk but positively associated with the risk of advanced/aggressive PC; modest evidence suggests that abdominal adipose tissue may increase the risk of PC. Future work should elucidate unique patterns of FM distribution and PC risk to triage men at risk for developing PC. This study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database as CRD42019133388.
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Affiliation(s)
- Sarah A Purcell
- Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Camila L P Oliveira
- Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Mackenzie
- Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Paula Robson
- Cancer Care Alberta and the Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - John D Lewis
- Department of Experimental Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Carla M Prado
- Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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7
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Lee H, Chung HS, Kim YJ, Choi MK, Roh YK, Chung W, Yu JM, Oh CM, Moon S. Association between body shape index and risk of mortality in the United States. Sci Rep 2022; 12:11254. [PMID: 35788633 PMCID: PMC9253149 DOI: 10.1038/s41598-022-15015-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
The body mass index (BMI) neither differentiates fat from lean mass nor does it consider adipose tissue distribution. In contrast, the recently introduced z-score of the log-transformed A Body Shape Index (LBSIZ) can be applied to measure obesity using waist circumference (WC), height, and weight. We aimed to investigate the association between LBSIZ and mortality. We used data from the National Health and Nutrition Examination Survey 1999–2014 and linked the primary dataset to death certificate data from the National Death Index with mortality follow-up through December 31, 2015. A multiple Cox regression analysis was performed to evaluate the hazard ratio (HR) of all-cause and cardiovascular disease (CVD) mortalities with adjustment for baseline characteristics. LBSIZ, WC, and BMI showed positive association with total fat percentage (P < 0.001); however, only WC and BMI were positively associated with appendicular skeletal mass index (ASMI) (P < 0.001). In the multiple Cox regression analysis, only LBSIZ showed a significant HR for all-cause and CVD mortalities. Under restricted cubic spline regression, mortality risk increased with LBSIZ. However, BMI and WC showed a U-shape association. In conclusion, LBSIZ is strongly associated with all-cause and CVD mortalities. Since LBSIZ is independent of BMI, LBSIZ complements BMI to identify high-risk groups for mortality even in individuals with low or normal BMI.
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Affiliation(s)
- Heysoo Lee
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, 07441, Seoul, Korea
| | - Yoon Jung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, 07441, Seoul, Korea
| | - Min Kyu Choi
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Yong Kyun Roh
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Wankyo Chung
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Jae Myung Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, 07441, Seoul, Korea
| | - Chang-Myung Oh
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, Korea.
| | - Shinje Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, 07441, Seoul, Korea.
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Sattayapiwat O, Wan P, Hernandez BY, Le Marchand L, Wilkens L, Haiman CA. Association of Anthropometric Measures With the Risk of Prostate Cancer in the Multiethnic Cohort. Am J Epidemiol 2021; 190:1770-1783. [PMID: 33751036 PMCID: PMC8675395 DOI: 10.1093/aje/kwab054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
In studies of anthropometric measures and prostate cancer risk, conducted primarily in White men, positive associations with advanced disease have been reported. We assessed body size in relation to incident prostate cancer risk in 79,950 men from the Multiethnic Cohort, with 8,819 cases identified over 22 years (1993-2015). Height was associated with increased risk of advanced prostate cancer (≥68 inches (≥ 173 cm) vs. < 66 inches (168 cm); hazard ratio (HR) = 1.24, 95% confidence interval (CI): 1.04, 1.48) and high-grade disease (HR = 1.15, 95% CI: 1.02, 1.31). Compared with men of normal weight, men overweight at baseline were at higher risk of high-grade cancer (HR = 1.15, 95% CI: 1.04, 1.26). Greater weight was positively associated with localized and low-grade disease in Blacks and Native Hawaiians (by race, P for heterogeneity = 0.0002 and 0.008, respectively). Weight change since age 21 years was positively associated with high-grade disease (for ≥ 40 pounds (18 kg) vs. 10 pounds (4.5 kg), HR = 1.20, 95% CI: 1.05, 1.37; P for trend = 0.005). Comparing highest versus lowest quartile, waist-to-hip ratio was associated with a 1.78-fold increase (95% CI: 1.28, 2.46) in the risk of advanced prostate cancer. Positive associations with the majority of anthropometric measures were observed in all 5 racial/ethnic groups, suggesting a general impact of anthropometric measures on risk across populations.
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Affiliation(s)
| | | | | | | | | | - Christopher A Haiman
- Correspondence to Dr. Christopher A. Haiman, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Harlyne Norris Research Tower, 1450 Biggy Street, Room 1504A, Mail Code LG591 MC9601, Los Angeles, CA 90033 (e-mail: )
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9
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Vallières E, Mésidor M, Roy-Gagnon MH, Richard H, Parent MÉ. General and abdominal obesity trajectories across adulthood, and risk of prostate cancer: results from the PROtEuS study, Montreal, Canada. Cancer Causes Control 2021; 32:653-665. [PMID: 33818663 DOI: 10.1007/s10552-021-01419-z] [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: 09/10/2020] [Accepted: 03/16/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Greater body fatness is a probable cause of advanced prostate cancer (PCa). Body fat distribution and timing of exposure may be relevant. We investigated associations between body size trajectories and PCa incidence in a population-based case-control study in Montreal, Canada. METHODS Cases (n = 1,931), aged ≤ 75 years, were diagnosed with PCa in 2005-2009; 1,994 controls were selected from the electoral list. Interviews were conducted to assess body mass index (BMI) and Stunkard's silhouette at ages 20, 40, 50, 60 years, and before interview. Current waist and hip circumferences were measured, and a predictive model estimated waist circumference in the past. BMI and waist circumference trajectories were determined to identify subgroups. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for the association between anthropometric indicators and PCa. RESULTS Subjects with a current BMI ≥ 30 kg/m2 had a lower risk of overall PCa (OR 0.71, 95% CI 0.59-0.85). Associations with adult BMI followed similar trends for less and more aggressive tumors, with stronger inverse relationships in early adulthood. Contrastingly, current waist circumference ≥ 102 cm was associated with elevated risk of high-grade PCa (OR 1.33, 95% CI 1.03-1.71). Men with increasing BMI or waist circumference adult trajectories had a lower risk of PCa, especially low-grade, than those in the normal-stable range. This was especially evident among men in the obese-increase group for BMI and waist circumference. CONCLUSION Abdominal obesity increased the risk of aggressive PCa. The inverse relationship between body size trajectories and PCa may reflect PSA hemodilution, lower detection, and/or a true etiological effect.
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Affiliation(s)
- Eric Vallières
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, University of Quebec, 531 Boul. des Prairies, Laval, QC, H7V 1B7, Canada.,School of Public Health, Department of Social and Preventive Medicine, University of Montreal, 7101 avenue du Parc, Montreal, QC, H3N 1X9, Canada
| | - Miceline Mésidor
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, University of Quebec, 531 Boul. des Prairies, Laval, QC, H7V 1B7, Canada.,School of Public Health, Department of Social and Preventive Medicine, University of Montreal, 7101 avenue du Parc, Montreal, QC, H3N 1X9, Canada.,University of Montreal Hospital Research Centre, 900 Saint-Denis, Tour Viger, Pavillon R, Montreal, QC, H2X 0A9, Canada
| | - Marie-Hélène Roy-Gagnon
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Hugues Richard
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, University of Quebec, 531 Boul. des Prairies, Laval, QC, H7V 1B7, Canada
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, University of Quebec, 531 Boul. des Prairies, Laval, QC, H7V 1B7, Canada. .,School of Public Health, Department of Social and Preventive Medicine, University of Montreal, 7101 avenue du Parc, Montreal, QC, H3N 1X9, Canada. .,University of Montreal Hospital Research Centre, 900 Saint-Denis, Tour Viger, Pavillon R, Montreal, QC, H2X 0A9, Canada.
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10
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Cho HW, Chung W, Moon S, Ryu OH, Kim MK, Kang JG. Effect of Sarcopenia and Body Shape on Cardiovascular Disease According to Obesity Phenotypes. Diabetes Metab J 2021; 45:209-218. [PMID: 32662256 PMCID: PMC8024159 DOI: 10.4093/dmj.2019.0223] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/06/2019] [Indexed: 12/13/2022] Open
Abstract
Background This study aimed to assess the effects of sarcopenia and A Body Shape Index (ABSI) on cardiovascular disease (CVD) risk according to obesity phenotypes. Methods We used data from the National Health and Nutrition Examination Survey 1999 to 2012. A total of 25,270 adults were included and classified into the following groups: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO). Sarcopenia was defined as the appendicular skeletal mass index <7 kg/m2 in men and <5.5kg/m2 in women. A multivariate logistic regression analysis was performed to evaluate the odds ratio (OR) of sarcopenia and ABSI for CVD events according to the obesity phenotype. Results The MHNW participants with sarcopenia had higher risk for CVD than those without sarcopenia (OR, 2.69; 95% confidence interval [CI], 1.56 to 4.64). In the analysis with MHNW participants without sarcopenia as a reference, the participants with sarcopenia showed a higher OR for CVD than those without sarcopenia in both MHO (OR in participants without sarcopenia, 3.31; 95% CI, 1.94 to 5.64) (OR in participants with sarcopenia, 8.59; 95% CI, 2.63 to 28.04) and MUO participants (OR in participants without sarcopenia, 5.11; 95% CI, 3.21 to 8.15) (OR in participants with sarcopenia, 8.12; 95% CI, 4.04 to 16.32). Participants within the second and third tertiles of ABSI had higher ORs for CVDs than the counterpart of obesity phenotypes within the first tertile. Conclusion These results suggest that clinical approaches that consider muscle and body shape are required.
