Department of Internal Medicine, University of Michigan Medical School and Comprehensive Cancer Center, Ann Arbor, MI 48109-5376, USA.
Prostate Cancer Prostatic Dis. 2013 Mar;16(1):62-6. doi: 10.1038/pcan.2012.32. Epub 2012 Aug 21.
The metabolic syndrome (MetS) comprises a constellation of risk factors associated with an increased risk for cardiovascular disease. Components of MetS have emerged as putative risk factors for prostate carcinoma. In this study, we examine the association between three features of the MetS (obesity, hypertension and diabetes) and the risk of biochemical recurrence (BCR) after radical prostatectomy (RP).
We examined data from 1428 men in the University of Michigan Prostate Cancer Data Bank who elected to have RP as their primary treatment. We calculated body mass index from patients' weight and height measured at the time of prostate cancer diagnosis. We used the University of Michigan's Electronic Medical Record Search Engine to identify subjects with hypertension and/or diabetes before their prostate cancer diagnosis.
Of 1428 men who underwent RP, 107 (8%) subsequently developed BCR with a median length of follow-up post-surgery of 3.6 years. Obesity and hypertension were each associated with an increased risk of BCR (adjusted hazard ratio (aHR) = 1.37; 95% CI 0.92-2.09 and aHR = 1.51, 95% CI 1.01-2.26), whereas no association was observed between diabetes and BCR (aHR = 0.73; 95% CI 0.40-1.33).
Obesity and hypertension were each associated with an increased risk for BCR of prostate cancer after RP, independent of age at diagnosis and tumor pathological features. Given the increasing rates of obesity, hypertension and prostate cancer, a better understanding of the relationship between these entities is of significant public health importance. Elucidation of the involved pathogenic mechanisms will be needed to establish causality.
代谢综合征(MetS)由一系列与心血管疾病风险增加相关的危险因素组成。MetS 的成分已成为前列腺癌的潜在危险因素。在这项研究中,我们研究了 MetS 的三个特征(肥胖、高血压和糖尿病)与根治性前列腺切除术(RP)后生化复发(BCR)风险之间的关联。
我们检查了密歇根大学前列腺癌数据库中 1428 名选择 RP 作为主要治疗方法的男性的数据。我们根据患者在诊断前列腺癌时的体重和身高计算体重指数。我们使用密歇根大学的电子病历搜索引擎来确定在前列腺癌诊断前患有高血压和/或糖尿病的患者。
在接受 RP 的 1428 名男性中,有 107 名(8%)随后发生 BCR,手术后中位随访时间为 3.6 年。肥胖和高血压都与 BCR 的风险增加相关(调整后的危险比(aHR)= 1.37;95%CI 0.92-2.09 和 aHR = 1.51,95%CI 1.01-2.26),而糖尿病与 BCR 之间无关联(aHR = 0.73;95%CI 0.40-1.33)。
肥胖和高血压与 RP 后前列腺癌的 BCR 风险增加有关,与诊断时的年龄和肿瘤病理特征无关。鉴于肥胖、高血压和前列腺癌的发病率不断上升,更好地了解这些实体之间的关系具有重要的公共卫生意义。需要阐明相关的发病机制才能确定因果关系。