De Nunzio Cosimo, Presicce Fabrizio, Lombardo Riccardo, Cancrini Fabiana, Petta Stefano, Trucchi Alberto, Gacci Mauro, Cindolo Luca, Tubaro Andrea
Department of Urology, Sant' Andrea Hospital, 'La Sapienza' University of Rome, Rome, Italy.
Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
BJU Int. 2016 Jun;117(6B):E29-35. doi: 10.1111/bju.13157. Epub 2015 Jun 6.
To assess the association between physical activity, evaluated by the Physical Activity Scale for the Elderly (PASE) questionnaire, and prostate cancer risk in a consecutive series of men undergoing prostate biopsy.
From 2011 onwards, consecutive men undergoing 12-core prostate biopsy were enrolled into a prospective database. Indications for a prostatic biopsy were a prostate-specific antigen (PSA) value of ≥4 ng/mL and/or a positive digital rectal examination. Body mass index (BMI) and waist circumferences were measured before the biopsy. Fasting blood samples were collected before biopsy and tested for: total PSA, glucose, high-density lipoprotein cholesterol, and trygliceride levels. Blood pressure was recorded. Metabolic syndrome (MetS) was defined according to the Adult Treatment panel III. The PASE questionnaire was completed before the biopsy.
In all, 286 patients were enrolled with a median (interquartile range, IQR) age and PSA level of 68 (62-74) years and 6.1 (5-8.8) ng/mL, respectively. The median (IQR) BMI was 26.4 (24.6-29) kg/m(2) and waist circumference was 102 (97-108) cm, with 75 patients (26%) presenting with MetS. In all, 106 patients (37%) had prostate cancer at biopsy. Patients with prostate cancer had higher PSA levels (median [IQR] 6.7 [5-10] vs 5.6 [4.8-8] ng/mL; P = 0.007) and lower LogPASE scores (median [IQR] 2.03 [1.82-2.18] vs 2.10 [1.92-2.29]; P = 0.005). On multivariate analysis, in addition to well-recognised risk factors such as age, PSA level and prostate volume, LogPASE score was an independent risk factor for prostate cancer diagnosis (odds ratio [OR] 0.146, 95% confidence interval [CI] 0.037-0.577; P = 0.006]. LogPASE score was also an independent predictor of high-grade cancer (OR 0.07, 95% CI 0.006-0.764; P = 0.029).
In our single-centre study, increased physical activity, evaluated by the PASE questionnaire, is associated with a reduced risk of prostate cancer and of high-grade prostate cancer at biopsy. Further studies should clarify the molecular pathways behind this association.
通过老年人身体活动量表（PASE）问卷评估身体活动与连续一系列接受前列腺活检的男性前列腺癌风险之间的关联。
从2011年起，将连续接受12针前列腺活检的男性纳入前瞻性数据库。前列腺活检的指征为前列腺特异性抗原（PSA）值≥4 ng/mL和/或直肠指检阳性。在活检前测量体重指数（BMI）和腰围。在活检前采集空腹血样并检测：总PSA、血糖、高密度脂蛋白胆固醇和甘油三酯水平。记录血压。根据成人治疗小组III定义代谢综合征（MetS）。在活检前完成PASE问卷。
总共纳入了286例患者，年龄中位数（四分位间距，IQR）和PSA水平分别为68（62 - 74）岁和6.1（5 - 8.8）ng/mL。BMI中位数（IQR）为26.4（24.6 - 29）kg/m²，腰围为102（97 - 108）cm，75例患者（26%）患有MetS。总共有106例患者（37%）在活检时患有前列腺癌。患有前列腺癌的患者PSA水平更高（中位数[IQR] 6.7 [5 - 10] vs 5.6 [4.8 - 8] ng/mL；P = 0.007）且LogPASE评分更低（中位数[IQR] 2.03 [1.82 - 2.