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Affiliation(s)
- Hyun-Woong Cho
- Division of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, Korea
| | - Wankyo Chung
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Shinje Moon
- Division of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, Korea
| | - Ohk-Hyun Ryu
- Division of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, Korea
| | - Min Kyung Kim
- Division of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, Korea
| | - Jun Goo Kang
- Division of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, Korea
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11
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Abstract
OBJECTIVE To project the prevalence of obesity in 2040 among individuals 19 years and older in South Korea. DESIGN, SETTING, AND PARTICIPANTS Using the 'Population Health Model-body mass index' (BMI) microsimulation model, the prevalence of obesity in Korean adults 19 years and older was projected until 2040. The model integrated individual survey data from the Korea Health Panel Survey of 2011 and 2012, population statistics based on resident registration, population projections and complete life tables categorised by sex and age. Birth rate, life expectancy and international migration were based on a medium growth scenario. The base population of Korean adults in 2012, devised through data aggregation, was 39 842 730. The prediction equations were formulated using BMI as the dependent variable; the individual's sex, age, smoking status, physical activity and preceding year's BMI were used as predictive factors. OUTCOME MEASURE BMI categorised by sex. RESULTS The median BMI for Korean adults in 2040 was expected to be 23.55 kg/m2 (23.97 and 23.17 kg/m2 for men and women, respectively). According to the Korean BMI classification, 70.05% of all adults were expected to be 'preobese' (ie, have BMIs 23-24.9 kg/m2) by 2040 (81.23% of men and 59.07% of women) and 24.88% to be 'normal'. CONCLUSIONS We explored the possibility of applying and expanding on the concept of microsimulation in the field of healthcare by combining data sources available in Korea and found that more than half of the adults in this study population will be preobese, and the proportions of 'obesity' and 'normal' will decrease compared with those in 2012. The results of our study will aid in devising healthy strategies and spreading public awareness for preventing this condition.
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Affiliation(s)
- Yoon-Sun Jung
- Department of Public Health, Graduate School, Korea University, Seoul, Korea (the Republic of)
| | - Young-Eun Kim
- Big Data Department, National Health Insurance Service, Wonju, Korea (the Republic of)
| | - Dun-Sol Go
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong, Korea (the Republic of)
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea (the Republic of)
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12
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Aladwani M, Lophatananon A, Robinson F, Rahman A, Ollier W, Kote-Jarai Z, Dearnaley D, Koveela G, Hussain N, Rageevakumar R, Keating D, Osborne A, Dadaev T, Brook M, Eeles R, Muir KR. Relationship of self-reported body size and shape with risk for prostate cancer: A UK case-control study. PLoS One 2020; 15:e0238928. [PMID: 32941451 PMCID: PMC7498010 DOI: 10.1371/journal.pone.0238928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/26/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Previous evidence has suggested a relationship between male self-reported body size and the risk of developing prostate cancer. In this UK-wide case-control study, we have explored the possible association of prostate cancer risk with male self-reported body size. We also investigated body shape as a surrogate marker for fat deposition around the body. As obesity and excessive adiposity have been linked with increased risk for developing a number of different cancers, further investigation of self-reported body size and shape and their potential relationship with prostate cancer was considered to be appropriate. OBJECTIVE The study objective was to investigate whether underlying associations exist between prostate cancer risk and male self-reported body size and shape. METHODS Data were collected from a large case-control study of men (1928 cases and 2043 controls) using self-administered questionnaires. Data from self-reported pictograms of perceived body size relating to three decades of life (20's, 30's and 40's) were recorded and analysed, including the pattern of change. The associations of self-identified body shape with prostate cancer risk were also explored. RESULTS Self-reported body size for men in their 20's, 30's and 40's did not appear to be associated with prostate cancer risk. More than half of the subjects reported an increase in self-reported body size throughout these three decades of life. Furthermore, no association was observed between self-reported body size changes and prostate cancer risk. Using 'symmetrical' body shape as a reference group, subjects with an 'apple' shape showed a significant 27% reduction in risk (Odds ratio = 0.73, 95% C.I. 0.57-0.92). CONCLUSIONS Change in self-reported body size throughout early to mid-adulthood in males is not a significant risk factor for the development of prostate cancer. Body shape indicative of body fat distribution suggested that an 'apple' body shape was protective and inversely associated with prostate cancer risk when compared with 'symmetrical' shape. Further studies which investigate prostate cancer risk and possible relationships with genetic factors known to influence body shape may shed further light on any underlying associations.
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Affiliation(s)
- Mohammad Aladwani
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Fredie Robinson
- School of Medicine, University Malaysia Sabah, Sabah, Malaysia
| | - Aneela Rahman
- Shaheed Mohtarma Benazir Bhutto Medical University, Bakrani, Pakistan
| | - William Ollier
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | | | | | | | - Nafisa Hussain
- The Institute of Cancer Research, London, United Kingdom
| | | | - Diana Keating
- The Institute of Cancer Research, London, United Kingdom
| | - Andrea Osborne
- The Institute of Cancer Research, London, United Kingdom
| | - Tokhir Dadaev
- The Institute of Cancer Research, London, United Kingdom
| | - Mark Brook
- The Institute of Cancer Research, London, United Kingdom
| | | | - Rosalind Eeles
- The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Kenneth R. Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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13
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Harrison S, Tilling K, Turner EL, Martin RM, Lennon R, Lane JA, Donovan JL, Hamdy FC, Neal DE, Bosch JLHR, Jones HE. Systematic review and meta-analysis of the associations between body mass index, prostate cancer, advanced prostate cancer, and prostate-specific antigen. Cancer Causes Control 2020; 31:431-449. [PMID: 32162172 PMCID: PMC7105428 DOI: 10.1007/s10552-020-01291-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 02/27/2020] [Indexed: 01/15/2023]
Abstract
PURPOSE The relationship between body mass index (BMI) and prostate cancer remains unclear. However, there is an inverse association between BMI and prostate-specific antigen (PSA), used for prostate cancer screening. We conducted this review to estimate the associations between BMI and (1) prostate cancer, (2) advanced prostate cancer, and (3) PSA. METHODS We searched PubMed and Embase for studies until 02 October 2017 and obtained individual participant data from four studies. In total, 78 studies were identified for the association between BMI and prostate cancer, 21 for BMI and advanced prostate cancer, and 35 for BMI and PSA. We performed random-effects meta-analysis of linear associations of log-PSA and prostate cancer with BMI and, to examine potential non-linearity, of associations between categories of BMI and each outcome. RESULTS In the meta-analyses with continuous BMI, a 5 kg/m2 increase in BMI was associated with a percentage change in PSA of - 5.88% (95% CI - 6.87 to - 4.87). Using BMI categories, compared to normal weight men the PSA levels of overweight men were 3.43% lower (95% CI - 5.57 to - 1.23), and obese men were 12.9% lower (95% CI - 15.2 to - 10.7). Prostate cancer and advanced prostate cancer analyses showed little or no evidence associations. CONCLUSION There is little or no evidence of an association between BMI and risk of prostate cancer or advanced prostate cancer, and strong evidence of an inverse and non-linear association between BMI and PSA. The association between BMI and prostate cancer is likely biased if missed diagnoses are not considered.
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Affiliation(s)
- Sean Harrison
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England.
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, England.
| | - Kate Tilling
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, England
| | - Emma L Turner
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Richard M Martin
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, England
| | - Rosie Lennon
- Department of Environment and Geography, University of York, York, England
| | - J Athene Lane
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, England
| | - Jenny L Donovan
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West, University Hospitals Bristol NHS Trust, Bristol, England
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, England
| | - David E Neal
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, England
- Department of Oncology, Addenbrooke's Hospital, University of Cambridge, Cambridge, England
| | - J L H Ruud Bosch
- Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hayley E Jones
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
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14
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Kensler KH, Rebbeck TR. Cancer Progress and Priorities: Prostate Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:267-277. [PMID: 32024765 PMCID: PMC7006991 DOI: 10.1158/1055-9965.epi-19-0412] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/10/2019] [Accepted: 12/03/2019] [Indexed: 02/06/2023] Open
Affiliation(s)
- Kevin H Kensler
- Division of Population Sciences, Dana-Farber Cancer Institute and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Timothy R Rebbeck
- Division of Population Sciences, Dana-Farber Cancer Institute and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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15
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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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16
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Chung W, Park JH, Chung HS, Yu JM, Moon S, Kim DS. The Association between Z-Score of Log-Transformed A Body Shape Index and Cardiovascular Disease in Korea. Diabetes Metab J 2019; 43:675-682. [PMID: 31237130 PMCID: PMC6834836 DOI: 10.4093/dmj.2018.0169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 01/15/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND In order to overcome the limitations of body mass index (BMI) and waist circumference (WC), the z-score of the log-transformed A Body Shape Index (LBSIZ) has recently been introduced. In this study, we analyzed the relationship between the LBSIZ and cardiovascular disease (CVD) in a Korean representative sample. METHODS Data were collected from the Korea National Health and Nutrition Examination VI to V. The association between CVD and obesity indices was analyzed using a receiver operating characteristic curve. The cut-off value for the LBSIZ was estimated using the Youden index, and the odds ratio (OR) for CVD was determined via multivariate logistic regression analysis. ORs according to the LBSIZ value were analyzed using restricted cubic spline regression plots. RESULTS A total of 31,227 Korean healthy adults were analyzed. Area under the curve (AUC) of LBSIZ against CVD was 0.686 (95% confidence interval [CI], 0.671 to 0.702), which was significantly higher than the AUC of BMI (0.583; 95% CI, 0.567 to 0.599) or WC (0.646; 95% CI, 0.631 to 0.661) (P<0.001). Similar results were observed for stroke and coronary artery diseases. The cut-off value for the LBSIZ was 0.35 (sensitivity, 64.5%; specificity, 64%; OR, 1.29, 95% CI, 1.12 to 1.49). Under restricted cubic spline regression, LBSIZ demonstrated that OR started to increase past the median value. CONCLUSION The findings of this study suggest that the LBSIZ might be more strongly associated with CVD risks compared to BMI or WC. These outcomes would be helpful for CVD risk assessment in clinical settings, especially the cut-off value of the LBSIZ suggested in this study.
