Louisiana State University Health Sciences Center, School of Public Health, New Orleans, Louisiana, USA.
Cancer Epidemiol Biomarkers Prev. 2011 May;20(5):844-53. doi: 10.1158/1055-9965.EPI-10-0684. Epub 2011 Apr 5.
This study evaluated obesity and prostate cancer aggressiveness relationship in a population-based incident prostate cancer study.
The North Carolina-Louisiana Prostate Cancer Project includes medical records data for classification of prostate cancer aggressiveness at diagnosis by using clinical criteria for 1,049 African American (AA) and 1,083 Caucasian American (CA) participants. An association between prostate cancer aggressiveness and obesity, measured using body mass indices (BMI) and waist-to-hip ratio (WHR), was assessed using ORs and 95% CIs adjusted for confounders.
A significantly positive association was found between prostate cancer aggressiveness and obesity. The ORs for high aggressive prostate cancer among prediagnosis obese and severely obese were 1.48 (95% CI = 1.02-2.16) and 1.98 (95% CI = 1.31-2.97), respectively, compared with normal weight research subjects. Race-stratified results suggested the association is stronger among CAs. Interaction model showed that normal weight AAs had more aggressive prostate cancer than normal weight CAs (OR = 2.69, 95% CI = 1.36-5.30); severe obesity was associated with aggressive disease in AAs (OR = 3.90, 95% CI = 1.97-7.75). WHR > 0.98 among all research subjects adjusted for race was significantly associated with high aggressive prostate cancer (OR = 1.42, 95% CI = 1.00-2.00) when compared with WHR < 0.90. The stratified result is less clear among AAs.
This study shows a positive association between obesity and aggressive prostate cancer. AAs have more aggressive prostate cancer in general than CAs even at normal weight. Therefore, the association between obesity and aggressiveness is not as evident in AAs as in CAs.
This study provides a unique opportunity to examine impact of race on obesity and high aggressive prostate cancer relationship.
本研究在一项基于人群的前列腺癌发病研究中评估了肥胖与前列腺癌侵袭性之间的关系。
北卡罗来纳州-路易斯安那前列腺癌项目包括了 1049 名非裔美国（AA）和 1083 名白种美国（CA）参与者的病历数据，用于根据临床标准对前列腺癌侵袭性进行分类。使用体质量指数（BMI）和腰围-臀围比（WHR）评估肥胖与前列腺癌侵袭性之间的关联，采用 OR 和 95%CI 调整混杂因素。
发现前列腺癌侵袭性与肥胖之间存在显著的正相关关系。与正常体重的研究对象相比，肥胖和重度肥胖患者中高侵袭性前列腺癌的 OR 分别为 1.48（95%CI=1.02-2.16）和 1.98（95%CI=1.31-2.97）。按种族分层的结果表明，这种关联在 CA 中更强。交互模型显示，正常体重的 AA 比正常体重的 CA 更易发生侵袭性前列腺癌（OR=2.69，95%CI=1.36-5.30）；重度肥胖与 AA 中的侵袭性疾病相关（OR=3.90，95%CI=1.97-7.75）。所有研究对象的 WHR>0.98 经种族调整后与高侵袭性前列腺癌显著相关（OR=1.42，95%CI=1.00-2.00），而 WHR<0.90 的则无显著相关。在 AA 中，分层结果不太明确。
本研究表明肥胖与侵袭性前列腺癌之间存在正相关关系。AA 即使在正常体重时也比 CA 更易发生侵袭性前列腺癌。因此，肥胖与侵袭性之间的关联在 AA 中不如 CA 中明显。
本研究为研究种族对肥胖与高侵袭性前列腺癌关系的影响提供了一个独特的机会。
