Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Korean Med Sci. 2019 Jan 31;34(6):e49. doi: 10.3346/jkms.2019.34.e49. eCollection 2019 Feb 18.
We assessed the association between metabolic health status and incidence of prostate cancer using the National Health Check-ups (NHC) database of Korea.
A total of 11,771,252 men who participated in the NHC between 2009 and 2012 and 56,552 men who were newly diagnosed with prostate cancer were analyzed. Normal-weight and obesity were defined as body mass index (BMI) < 25 kg/m and ≥ 25 kg/m, respectively. Metabolic obesity was defined as the presence ≥ 3 components of the metabolic syndrome. Participants were stratified into 4 groups: metabolically healthy, normal-weight; metabolically obese, normal-weight (MONW); metabolically healthy, obese (MHO); and metabolically obese, obese. Multivariate Cox regression analysis was performed to examine the relationship between metabolic health status and incidence of prostate cancer.
During a mean 5.4 ± 1.1 years of follow-up, 56,552 patients were registered with a diagnosis of prostate cancer. When analyzed according to metabolic health status classification, the multivariable-adjusted hazard ratio (HR) was 1.143 for the MONW group, 1.097 for the MHO group, showing the HR for the MONW group was higher than that for the MHO group. As the number of metabolic syndrome components increased, HR increased significantly. When stratified based on BMI, metabolically obese patients showed significantly higher HR than metabolically healthy patients in all BMI groups.
This population-based nationwide study revealed an association between metabolic health status and the incidence of prostate cancer, and the risk increased according to the number of components of the metabolic syndrome.
本研究利用韩国国民健康检查数据库（NHC）评估了代谢健康状况与前列腺癌发病风险之间的关系。
共纳入 11771252 名 2009 年至 2012 年期间参加 NHC 的男性和 56552 名新诊断为前列腺癌的男性。正常体重和肥胖定义为体重指数（BMI）<25kg/m²和≥25kg/m²。代谢性肥胖定义为存在≥3 项代谢综合征成分。将参与者分为 4 组：代谢健康，正常体重；代谢肥胖，正常体重（MONW）；代谢健康，肥胖（MHO）；代谢肥胖，肥胖。采用多变量 Cox 回归分析来研究代谢健康状况与前列腺癌发病风险之间的关系。
在平均 5.4±1.1 年的随访期间，有 56552 名患者被确诊为前列腺癌。根据代谢健康状况分类进行分析时，MONW 组的多变量校正后的风险比（HR）为 1.143，MHO 组为 1.097，表明 MONW 组的 HR 高于 MHO 组。随着代谢综合征成分数量的增加，HR 显著升高。根据 BMI 分层，在所有 BMI 组中，代谢肥胖患者的 HR 均明显高于代谢健康患者。
本基于人群的全国性研究揭示了代谢健康状况与前列腺癌发病风险之间的关联，且随着代谢综合征成分数量的增加，风险增加。