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Affiliation(s)
- Wankyo Chung
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hye Soo Chung
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jae Myung Yu
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Shinje Moon
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
- Department of Internal Medicine, Graduate School, Hanyang University, Seoul, Korea
| | - Dong Sun Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
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17
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Utility of the Z-score of log-transformed A Body Shape Index (LBSIZ) in the assessment for sarcopenic obesity and cardiovascular disease risk in the United States. Sci Rep 2019; 9:9292. [PMID: 31243316 PMCID: PMC6594943 DOI: 10.1038/s41598-019-45717-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 06/11/2019] [Indexed: 12/14/2022] Open
Abstract
Body mass index (BMI) has limited accuracy for predicting cardiovascular diseases (CVD) and is not capable of identifying sarcopenic obesity, the combination of sarcopenia (an age-associated decline in muscle mass and physical function) and obesity. To overcome this, the z-score of the log-transformed A Body Shape Index (LBSIZ) was recently introduced as a measure of obesity using waist circumference, height, and weight. We aimed to investigate the association of LBSIZ with sarcopenic obesity and CVD, and propose appropriate cut-off values using the National Health and Nutrition Examination Survey 1999–2016 data. Of 92,062 participants, 40,468 adults (≥20 years) were included. Overall area under curve (AUC) of LBSIZ was 0.735 (95% confidence interval [CI]: 0.716–0.754) for sarcopenic obesity, and 0.695 (95% CI: 0.687–0.703) for CVD. The subgroup analysis of ethnicity/race showed similar results. Waist circumference (WC), BMI, conicity index, body roundness index (BRI), Clinica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), new BMI, and waist to height ratio (WHtR) showed a negative association with sarcopenic obesity, while LBSIZ and conicity index showed a positive association. The AUC of LBSIZ was significantly higher for sarcopenic obesity than that of conicity index (p < 0.001). The AUC of LBSIZ was significantly higher for CVD than those of parameters including WC, BMI, BRI, CUN-BAE, new BMI, and WHtR (p < 0.001). The AUC for conicity index alone was comparable to that of LBSIZ for CVD. Overall LBSIZ cut-off was 0.35 for both sarcopenic obesity (sensitivity, 65.3%; specificity, 71.5%) and CVD (sensitivity, 63.3%; specificity, 66.6%). These results may be useful not only to identify sarcopenic obesity, but also to conduct CVD risk assessment in the clinical setting.
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18
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Dickerman BA, Torfadottir JE, Valdimarsdottir UA, Giovannucci E, Wilson KM, Aspelund T, Tryggvadottir L, Sigurdardottir LG, Harris TB, Launer LJ, Gudnason V, Markt SC, Mucci LA. Body fat distribution on computed tomography imaging and prostate cancer risk and mortality in the AGES-Reykjavik study. Cancer 2019; 125:2877-2885. [PMID: 31179538 DOI: 10.1002/cncr.32167] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/07/2018] [Accepted: 12/24/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND The World Cancer Research Fund classifies as "strong evidence" the link between obesity and the risk of advanced prostate cancer. In light of the different hormonal profiles associated with where adipose is stored, this study investigated the role of objectively measured body fat distribution and the risk of clinically relevant prostate cancer. METHODS This was a prospective study of 1832 men in the Age, Gene/Environment Susceptibility-Reykjavik study. From 2002 to 2006, participants underwent baseline computed tomography imaging of fat deposition, bioelectric impedance analysis, and measurement of body mass index (BMI) and waist circumference. Men were followed through linkage with nationwide cancer registries for the incidence of total (n = 172), high-grade (Gleason grade ≥8; n = 43), advanced (≥cT3b/N1/M1 at diagnosis or fatal prostate cancer over follow-up; n = 41), and fatal prostate cancer (n = 31) through 2015. Cox regression was used to evaluate the association between adiposity measures and prostate cancer outcomes. RESULTS Among all men, visceral fat (hazard ratio [HR], 1.31 per 1-standard deviation [SD] increase; 95% confidence interval [CI], 1.00-1.72) and thigh subcutaneous fat (HR, 1.37 per 1-SD increase; 95% CI, 1.00-1.88) were associated with risk of advanced and fatal disease, respectively. Among men who were leaner based on BMI, visceral fat was associated with both advanced and fatal disease. BMI and waist circumference were associated with a higher risk of advanced and fatal disease. No adiposity measures were associated with total or high-grade disease. CONCLUSIONS Specific fat depots as well as BMI and waist circumference were associated with the risk of aggressive prostate cancer, which may help to elucidate underlying mechanisms and target intervention strategies.
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Affiliation(s)
- Barbra A Dickerman
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Johanna E Torfadottir
- Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland.,Icelandic Cancer Registry, Reykjavik, Iceland
| | - Unnur A Valdimarsdottir
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland.,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Kathryn M Wilson
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Thor Aspelund
- Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland.,Icelandic Heart Association, Kopavogur, Iceland
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - 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, Icelandic Cancer Society, Reykjavik, Iceland
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, Maryland
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, Maryland
| | - Vilmundur Gudnason
- Icelandic Cancer Registry, Reykjavik, Iceland.,Icelandic Heart Association, Kopavogur, Iceland
| | - Sarah C Markt
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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19
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Sex differences in relationship between body composition and digit length ratio (2D:4D) in students of military courses. ANTHROPOLOGICAL REVIEW 2018. [DOI: 10.2478/anre-2018-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
It is believed that the second to fourth finger length ratio is an indirect indicator of fetal testosterone levels. It is pointed out that there is a relationship between the 2nd to 4th finger length ratio and the body structure in women and men. Studies on the relationship between body composition and 2D:4D finger length among military students have not been carried out so far. The work aims to determine the dependence of body composition and the quotient of the 2nd and 4th fingers length of military students. The research material has been gathered as a result of examinations of women and men studying military subjects. The study involved 55 women and 65 men. The tests included anthropometric measurements (body height, body weight, length of the second and the fourth fingers) and body composition measurements. As a result of the tests, no dimorphic differentiations in the digit length ratio (2D:4D) was indicated. The BMI, muscle mass, lean body mass and water in the body demonstrated higher values in men than in women. However, the fat content in men was low. It was found that the relationship exists between muscle mass, lean mass and total water content in the body and the 2D:4D finger length ratio in the left hand in women. A higher level of fetal testosterone, characterized by lower values of the 2nd to 4th finger length ratio, may be associated with a higher content of muscle mass, lean body mass and water in the body of adult women leading a similar lifestyle.
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20
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Abdominal obesity and prostate cancer risk: epidemiological evidence from the EPICAP study. Oncotarget 2018; 9:34485-34494. [PMID: 30349643 PMCID: PMC6195387 DOI: 10.18632/oncotarget.26128] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 09/03/2018] [Indexed: 11/29/2022] Open
Abstract
Obesity is associated with an increased risk of several cancers, but inconsistent results have been observed between body mass index (BMI) and prostate cancer (PCa) risk. However, some associations have been reported with other indicators such as waist circumference (WC) and waist-hip ratio (WHR). We investigated the role of anthropometric indicators in PCa risk based on data from the Epidemiological study of Prostate Cancer (EPICAP). EPICAP is a population-based case-control study that included 819 incident PCa in 2012–2013 and 879 controls frequency matched by age. Anthropometric indicators (weight, height, WC, and hip circumference) have been measured at interview. Logistic regression models were used to assess odds ratios (ORs) for the associations between anthropometric indicators (BMI, WC and WHR) and PCa risk. We observed a slight, but not significant increased risk of PCa for men with a WC > 94 cm (OR 1.20, 95% CI 0.92–1.56) and for men with a WHR ≥ 0.95 (OR 1.30, 95% CI 1.00–1.70 between 0.95 and 1.00, OR 1.25, 95% CI 0.96–1.61 above 1.00). Associations were more pronounced after adjustment and stratification for BMI and in men with aggressive PCa. Our results suggest that abdominal obesity may be associated with an increased risk of PCa, especially aggressive PCa.
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21
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Chung W, Park JH, Ryu OH, Yu JM, Yoo HJ, Moon S. Association of Z-Score of the Log-Transformed A Body Shape Index with Cardiovascular Disease in People Who Are Obese but Metabolically Healthy: The Korea National Health and Nutrition Examination Survey 2007-2010. J Obes Metab Syndr 2018; 27:158-165. [PMID: 31089558 PMCID: PMC6504195 DOI: 10.7570/jomes.2018.27.3.158] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/22/2018] [Accepted: 07/18/2018] [Indexed: 01/20/2023] Open
Abstract
Background We aimed at evaluating the effect of the z-score of the log-transformed A Body Shape Index (LBSIZ) on cardiovascular disease (CVD) outcomes according to obesity phenotype. Methods Data were collected from the Korea National Health and Nutrition Examination Survey conducted from 2007 to 2010. Obesity was defined as a body mass index above 25 kg/m2 and metabolic abnormality was defined as the presence of two or more metabolic risk factors of the Adult Treatment Panel III definition. The participants were classified by obesity and metabolic healthy status: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). Each group was further classified into three groups based on the tertile of LBSIZ. A multivariate logistic regression analysis with adjustment for age, sex, smoking status, income, education level, physical activities, alcohol, and energy intake was conducted to evaluate the odds ratio (OR) for CVD events. Results In the multivariate logistic regression model, MHO participants who are within the third tertile of LBSIZ had a significantly higher OR for CVD events, whereas those who are within the first and second tertile of LBSIZ were not at high risk of developing CVDs compared to MHNO participants who are within the first tertile of LBSIZ. In addition, a similar increase in the OR was observed in MUNO or MUO participants. Conclusion LBSIZ had the lowest risk for CVDs in the first tertile of LBSIZ and a linear relationship with all its tertiles in MHO, MUNO, and MUO participants.
