Division of Urology, Department of Surgery, UC San Diego Medical Center, CA, USA.
BJU Int. 2011 Dec;108(11):1750-5. doi: 10.1111/j.1464-410X.2011.10227.x. Epub 2011 Jul 8.
What's known on the subject? and What does the study add? Obesity is associated with prostate enlargement in men without prostate cancer. This study demonstrates an association between obesity and prostate enlargement in men with prostate cancer, and leads to possible implications for prostate cancer screening and diagnosis.
• To determine if obesity is associated with prostate size in men with prostate cancer.
• We examined preoperative body mass index (BMI) and whole prostate weight in a cohort of 16,325 patients undergoing radical prostatectomy for localized prostate cancer from 1975 to 2008 at a single institution. • We used multivariable regression modelling adjusting for age, year of surgery, preoperative serum prostate-specific antigen (PSA), pathological stage and Gleason grade.
• Of the entire cohort, 13,343 (82%) patients had a prostate weight of at least 40 g. These men were older (P < 0.001), had a higher preoperative BMI (P < 0.002), higher preoperative PSA (P < 0.001), and were more likely to have pT2 disease (P < 0.001). • In multivariable regression, preoperative BMI was associated with increased prostate weight: for each 1 kg/m(2) increase in BMI, prostate weight increased by 0.45 g (95% CI 0.35-0.55, P-trend < 0.001). • Compared with men with BMI < 25 kg/m(2) , men with a BMI ≥35 kg/m(2) had a 40% (odds ratio 1.40, 95% CI 1.01-1.95) increased risk of prostate weight of at least 40 g and a 70% (odds ratio 1.70, 95% CI 1.32-2.20) increased risk of prostate weight of at least 50 g.
• In men with localized prostate cancer, obesity is associated with an increased risk of prostate enlargement. • These data validate other observations linking obesity with prostate enlargement and may have important ramifications for prostate cancer diagnosis in obese men.
肥胖与无前列腺癌男性的前列腺增大有关。本研究表明，肥胖与前列腺癌男性的前列腺增大有关，并可能对前列腺癌的筛查和诊断产生影响。
确定肥胖与前列腺癌患者的前列腺大小是否相关。
我们在一家机构检查了 1975 年至 2008 年期间因局限性前列腺癌接受根治性前列腺切除术的 16325 名患者的术前体重指数（BMI）和整个前列腺重量。我们使用多变量回归模型，根据年龄、手术年份、术前血清前列腺特异性抗原（PSA）、病理分期和 Gleason 分级进行调整。
在整个队列中，13343 名（82%）患者的前列腺重量至少为 40 克。这些男性年龄较大（P<0.001），术前 BMI 较高（P<0.002），术前 PSA 较高（P<0.001），且更有可能患有 pT2 疾病（P<0.001）。在多变量回归中，术前 BMI 与前列腺重量增加相关：BMI 每增加 1kg/m2，前列腺重量增加 0.45g（95%CI 0.35-0.55，P 趋势<0.001）。与 BMI<25kg/m2 的男性相比，BMI≥35kg/m2 的男性前列腺重量至少为 40g 的风险增加 40%（优势比 1.40，95%CI 1.01-1.95），前列腺重量至少为 50g 的风险增加 70%（优势比 1.70，95%CI 1.32-2.20）。
在患有局限性前列腺癌的男性中，肥胖与前列腺增大的风险增加有关。这些数据验证了其他将肥胖与前列腺增大联系起来的观察结果，并可能对肥胖男性的前列腺癌诊断产生重要影响。
