Liu Wen, Li Wenxian, Wang Zhankun, Zhu Yao, Ye Dingwei, Zhang Guiming
Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.
Department of Urology, Qingdao Eighth People's Hospital, Qingdao, People's Republic of China.
Cancer Manag Res. 2020 Mar 10;12:1779-1787. doi: 10.2147/CMAR.S242193. eCollection 2020.
To investigate the pathological risk of prostate cancer (PCa) according to the obesity and metabolic status of Chinese patients undergoing radical prostatectomy.
We performed a retrospective cross-sectional study of 1016 patients with PCa who underwent radical prostatectomy and whose metabolic status and body mass index were examined. Multivariate logistic regression analysis was performed to examine the relationship between different metabolic obesity phenotypes and the pathological outcomes of PCa.
Among 1016 men, 551 (54.2%), 106 (10.4%), 238 (23.4%), and 121 (11.9%) were assigned to the metabolically healthy and normal weight (MHNW) group, metabolically abnormal but normal weight (MANW) group, metabolically healthy but overweight or obese (MHO) group, and metabolically abnormal and overweight or obese (MAO) group, respectively. Compared with the MHNW group, the MAO group had a significantly greater risk of a higher prostatectomy Gleason score [odds ratio (OR), 1.907; 95% confidence interval (95% CI), 1.144-3.182], pathological stage (OR, 1.606; 95% CI, 1.035-2.493), and seminal vesicle invasion (OR, 1.673; 95% CI, 1.041-2.687). In contrast, the ORs were not increased in the MHO or MANW group. In the context of normal weight, metabolic disorders were associated with lymph node involvement. The metabolic status and body mass index were not associated with extracapsular extension or surgical margins in any of the four groups.
The MAO phenotype is associated with aggressive PCa, including a higher prostatectomy Gleason score, pathological stage, and seminal vesicle invasion and might also be associated with disease progression. Obesity and metabolic disorders act synergistically to increase the pathological risk of PCa.
根据接受根治性前列腺切除术的中国患者的肥胖和代谢状况，探讨前列腺癌（PCa）的病理风险。
我们对1016例行根治性前列腺切除术且检查了代谢状况和体重指数的PCa患者进行了回顾性横断面研究。采用多因素logistic回归分析来检验不同代谢性肥胖表型与PCa病理结果之间的关系。
在1016名男性中，分别有551名（54.2%）、106名（10.4%）、238名（23.4%）和121名（11.9%）被归入代谢健康且体重正常（MHNW）组、代谢异常但体重正常（MANW）组、代谢健康但超重或肥胖（MHO）组以及代谢异常且超重或肥胖（MAO）组。与MHNW组相比，MAO组出现更高前列腺切除格里森评分[比值比（OR），1.907；95%置信区间（95%CI），1.144 - 3.182]、病理分期（OR，1.606；95%CI，1.035 - 2.493）以及精囊侵犯（OR，1.673；95%CI，1.041 - 2.687）的风险显著更高。相比之下，MHO组或MANW组的OR并未升高。在体重正常的情况下，代谢紊乱与淋巴结受累相关。在四组中的任何一组中，代谢状况和体重指数均与包膜外侵犯或手术切缘无关。
MAO表型与侵袭性PCa相关，包括更高的前列腺切除格里森评分、病理分期和精囊侵犯，并且可能也与疾病进展相关。肥胖和代谢紊乱协同作用增加PCa的病理风险。