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Affiliation(s)
- Wankyo Chung
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ohk-Hyun Ryu
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea
| | - Jae Myung Yu
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea
| | - Hyung Joon Yoo
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea.,Department of Internal Medicine, CM Hospital, Seoul, Korea
| | - Shinje Moon
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea
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22
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Effectiveness of Z-score of log-transformed A Body Shape Index (LBSIZ) in predicting cardiovascular disease in Korea: the Korean Genome and Epidemiology Study. Sci Rep 2018; 8:12094. [PMID: 30108276 PMCID: PMC6092353 DOI: 10.1038/s41598-018-30600-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 08/02/2018] [Indexed: 12/17/2022] Open
Abstract
Body mass index (BMI) and waist circumference (WC) have limitations in stratifying cardio-metabolic risks. Another obesity measure, A Body Shape Index (ABSI), has been introduced but its applicability remains limited. To address this, the z-score of the log-transformed ABSI (LBSIZ) was recently developed. This study aimed to examine the ability of LBSIZ, compared to that of WC and BMI, to predict cardiovascular disease (CVD) risk. The study included 8,485 participants aged 40-69 years (mean age = 52.1) who were followed for 10 years and recruited from the Korean Genome and Epidemiology Study, a population-based cohort study. The area under the curve was 0.635 (95% confidence interval [CI]: 0.614-0.657) for LBSIZ, 0.604 (95%CI: 0.580-0.627) for WC, and 0.538 (95%CI: 0.514-0.562) for BMI. The AUC of the Framingham risk score (FRS) was 0.680 (95%CI: 0.659-0.701) in comparison. When we added LBSIZ to the model, the integrated AUC significantly improved from 0.680 to 0.692 (95%CI: 0.672-0.713; p value, 0.033), whereas there were no changes with BMI (AUC, 0.678; 95%CI: 0.656-0.699) or WC (AUC, 0.679; 95%CI: 0.658-0.701). In the multivariate Cox regression analysis, LBSIZ but not BMI or WC showed a significant hazard ratio of CVD event compared to 1st decile of each parameter. In the restricted cubic spline regression, BMI and WC showed an overall J-shaped relationship with CVD events whereas LBSIZ showed a linear relationship. LBSIZ is strongly associated with CVD risk and should predict CVD risk better than BMI and WC in the general population.
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23
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Perez-Cornago A, Key TJ, Allen NE, Fensom GK, Bradbury KE, Martin RM, Travis RC. Prospective investigation of risk factors for prostate cancer in the UK Biobank cohort study. Br J Cancer 2017; 117:1562-1571. [PMID: 28910820 PMCID: PMC5680461 DOI: 10.1038/bjc.2017.312] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/03/2017] [Accepted: 08/15/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Prostate cancer is the most common cancer in British men but its aetiology is not well understood. We aimed to identify risk factors for prostate cancer in British males. METHODS We studied 219 335 men from the UK Biobank study who were free from cancer at baseline. Exposure data were collected at recruitment. Prostate cancer risk by the different exposures was estimated using multivariable-adjusted Cox proportional hazards models. RESULTS In all, 4575 incident cases of prostate cancer occurred during 5.6 years of follow-up. Prostate cancer risk was positively associated with the following: black ethnicity (hazard ratio black vs white=2.61, 95% confidence interval=2.10-3.24); having ever had a prostate-specific antigen test (1.31, 1.23-1.40); being diagnosed with an enlarged prostate (1.54, 1.38-1.71); and having a family history of prostate cancer (1.94, 1.77-2.13). Conversely, Asian ethnicity (Asian vs white hazard ratio=0.62, 0.47-0.83), excess adiposity (body mass index (⩾35 vs <25 kg m-2=0.75, 0.64-0.88) and body fat (⩾30.1 vs <20.5%=0.81, 0.73-0.89)), cigarette smoking (current vs never smokers=0.85, 0.77-0.95), having diabetes (0.70, 0.62-0.80), and never having had children (0.89, 0.81-0.97) or sexual intercourse (0.53, 0.33-0.84) were related to a lower risk. CONCLUSIONS In this new large British prospective study, we identified associations with already-established, putative and possible novel risk factors for being diagnosed with prostate cancer. Future research will examine associations by tumour characteristics.
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Affiliation(s)
- Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford OX3 7LF, UK
| | - Georgina K Fensom
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Kathryn E Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS6 7QD, UK
- Medical Research Council/University of Bristol Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
- National Institute for Health Research Bristol Biomedical Research Unit in Nutrition, Bristol Education & Research Centre, Upper Maudlin Street, Bristol BS2 8AE, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
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24
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Xie B, Zhang G, Wang X, Xu X. Body mass index and incidence of nonaggressive and aggressive prostate cancer: a dose-response meta-analysis of cohort studies. Oncotarget 2017; 8:97584-97592. [PMID: 29228634 PMCID: PMC5722586 DOI: 10.18632/oncotarget.20930] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/26/2017] [Indexed: 11/25/2022] Open
Abstract
The relationship between body mass index (BMI) and incidence of prostate cancer is still inconclusive. We performed a dose-response meta-analysis of eligible cohort studies to evaluate potential association of BMI with prostate cancer risk by subtype of prostate cancer (nonaggressive and aggressive). A comprehensive literature search was performed in PubMed and Web of Science databases through March 22, 2017. Linear and non-linear dose-response meta-analyses were carried out to evaluate the effects of BMI on incidence of prostate cancer. A total of 21 cohort or nested case-control studies (17 for nonaggressive and 21 for aggressive prostate cancer) were included in this meta-analysis. For nonaggressive prostate cancer, the pooled relative risk (RR) per 5 kg/m2 increment of BMI with 95% confidence interval (CI) was 0.96 (95% CI 0.92–1.00). Sensitivity analysis indicated that this result was not robust and steady. For aggressive prostate cancer, a significant linear direct relationship with BMI (RR, 1.07; 95% CI 1.03–1.12) for every 5 kg/m2 increase was observed. Statistically significant heterogeneity was detected for nonaggressive prostate cancer (P = 0.020, I2 = 46.1%) but not for aggressive prostate cancer (P = 0.174, I2 = 22.4%). In conclusion, BMI level may be positively associated with aggressive prostate cancer risk. Further large prospective cohort studies are warranted to confirm the findings from our study.
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Affiliation(s)
- Bo Xie
- Department of Urology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang 310012, China
| | - Guanjun Zhang
- Department of Urology, Hospital of Traditional Chinese Medicine of Shangyu, Shangyu 312300, Zhejiang, China
| | - Xiao Wang
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Xin Xu
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
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25
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Guerrios-Rivera L, Howard L, Frank J, De Hoedt A, Beverly D, Grant DJ, Hoyo C, Freedland SJ. Is Body Mass Index the Best Adiposity Measure for Prostate Cancer Risk? Results From a Veterans Affairs Biopsy Cohort. Urology 2017; 105:129-135. [PMID: 28408337 DOI: 10.1016/j.urology.2017.03.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/16/2017] [Accepted: 03/31/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To test multiple adiposity measures and prostate cancer (PC) risk in men undergoing prostate biopsy. We hypothesized that body mass index (BMI), body fat, and waist circumference would be highly correlated, and all would be associated with aggressive PC, but not overall risk. SUBJECTS AND METHODS A case (483)-control (496) study among men undergoing prostate biopsy from 2007 to 2016 was conducted at the Durham Veterans Affairs Medical Center. Anthropometric and self-reported measurements were taken. Percent body fat was measured. Associations between adiposity measures and PC risk and high-grade PC (Gleason ≥7) were examined using logistic regression. RESULTS BMI, percent body fat, and waist circumference were highly correlated (ρ ≥ .79) (P < .001). On multivariable analysis, BMI (P = .011) was associated with overall PC risk, but percent body fat (P = .16) and waist circumference (P = .19) were not. However, all adiposity measurements were associated with high-grade disease (P < .001). We found a strong relationship between self-reported and measured weight (ρ = .97) and height (ρ = .92). CONCLUSION BMI, body fat, and waist circumference were all highly correlated and associated with aggressive PC. This study supports the idea that higher adiposity is selectively associated with high-grade PC and reinforces the continued use of self-reported BMI as a measure of obesity in epidemiologic studies of PC.
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Affiliation(s)
- Lourdes Guerrios-Rivera
- Urology Section, Surgery Department, Veterans Administration Caribbean Healthcare System and University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Lauren Howard
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC; Urology Section, Veterans Affairs Medical Center Durham, Durham, NC
| | - Jennifer Frank
- Urology Section, Veterans Affairs Medical Center Durham, Durham, NC
| | - Amanda De Hoedt
- Urology Section, Veterans Affairs Medical Center Durham, Durham, NC
| | - Devon Beverly
- Urology Section, Veterans Affairs Medical Center Durham, Durham, NC
| | - Delores J Grant
- Department of Biology and Cancer Research Program, Julius L. Chambers Biomedical/Biotechnology Research Institute, North Carolina Central University Durham, NC
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC
| | - Stephen J Freedland
- Urology Section, Veterans Affairs Medical Center Durham, Durham, NC; Division of Urology, Department of Surgery, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA.
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26
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Khankari NK, Shu XO, Wen W, Kraft P, Lindström S, Peters U, Schildkraut J, Schumacher F, Bofetta P, Risch A, Bickeböller H, Amos CI, Easton D, Eeles RA, Gruber SB, Haiman CA, Hunter DJ, Chanock SJ, Pierce BL, Zheng W. Association between Adult Height and Risk of Colorectal, Lung, and Prostate Cancer: Results from Meta-analyses of Prospective Studies and Mendelian Randomization Analyses. PLoS Med 2016; 13:e1002118. [PMID: 27598322 PMCID: PMC5012582 DOI: 10.1371/journal.pmed.1002118] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 07/28/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Observational studies examining associations between adult height and risk of colorectal, prostate, and lung cancers have generated mixed results. We conducted meta-analyses using data from prospective cohort studies and further carried out Mendelian randomization analyses, using height-associated genetic variants identified in a genome-wide association study (GWAS), to evaluate the association of adult height with these cancers. METHODS AND FINDINGS A systematic review of prospective studies was conducted using the PubMed, Embase, and Web of Science databases. Using meta-analyses, results obtained from 62 studies were summarized for the association of a 10-cm increase in height with cancer risk. Mendelian randomization analyses were conducted using summary statistics obtained for 423 genetic variants identified from a recent GWAS of adult height and from a cancer genetics consortium study of multiple cancers that included 47,800 cases and 81,353 controls. For a 10-cm increase in height, the summary relative risks derived from the meta-analyses of prospective studies were 1.12 (95% CI 1.10, 1.15), 1.07 (95% CI 1.05, 1.10), and 1.06 (95% CI 1.02, 1.11) for colorectal, prostate, and lung cancers, respectively. Mendelian randomization analyses showed increased risks of colorectal (odds ratio [OR] = 1.58, 95% CI 1.14, 2.18) and lung cancer (OR = 1.10, 95% CI 1.00, 1.22) associated with each 10-cm increase in genetically predicted height. No association was observed for prostate cancer (OR = 1.03, 95% CI 0.92, 1.15). Our meta-analysis was limited to published studies. The sample size for the Mendelian randomization analysis of colorectal cancer was relatively small, thus affecting the precision of the point estimate. CONCLUSIONS Our study provides evidence for a potential causal association of adult height with the risk of colorectal and lung cancers and suggests that certain genetic factors and biological pathways affecting adult height may also affect the risk of these cancers.
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Affiliation(s)
- Nikhil K. Khankari
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Sara Lindström
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Joellen Schildkraut
- Cancer Prevention, Detection & Control Research Program, Duke Cancer Institute, Durham, North Carolina, United States of America
| | - Fredrick Schumacher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, California, United States of America
| | - Paolo Bofetta
- Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Angela Risch
- Division of Cancer Genetics/Epigenetics, Department of Molecular Biology, University of Salzburg, Salzburg, Austria
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany
| | - Heike Bickeböller
- Department of Genetic Epidemiology, University Medical Center, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Christopher I. Amos
- Center for Genomic Medicine, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire, United States of America
| | - Douglas Easton
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Rosalind A. Eeles
- Institute of Cancer Research, London, United Kingdom
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Stephen B. Gruber
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, United States of America
| | - Christopher A. Haiman
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, United States of America
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - David J. Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Stephen J. Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Brandon L. Pierce
- Department of Public Health Studies, University of Chicago, Chicago, Illinois, United States of America
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
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27
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Abstract
Prostate cancer is a leading cause of cancer-related death and morbidity in men in the Western world. Tumor progression is dependent on functioning androgen receptor signaling, and initial administration of antiandrogens and hormone therapy (androgen-deprivation therapy) prevent growth and spread. Tumors frequently develop escape mechanisms to androgen-deprivation therapy and progress to castration-resistant late-stage metastatic disease that, in turn, inevitably leads to resistance to all current therapeutics, including chemotherapy. In spite of the recent development of more effective inhibitors of androgen–androgen receptor signaling such as enzalutamide and abiraterone, patient survival benefits are still limited. Oncolytic adenoviruses have proven efficacy in prostate cancer cells and cause regression of tumors in preclinical models of numerous drug-resistant cancers. Data from clinical trials demonstrate that adenoviral mutants have limited toxicity to normal tissues and are safe when administered to patients with various solid cancers, including prostate cancer. While efficacy in response to adenovirus administration alone is marginal, findings from early-phase trials targeting local-ized and metastatic prostate cancer suggest improved efficacy in combination with cytotoxic drugs and radiation therapy. Here, we review recent progress in the development of multimodal oncolytic adenoviruses as biological therapeutics to improve on tumor elimination in prostate cancer patients. These optimized mutants target cancer cells by several mechanisms including viral lysis and by expression of cytotoxic transgenes and immune-stimulatory factors that activate the host immune system to destroy both infected and noninfected prostate cancer cells. Additional modifications of the viral capsid proteins may support future systemic delivery of oncolytic adenoviruses.
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Affiliation(s)
- Katrina Sweeney
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary, University of London, London, UK
| | - Gunnel Halldén
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary, University of London, London, UK
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28
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Chung W, Park CG, Ryu OH. Association of a New Measure of Obesity with Hypertension and Health-Related Quality of Life. PLoS One 2016; 11:e0155399. [PMID: 27183311 PMCID: PMC4868302 DOI: 10.1371/journal.pone.0155399] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/30/2016] [Indexed: 02/07/2023] Open
Abstract
Background Despite its shortcomings, body mass index (BMI) has traditionally been used to define obesity. Another recently introduced obesity measure, A Body Shape Index (ABSI), has been introduced to focus on abdominal obesity, but its applicability remains limited. We analyzed the statistical properties of the ABSI and propose a modified ABSI, the z-score of the log-transformed ABSI (LBSIZ), to improve its applicability. We also examined the sensitivity of the newly introduced index in diagnosing obesity based on the percentage of body fat and its ability to predict hypertension and impaired health-related quality of life (HRQOL). Methods and Results We transformed the ABSI to the LBSIZ in order to create a standard normalized obesity measure. All available data from the Korea National Health and Nutrition Examination Survey (KNHANES) (1998–2012) have shown BMI to be highly correlated with weight (r = 0.85 for women, r = 0.87 for men) and waist circumference (WC) (r = 0.86 for women, r = 0.85 for men), but the LBSIZ was found to be weakly correlated with weight (r = 0.001 for women, r = 0.0001 for men) and moderately correlated with WC (r = 0.51 for women, r = 0.52 for men). BMI showed an inverted U-shaped pattern when plotted against age, but a linear pattern was observed for the LBSIZ, indicating they are different kinds of obesity measures. Logistic regression showed that the odds ratio of obesity for the LBSIZ was 1.86 (95% confidence interval [CI] = 1.73–2.00) for males and 1.32 (95% CI = 1.24–1.40) for females after adjusting for weight, height, age, and year of participation in the KNHANES. While both BMI and the LBSIZ were significantly related to hypertension, the LBSIZ alone was significantly associated with impaired HRQOL. Conclusions The LBSIZ is a standard normalized obesity measure independent of weight, height, and BMI. LBSIZ is a new measure of abdominal obesity with the ability to predict hypertension and impaired HRQOL, irrespective of BMI.
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Affiliation(s)
- Wankyo Chung
- College of Business, Hallym University, Chuncheon, South Korea
- * E-mail:
| | - Chun Gun Park
- Department of Mathematics, College of Natural Sciences, Kyonggi University, Suwon, South Korea
| | - Ohk-Hyun Ryu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon, South Korea
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Bjerregaard LG, Aarestrup J, Gamborg M, Lange T, Tjønneland A, Baker JL. Childhood height, adult height, and the risk of prostate cancer. Cancer Causes Control 2016; 27:561-7. [PMID: 26951518 PMCID: PMC4796358 DOI: 10.1007/s10552-016-0731-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 02/20/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE We previously showed that childhood height is positively associated with prostate cancer risk. It is, however, unknown whether childhood height exerts its effects independently of or through adult height. We investigated whether and to what extent childhood height has a direct effect on the risk of prostate cancer apart from adult height. METHODS We included 5,871 men with height measured at ages 7 and 13 years in the Copenhagen School Health Records Register who also had adult (50-65 years) height measured in the Danish Diet, Cancer and Health study. Prostate cancer status was obtained through linkage to the Danish Cancer Registry. Direct and total effects of childhood height on prostate cancer risk were estimated from Cox regressions. RESULTS From 1996 to 2012, 429 prostate cancers occurred. Child and adult heights were positively and significantly associated with prostate cancer risk. When adjusted for adult height, height at age 7 years was no longer significantly associated with the risk of prostate cancer. Height at 13 years was significantly and positively associated with prostate cancer risk even when adult height was adjusted for; per height z-score the hazard ratio was 1.15 [95% confidence interval (CI) 1.01-1.32]. CONCLUSIONS The effect of height at 13 years on the risk of prostate cancer was not entirely mediated through adult height, suggesting that child height and adult height may be associated with prostate cancer through different pathways.
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Affiliation(s)
- Lise Geisler Bjerregaard
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, Hovedvejen, 2000, Frederiksberg, Denmark
| | - Julie Aarestrup
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, Hovedvejen, 2000, Frederiksberg, Denmark
| | - Michael Gamborg
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, Hovedvejen, 2000, Frederiksberg, Denmark
| | - Theis Lange
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5B, 1014, Copenhagen K, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen K, Denmark
| | - Jennifer L Baker
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, Hovedvejen, 2000, Frederiksberg, Denmark. .,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, 2200, Copenhagen K, Denmark.
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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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Möller E, Wilson KM, Batista JL, Mucci LA, Bälter K, Giovannucci E. Body size across the life course and prostate cancer in the Health Professionals Follow-up Study. Int J Cancer 2015; 138:853-65. [PMID: 26355806 DOI: 10.1002/ijc.29842] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 08/14/2015] [Accepted: 08/20/2015] [Indexed: 12/19/2022]
Abstract
Current evidence of an association between body size and prostate cancer is conflicting, possibly due to differential effects of body size across the lifespan and the heterogeneity of the disease. We therefore examined childhood and adult body size in relation to total incident prostate cancer and prognostic subtypes in a prospective cohort of 47,491 US men in the Health Professionals Follow-up Study. We assessed adult height, body mass index (BMI) in early and middle-to-late adulthood, adult waist circumference, and body shape at age 10. With follow-up from 1986 to 2010, we estimated the relative risk (RR) of prostate cancer using Cox proportional hazards models. We identified 6,183 incident cases. Tallness was associated with increased risk of advanced-stage tumors, particularly fatal disease (RR = 1.66, 95% CI 1.23-2.23, highest vs. lowest quintile, ptrend < 0.001). High BMI at age 21 was inversely associated with total prostate cancer (RR = 0.89, 95% CI 0.80-0.98, BMI ≥ 26 vs. 20-21.9, ptrend = 0.01) and with fatal and advanced disease. The association for late adult BMI differed by age (pinteraction < 0.001); high BMI was inversely associated with total prostate cancer (RR = 0.64, 95% CI 0.51-0.78, BMI ≥ 30 vs. 21-22.9, ptrend <0.001) and with non-advanced and less aggressive tumors among men ≤ 65 years, whereas no association was seen among men >65 years. Adult waist circumference was weakly inversely associated with less aggressive disease. Childhood obesity was unclearly related to risk. Our study confirms tall men to be at increased risk of fatal and advanced prostate cancer. The influence of adiposity varies by prognostic disease subtype and by age. The relationship between body size and prostate cancer is complex. Body size changes progressively throughout life and consequent effects on prostate cancer risk may be associated with related changes in hormonal and metabolic pathways. This large prospective study examined potential associations between the risk of various prostate cancer subtypes and multiple anthropometric measures at different ages in men. Tallness was confirmed to be associated with an elevated risk of advanced prostate cancer, particularly fatal disease. The extent to which body weight influenced risk varied according to factors such as age and disease subtype.
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Affiliation(s)
- Elisabeth Möller
- 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
| | - Julie L Batista
- 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
| | - 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.,Centre for Public Health Science, University of Iceland, Reykjavik, Iceland
| | - Katarina Bälter
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 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
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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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Chung W, Lee J, Ryu OH. Is the negative relationship between obesity and bone mineral content greater for older women? J Bone Miner Metab 2014; 32:505-13. [PMID: 24114196 DOI: 10.1007/s00774-013-0519-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 08/26/2013] [Indexed: 11/24/2022]
Abstract
Obesity and osteoporosis are two important body composition problems with increasing prevalences in aged populations. Traditionally, obesity has been regarded as being beneficial to bone health. However, the protective effect of obesity on osteoporosis has been questioned. In some recent studies, obesity, as defined by percentage body fat, was regarded as a risk factor for osteoporosis. The purpose of this study was to (1) evaluate the effect of waist circumference, a surrogate measure for abdominal obesity, on bone mineral content (BMC) and (2) examine whether the effect of waist circumference increases with advancing age. The study population is made up of women aged over 45 years who completed the body composition and bone mineral density examinations in the fifth Korea National Health and Nutrition Examination Survey in 2010. Subjects who take estrogen or are under medical treatment for osteoporosis were excluded. Stroke patients are also excluded. Femoral neck, total-hip, and whole-body BMC were measured by dual-energy X-ray absorptiometry. A total of 1,434 subjects were included in the analysis. Waist circumference was negatively associated with BMC in all tested regions after correction for weight, menopausal status, smoking, drinking, and exercise. In addition, the negative association between waist circumference and BMC in the femoral neck and total hip increases with age, after correction for confounding factors, showing an interaction effect between waist circumference and age on BMC. In conclusion, this study shows that the negative relationship between waist circumference and BMC in the femoral neck and total hip is greater for older women.
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Affiliation(s)
- Wankyo Chung
- College of Business, Hallym University, Chuncheon-si, South Korea
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Drake I, Wallström P, Hindy G, Ericson U, Gullberg B, Bjartell A, Sonestedt E, Orho-Melander M, Wirfält E. TCF7L2 type 2 diabetes risk variant, lifestyle factors, and incidence of prostate cancer. Prostate 2014; 74:1161-70. [PMID: 24961829 DOI: 10.1002/pros.22832] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 05/08/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND Variation in transcription factor 7-like 2 (TCF7L2), the strongest genetic risk factor for type 2 diabetes (T2D), may play a role in prostate cancer (PCa) depending on lifestyle factors. The aims of this study were to determine if TCF7L2 rs7903146 is associated with risk of PCa and if the association is modified by lifestyle factors independently of T2D status. METHODS We prospectively followed 8,558 men in the Malmö Diet and Cancer Study from baseline 1991-1996 until end of 2009. Cox regression models were used to assess the association between rs7903146 T2D-risk allele (T) and PCa. Effect modification by incident T2D status, fasting glucose levels, dietary, and lifestyle risk factors were tested. RESULTS During follow-up 855 incident PCa cases were registered. We observed a non-significant tendency for the TCF7L2 variant to associate with higher risk of PCa, which was unaffected by adjustment for incident T2D (HR = 1.24; 95% CI: 0.96, 1.60; P = 0.079) but more pronounced among subjects who developed T2D (HR = 1.91, 95% CI: 0.88, 4.14; P = 0.064). In a sub-sample of hyperglycemic men we observed an increased risk of PCa among T-allele carriers (HR = 2.72, 95% CI: 1.22, 6.04; P = 0.014; P(interaction) = 0.056). T-allele carriers with higher number of lifestyle risk factors had an increased risk of PCa (P(interaction) = 0.006). CONCLUSIONS We found no independent association between TCF7L2 rs7903146 and PCa risk. However, among hyperglycemic men we observed that the risk allele may increase risk of PCa. The association between rs7903146 and PCa risk may also be modified by lifestyle factors.
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Affiliation(s)
- Isabel Drake
- Department of Clinical Sciences in Malmö, Research Group in Nutritional Epidemiology, Lund University, Lund, Sweden
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35
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Möller E, Adami HO, Mucci LA, Lundholm C, Bellocco R, Johansson JE, Grönberg H, Bälter K. Lifetime body size and prostate cancer risk in a population-based case-control study in Sweden. Cancer Causes Control 2013; 24:2143-55. [PMID: 24048969 DOI: 10.1007/s10552-013-0291-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 09/12/2013] [Indexed: 01/06/2023]
Abstract
PURPOSE The role of body size in prostate cancer etiology is unclear and potentially varies by age and disease subtype. We investigated whether body size in childhood and adulthood, including adult weight change, is related to total, low-intermediate-risk, high-risk, and fatal prostate cancer. METHODS We used data on 1,499 incident prostate cancer cases and 1,118 population controls in Sweden. Body figure at age 10 was assessed by silhouette drawings. Adult body mass index (BMI) and weight change were based on self-reported height and weight between ages 20 and 70. We estimated odds ratios (ORs) with 95 % confidence intervals (CIs) by unconditional logistic regression. RESULTS Height was positively associated with prostate cancer. Overweight/obesity in childhood was associated with a 54 % increased risk of dying from prostate cancer compared to normal weight, whereas a 27 % lower risk was seen in men who were moderately thin (drawing 2) in childhood (P trend = 0.01). Using BMI <22.5 as a reference, we observed inverse associations between BMI 22.5 to <25 at age 20 and all prostate cancer subtypes (ORs in the range 0.72-0.82), and between mean adult BMI 25 to <27.5 and low-intermediate-risk disease (OR 0.75, 95 % CI 0.55-1.02). Moderate adult weight gain increased the risk of disease in men with low BMI at start and in short men. CONCLUSIONS Our comprehensive life-course approach revealed no convincing associations between anthropometric measures and prostate cancer risk. However, we found some leads that deserve further investigation, particularly for early-life body size. Our study highlights the importance of the time window of exposure in prostate cancer development.
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Affiliation(s)
- Elisabeth Möller
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O. Box 281, SE-171 77, Stockholm, Sweden,
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36
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Edwards TL, Giri A, Motley S, Duong W, Fowke JH. Pleiotropy between genetic markers of obesity and risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 2013; 22:1538-46. [PMID: 23810916 DOI: 10.1158/1055-9965.epi-13-0123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To address inconsistent findings of obesity and prostate cancer risk, we analyzed the association between prostate cancer and genetic markers of obesity and metabolism. METHODS Analyses included 176,520 single-nucleotide polymorphisms (SNP) associated with 23 metabolic traits. We examined the association between SNPs and prostate cancer in 871 cases and 906 controls, including 427 high-grade cases with Gleason ≥ 7. Genetic risk scores (GRS) for body mass index (BMI) and waist-to-hip ratio (WHR) were also created by summing alleles associated with increasing BMI or WHR. RESULTS Prostate cancer was associated with five loci, including cyclin M2, with P values less than 1 × 10(-4). In addition, the WHR GRS was associated with high-grade prostate cancer versus controls [OR, 1.05; 95% confidence interval (CI), 1.00-1.11; P = 0.048] and high-grade prostate cancer versus low-grade prostate cancer (OR, 1.07; 95% CI, 1.01-1.13; P = 0.03). None of these findings exceeds the threshold for significance after correction for multiple testing. CONCLUSIONS Variants in genes known to be associated with metabolism and obesity may be associated with prostate cancer. We show evidence for pleiotropy between WHR GRS and prostate cancer grade. This finding is consistent with the function of several WHR genes and previously described relationships with cancer traits. IMPACT Limitations in standard obesity measures suggest alternative characterizations of obesity may be needed to understand the role of metabolic dysregulation in prostate cancer. The underlying genetics of WHR or other Metabochip SNPs, while not statistically significant beyond multiple testing thresholds within our sample size, support the metabolic hypothesis of prostate carcinogenesis and warrant further investigation in independent samples.
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Affiliation(s)
- Todd L Edwards
- Division of Epidemiology, Department of Medicine, Center for Human Genetics Research, Vanderbilt University, Nashville, TN 37203, USA
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Gacci M, Sebastianelli A, Salvi M, De nunzio C, Schiavina R, Simonato A, Tubaro A, Mirone V, Carini M, Carmignani G. Role of abdominal obesity for functional outcomes and complications in men treated with radical prostatectomy for prostate cancer: results of the Multicenter Italian Report on Radical Prostatectomy (MIRROR) study. Scand J Urol 2013; 48:138-45. [DOI: 10.3109/21681805.2013.803151] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Böhm A, Heitmann BL. The use of bioelectrical impedance analysis for body composition in epidemiological studies. Eur J Clin Nutr 2013; 67 Suppl 1:S79-85. [PMID: 23299875 DOI: 10.1038/ejcn.2012.168] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Bioelectrical impedance analysis (BIA) is a relatively simple, inexpensive and non-invasive technique to measure body composition and is therefore suitable in field studies and larger surveys. SUBJECTS/METHODS We performed an overview of BIA-derived body fat percentages (BF%) from 55 published studies of healthy populations aged 6-80 years. In addition, the relationship between body mass index (BMI) and body composition is documented in the context of BIA as a good alternative to closely differentiate which composition of the body better relates to the risk of cardiovascular diseases (CVDs)and all-cause mortality. RESULTS AND CONCLUSIONS BIA-estimated percentage of BF varies greatly with population and age. BIA-estimated BF% is directly and closely related to various health outcomes such as CVDs, which is in contrast to BMI where both high and low BMIs are associated with increased risk of developing chronic diseases. Studies, among others using BIA, suggest that low BMI may reflect low muscle and high BMI fat mass (FM). BIA-derived lean and FM is directly associated with morbidity and mortality. To the contrary, BMI is rather of limited use for measuring BF% in epidemiological studies.
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Affiliation(s)
- A Böhm
- Institute of Preventive Medicine, Research Unit for Dietary Studies, Frederiksberg Hospital, Frederiksberg, Denmark
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39
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Holmberg S, Thelin A. High dairy fat intake related to less central obesity: a male cohort study with 12 years' follow-up. Scand J Prim Health Care 2013; 31:89-94. [PMID: 23320900 PMCID: PMC3656401 DOI: 10.3109/02813432.2012.757070] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To study associations between dairy fat intake and development of central obesity. DESIGN A prospective population-based cohort study with two surveys 12 years apart. SETTING Nine municipalities selected from different parts of Sweden representing the rural areas in the country. SUBJECTS 1782 men (farmers and non-farmers) aged 40-60 years at baseline participated in a baseline survey (participation rate 76%) and 1589 men participated at the follow-up. 116 men with central obesity at baseline were excluded from the analyses. MAIN OUTCOME MEASURES Central obesity at follow-up defined as waist hip ratio ≥ 1. RESULTS 197 men (15%) developed central obesity during follow-up. A low intake of dairy fat at baseline (no butter and low fat milk and seldom/never whipping cream) was associated with a higher risk of developing central obesity (OR 1.53, 95% CI 1.05-2.24) and a high intake of dairy fat (butter as spread and high fat milk and whipping cream) was associated with a lower risk of central obesity (OR 0.52, 95% CI 0.33-0.83) as compared with medium intake (all other combinations of spread, milk, and cream) after adjustment for intake of fruit and vegetables, smoking, alcohol consumption, physical activity, age, education, and profession. The associations between dairy fat intake and central obesity were consistent across body mass index categories at baseline. CONCLUSION A high intake of dairy fat was associated with a lower risk of central obesity and a low dairy fat intake was associated with a higher risk of central obesity.
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Affiliation(s)
- Sara Holmberg
- Research and Development Center, Kronoberg County Council, Växjö, Sweden.
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40
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Pierce BL. Why are diabetics at reduced risk for prostate cancer? A review of the epidemiologic evidence. Urol Oncol 2013; 30:735-43. [PMID: 23021557 DOI: 10.1016/j.urolonc.2012.07.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 07/23/2012] [Accepted: 07/23/2012] [Indexed: 11/25/2022]
Abstract
A large body of epidemiologic evidence provides strong support for the notion that type-2 diabetics are at decreased risk for prostate cancer. In this review article, we summarize the epidemiologic literature that explores the role of diabetes mellitus and related biomarkers in prostate cancer risk and detection, in order to create a better understanding of the potential mechanisms that underlie this inverse association. The bulk of the data supporting this association comes from the USA, as evidence for this association is less consistent in many other regions of the world. The relationship between diabetes and prostate cancer is suspected to be causal due to evidence of decreasing prostate cancer risk with increasing diabetes duration and lack of evidence for any confounding of this association. Hypothesized mechanisms for decreased prostate cancer risk among diabetics include (1) decreased levels of hormones and other cancer-related growth factors among diabetics, (2) the impact of diabetes on detection-related factors, such as prostate size, circulating prostate-specific antigen (PSA), and health-care seeking behaviors, (3) protective effects of diabetes medications, and (4) a protective effect of diabetes-induced vascular damage in the prostate. The evidence for screening-related factors is compelling, as diabetics appear to have reduced PSA and lower levels of health-care seeking behavior compared with nondiabetics. Furthermore, the inverse association between diabetes and prostate cancer is much less apparent in populations that do not perform biopsies based on PSA levels and in studies restricted to biopsied individuals. The inverse association appears to be stronger for low-grade disease, as compared with high-grade (Gleason >7), which is consistent with the observation that among patients receiving biopsy or prostate cancer treatment, diabetics are more likely to have high-grade disease as compared to nondiabetics, potentially resulting in worse outcomes for diabetics. Epidemiological research has reveals a great deal regarding the relationship between diabetes and prostate cancer risk, but additional research is needed to further clarify the mechanisms underlying this inverse association.
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Affiliation(s)
- Brandon L Pierce
- Department of Health Studies and Comprehensive Cancer Center, the University of Chicago, IL 60637, USA.
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41
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Esposito K, Chiodini P, Capuano A, Bellastella G, Maiorino MI, Parretta E, Lenzi A, Giugliano D. Effect of metabolic syndrome and its components on prostate cancer risk: meta-analysis. J Endocrinol Invest 2013; 36:132-9. [PMID: 23481613 DOI: 10.1007/bf03346748] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Literature data examining the role of metabolic syndrome and its components in prostate cancer risk are limited and contradictory. AIM We did a meta-analysis of studies that evaluated the association between metabolic syndrome, its components, and risk of prostate cancer. SUBJECTS AND METHODS We conducted an electronic search for articles published through September 2012 without restrictions. Every included study was to report risk estimates with 95% confidence intervals for the association between metabolic syndrome and prostate cancer. RESULTS The final number of papers included in the meta-analysis was 14, all published in English, with 4728 prostate cancer cases. Metabolic syndrome was associated with a 12% increase in prostate cancer risk (p=0.231), that was lower in cohort studies (7 studies, RR=1.04, p=0.791) than other studies (RR=1.23, p=0.125). The association was significant in the 8 European studies (RR=1.30, p=0.034), but not in the 4 U.S. or 2 Asiatic studies. The risk estimates of prostate cancer for higher values of body mass index, dysglycemia or dyslipidemia (high triglycerides, low HDL-cholesterol) were not significant; on the contrary, hypertension and waist circumference >102 cm were associated with a significant 15% (p=0.035) and 56% (p=0.007) greater risk of prostate cancer, respectively. CONCLUSIONS Metabolic syndrome is weakly and non significantly associated with prostate cancer risk, but associations vary with geography. Among single components of the syndrome, hypertension and higher waist circumference are significantly associated with increased risk of prostate cancer.
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Affiliation(s)
- K Esposito
- Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Naples, Italy.
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Korpela K, Roos E, Lallukka T, Rahkonen O, Lahelma E, Laaksonen M. Different measures of body weight as predictors of sickness absence. Scand J Public Health 2012; 41:25-31. [PMID: 23221374 DOI: 10.1177/1403494812468965] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Excessive weight is associated with increased sickness absence from work due to obesity-linked health problems. However, it is not known which obesity measure best predicts sickness absence. First, we aimed to compare body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) as predictors of sickness absence spells of various lengths. Second, we aimed to compare BMI based on self-reported and measured weight and height as a predictor of sickness absence to assess the validity of self-reported BMI. METHODS The participants were 5750 employees of the City of Helsinki, aged 40-60 years, who were followed up on average for 4.8 years using the employer's register. Sickness absence spells were classified as self-certified short (1-3 days), medically certified medium length (4-14 days), and long (>14 days) absence spells. RESULTS All measures of body weight predicted sickness absence. The relative rates of long sickness absence in the highest quintile as compared to the lowest quintile varied in women from 1.62 (95% CI 1.35-1.94) to 1.89 (95% CI 1.62-2.23) and in men from 1.40 (95% CI 0.76-2.59) to 2.33 (95% CI 1.32-4.11). Differences in the predictive power of BMI and WC were small: both were more strongly associated with sickness absence than WHR. Self-reported BMI performed equally well as measured BMI. CONCLUSIONS BMI - measured or self-reported - is a valid anthropometric indicator of body weight and predictor of obesity-associated health-risks. Its use is feasible for research purposes as well as for the assessment of weight-related risks to work ability.
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Affiliation(s)
- Katri Korpela
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Zhang F, Yang Y, Skrip L, Hu D, Wang Y, Wong C, Qiu J, Lei H. Diabetes mellitus and risk of prostate cancer: an updated meta-analysis based on 12 case-control and 25 cohort studies. Acta Diabetol 2012; 49 Suppl 1:S235-46. [PMID: 23124624 DOI: 10.1007/s00592-012-0439-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 10/25/2012] [Indexed: 12/11/2022]
Abstract
The association between diabetes and risk of prostate cancer has been investigated widely. However, study results remain inconsistent and contradictory. Using a meta-analytic approach, the present study explore the relationship incorporating more recent studies and provide more powerful evidence without the limitations of any individual study. Relevant studies were identified by searching Pubmed and the Cochrane Central Register of Controlled Trials through May 18, 2012. The strength of the relationship between diabetes mellitus and risk of prostate cancer was assessed using relative risk (RR). Either a fixed effects or random effects model was used to calculate the pooled RRs. Stratification analyses and sensitivity analyses were conducted, and publication bias was assessed by Egger's test and Begg's test. Twelve case-control studies involving 9,767 cases and 19,790 controls, and 25 cohort studies involving 118,825 cases were included. The person-years of follow-up ranged from 29,963 to 6,264,890 among included cohort studies. Diabetes was not significantly associated with incidence of prostate cancer in our analysis of case-control studies only (RR = 0.846, 95 % CI [0.710, 1.009]) or that of cohort studies only (RR = 0.925, 95 % CI [0.811, 1.054]). However, through subgroup analyses, statistically significant associations between diabetes and prostate cancer were found when considering population-based studies only (RR = 0.719, 95 % CI [0.637, 0.812]), cohort studies conducted in the United States (RR = 0.789, 95 % CI [0.727, 0.857]), and studies with follow-up of more than 5 years. Compared to risk of prostate cancer among people without diabetes, diabetic patients using insulin treatment experienced reduced incidence of prostate cancer in both case-control and cohort studies. The results suggest that diabetes mellitus is associated with decreased incidence of prostate cancer, specifically in the population of the United States. In addition, the time since onset of diabetes was positively associated with decreasing incidence of prostate cancer. The present conclusions should be considered carefully, however, and confirmed with further studies.
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Affiliation(s)
- Fan Zhang
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China
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Fowke JH, Motley S, Dai Q, Concepcion R, Barocas DA. Association between biomarkers of obesity and risk of high-grade prostatic intraepithelial neoplasia and prostate cancer--evidence of effect modification by prostate size. Cancer Lett 2012; 328:345-52. [PMID: 23079532 DOI: 10.1016/j.canlet.2012.10.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 10/08/2012] [Accepted: 10/09/2012] [Indexed: 11/29/2022]
Abstract
Prostate enlargement is common with aging and obesity. We investigated the association between obesity and prostate cancer controlling for differential detection related to prostate enlargement. In an analysis of 500 men, we found body mass index, waist-hip ratio, and blood leptin levels were significantly associated with high-grade PC, but only among men without prostate enlargement. Leptin was also significantly associated with high-grade prostatic intraepithelial neoplasia (HGPIN) in the absence of prostate enlargement. Our results suggest obesity advances prostate carcinogenesis, and that detection biases at prostate biopsy may explain past inconsistencies in the association between obesity and PC.
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Affiliation(s)
- Jay H Fowke
- Vanderbilt University Medical Center, Division of Epidemiology, Nashville, TN 37203, United States.
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45
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Bansal D, Bhansali A, Kapil G, Undela K, Tiwari P. Type 2 diabetes and risk of prostate cancer: a meta-analysis of observational studies. Prostate Cancer Prostatic Dis 2012; 16:151-8, S1. [PMID: 23032360 DOI: 10.1038/pcan.2012.40] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Emerging evidence suggests that diabetes may increase the risk of cancers. However, available evidence on prostate cancer is conflicting. We therefore examined the association between Type 2 diabetes and risk of prostate cancer by conducting a detailed meta-analysis of all studies published regarding this subject. METHODS PubMed database and bibliographies of retrieved articles were searched for epidemiological studies (published between 1970 and 2011), investigating the relationship between Type 2 diabetes and prostate cancer. Pooled risk ratio (RR) was calculated using random-effects model. Subgroup, sensitivity analysis and cumulative meta-analysis were also done. RESULTS Forty-five studies (29 cohort and 16 case-control studies) involving 8.1 million participants and 132 331 prostate cancer cases detected a significant inverse association between Type 2 diabetes and risk of prostate cancer (RR 0.86, 95% confidence interval (CI) 0.80-0.92). For cohort studies alone, the RR was 0.87 (95% CI 0.80-0.94), and for case-control studies alone, the RR was 0.85 (95% CI 0.74-0.96). Sensitivity analysis done by excluding one outlier further strengthened our negative association (RR 0.83, 95% CI 0.78-0.87). No evidence of publication bias was observed. CONCLUSIONS This meta-analysis provides strongest evidence supporting that Type 2 diabetes is significantly inversely associated with risk of developing prostate cancer.
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Affiliation(s)
- D Bansal
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Mohali, India
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Measures of birth size in relation to risk of prostate cancer: the Malmö Diet and Cancer Study, Sweden. J Dev Orig Health Dis 2012; 3:442-9. [DOI: 10.1017/s2040174412000402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is some evidence that perinatal factors, specifically birth weight (BW), may be related to the onset of prostate cancer (PRCA). This case–control study, nested within the Malmö Diet and Cancer Cohort Study, used archived birth record data from 308 incident PRCA cases diagnosed between 1991 and 2005, and 637 age-matched controls among 4781 men born (1923–1945) in Malmö and Lund, Sweden. We applied conditional logistic regression to examine the birth size–PRCA association, including tumour subtypes, adjusting for perinatal and adult factors. Compared with controls, cases had a non-significantly higher mean BW and were more likely to have high (>4000 g) BW (21% v. 18%), but did not differ in other birth size measures, nor in mean adult body mass index . We observed a non-linear association between BW and PRCA risk. Compared with BWs between 3000 and 3500 g (reference), the fully adjusted odds ratios (OR, 95% CI) were 0.55 (0.33–0.91) for <3000 g, 0.86 (0.61–1.22) for 3500–4000 g and 0.98 (0.64–1.50) for >4000 g. Among men with aggressive tumours, the reduction in risk for those with BWs <3000 g (OR 0.26, 95% CI 0.09–0.72) was stronger than the rate of risk for PRCA overall. Crude risk estimates were minimally attenuated when adjusted for gestational age, maternal age, birth order and adult factors. Birth length, head circumference and placental weight were not associated with prostate cancer. Our results indicate a protective effect of lower BW on risk of total and aggressive prostate cancer, rather than any direct effect of larger birth size.
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Abstract
Background Established risk factors for prostate cancer have not translated to effective prevention or adjuvant care strategies. Several epidemiologic studies suggest greater body adiposity may be a modifiable risk factor for high-grade (Gleason 7, Gleason 8-10) prostate cancer and prostate cancer mortality. However, BMI only approximates body adiposity, and may be confounded by centralized fat deposition or lean body mass in older men. Our objective was to use bioelectric impedance analysis (BIA) to measure body composition and determine the association between prostate cancer and total body fat mass (FM) fat-free mass (FFM), and percent body fat (%BF), and which body composition measure mediated the association between BMI or waist circumference (WC) with prostate cancer. Methods The study used a multi-centered recruitment protocol targeting men scheduled for prostate biopsy. Men without prostate cancer at biopsy served as controls (n = 1057). Prostate cancer cases were classified as having Gleason 6 (n = 402), Gleason 7 (n = 272), or Gleason 8-10 (n = 135) cancer. BIA and body size measures were ascertained by trained staff prior to diagnosis, and clinical and comorbidity status were determined by chart review. Analyses utilized multivariable linear and logistic regression. Results Body size and composition measures were not significantly associated with low-grade (Gleason 6) prostate cancer. In contrast, BMI, WC, FM, and FFM were associated with an increased risk of Gleason 7 and Gleason 8-10 prostate cancer. Furthermore, BMI and WC were no longer associated with Gleason 8-10 (ORBMI = 1.039 (1.000, 1.081), ORWC = 1.016 (0.999, 1.033), continuous scales) with control for total body FFM (ORBMI = 0.998 (0.946, 1.052), ORWC = 0.995 (0.974, 1.017)). Furthermore, increasing FFM remained significantly associated with Gleason 7 (ORFFM = 1.030 (1.008, 1.052)) and Gleason 8-10 (ORFFM = 1.044 (1.014, 1.074)) after controlling for FM. Conclusions Our results suggest that associations between BMI and WC with high-grade prostate cancer are mediated through the measurement of total body FFM. It is unlikely that FFM causes prostate cancer, but instead provides a marker of testosterone or IGF1 activities involved with retaining lean mass as men age.
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Discacciati A, Orsini N, Wolk A. Body mass index and incidence of localized and advanced prostate cancer--a dose-response meta-analysis of prospective studies. Ann Oncol 2012; 23:1665-71. [PMID: 22228452 DOI: 10.1093/annonc/mdr603] [Citation(s) in RCA: 194] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The relationship between obesity and risk of prostate cancer (PCa) is unclear; however, etiologic heterogeneity by subtype of PCa (localized, advanced) related to obesity was suggested. Therefore, we conducted a dose-response meta-analysis of prospective studies to assess the association between body mass index (BMI) and risk of localized and advanced PCa. MATERIALS AND METHODS Relevant prospective studies were identified by a search of Medline and Embase databases to 03 October 2011. Twelve studies on localized PCa (1,033,009 men, 19,130 cases) and 13 on advanced PCa (1,080,790 men, 7067 cases) were identified. We carried out a dose-response meta-analysis using random-effects model. RESULTS For localized PCa, we observed an inverse linear relationship with BMI [Ptrend<0.001, relative risk (RR): 0.94 (95% confidence interval, 95% CI, 0.91-0.97) for every 5 kg/m2 increase]; there was no evidence of heterogeneity (Pheterogeneity=0.27). For advanced PCa, we observed a linear direct relationship with BMI (Ptrend=0.001, RR: 1.09 (95% CI 1.02-1.16) for every 5 kg/m2 increase); there was weak evidence of heterogeneity (Pheterogeneity=0.08). Omitting one study that contributed substantially to the heterogeneity yielded a pooled RR of 1.07 (95% CI 1.01-1.13) for every 5 kg/m2 increase (Pheterogeneity=0.26). CONCLUSIONS The quantitative summary of the accumulated evidence indicates that obesity may have a dual effect on PCa-a decreased risk for localized PCa and an increased risk for advanced PCa.
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Affiliation(s)
- A Discacciati
- Nutritional Epidemiology Unit, Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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De Nunzio C, Freedland S, Miano L, Finazzi Agrò E, Bañez L, Tubaro A. The uncertain relationship between obesity and prostate cancer: An Italian biopsy cohort analysis. Eur J Surg Oncol 2011; 37:1025-9. [DOI: 10.1016/j.ejso.2011.09.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 08/23/2011] [Accepted: 09/15/2011] [Indexed: 12/18/2022] Open
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Gray A, Aronson WJ, Barnard RJ, Mehta H, Wan J, Said J, Cohen P, Galet C. Global Igfbp1 deletion does not affect prostate cancer development in a c-Myc transgenic mouse model. J Endocrinol 2011; 211:297-304. [PMID: 21903863 PMCID: PMC3271951 DOI: 10.1530/joe-11-0240] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Circulating insulin-like growth factor binding protein 1 (IGFBP1) levels vary in response to nutritional status, and pre-clinical studies suggest that elevated IGFBP1 may be protective against the development and progression of prostate cancer. We hypothesized that global deletion of Igfbp1 would accelerate the development of prostate cancer in a c-Myc transgenic mouse model. To test our hypothesis, c-Myc transgenic mice (Myc/BP-1 wild-type (WT)) were crossed and interbred with the Igfbp1 knockout mice (Myc/BP-1 KO). The animals were placed on a high-protein diet at weaning, weighed every 2 weeks, and euthanized at 16 weeks of age. Prostate histopathology was assessed and proliferation status was determined by Ki-67 and proliferating cell nuclear antigen analyses. IGF-related serum biomarkers and body composition were measured. No significant difference in the incidence of prostate cancer was observed between the Myc/BP-1 KO and the Myc/BP-1 WT mice (65 and 80% respectively, P=0.48). Proliferation was significantly decreased by 71% in prostate tissue of Myc/BP-1 KO mice compared with Myc/BP-1 WT mice. Myc/BP-1 KO mice exhibited a significant 6.7% increase in body weight relative to the Myc/BP-1 WT mice that was attributed to an increase in fat mass. Fasting insulin levels were higher in the Myc/BP-1 KO mice without any difference between the groups in fasting glucose concentrations. Thus, contrary to our hypothesis, global deletion of Igfbp1 in a c-Myc transgenic mouse model did not accelerate the development of prostate cancer. Global Igfbp1 deletion did result in a significant increase in body weight and body fat mass. Further studies are required to understand the underlying mechanisms for these metabolic effects.
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Affiliation(s)
- Ashley Gray
- Department of Integrative Biology and Physiology, University of California at Los Angeles, Los Angeles, California, USA
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