Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Cancer Med. 2021 Apr;10(8):2885-2896. doi: 10.1002/cam4.3827. Epub 2021 Mar 12.
We recently found a negative association between body mass index (BMI) and the risk of localised prostate cancer (PCa), no association with advanced PCa, and a positive association with PCa-specific mortality. In a 15% subpopulation of that study, we here investigated the measures of abdominal adiposity including waist circumference (WC) and A Body Shape Index (ABSI) in relation to PCa risk and mortality. We used data from 58,457 men from four Swedish cohorts to assess WC and ABSI in relation to PCa risk according to cancer risk category, including localised asymptomatic and symptomatic PCa and advanced PCa, and PCa-specific mortality. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). During, on average, 10 years of follow-up, 3290 men were diagnosed with PCa and 387 died of PCa. WC was negatively associated with the risk of total PCa (HR per 10 cm, 0.95; 95% CI 0.92-0.99), localised PCa (HR per 10 cm, 0.93, 95% CI 0.88-0.96) and localised asymptomatic PCa cases detected through a prostate-specific antigen (PSA) test (HR per 10 cm, 0.87, 95% CI 0.81-0.94). WC was not associated with the risk of advanced PCa (HR per 10 cm, 1.02, 95% CI 0.93-1.14) or with PCa-specific mortality (HR per 10 cm, 1.04, 95% CI 0.92-1.19). ABSI showed no associations with the risk of PCa or PCa-specific mortality. While the negative association between WC and the risk of localised PCa was partially driven by PSA-detected PCa cases, no association was found between abdominal adiposity and clinically manifest PCa in our population.
我们最近发现，体重指数（BMI）与局限性前列腺癌（PCa）风险呈负相关，与晚期 PCa 无关联，与 PCa 特异性死亡率呈正相关。在该研究的 15%的亚人群中，我们在此调查了腰围（WC）和体脂肪分布指数（ABSI）等腹部肥胖指标与 PCa 风险和死亡率的关系。我们使用来自瑞典四个队列的 58457 名男性的数据，评估了 WC 和 ABSI 与癌症风险类别（包括局限性无症状和有症状 PCa 以及晚期 PCa）和 PCa 特异性死亡率的关系。使用 Cox 回归模型计算风险比（HR）和 95%置信区间（CI）。在平均 10 年的随访期间，3290 名男性被诊断患有 PCa，387 名男性死于 PCa。WC 与总 PCa 风险呈负相关（每增加 10cm 的 HR 为 0.95；95%CI 0.92-0.99）、局限性 PCa 风险（每增加 10cm 的 HR 为 0.93，95%CI 0.88-0.96）和通过前列腺特异性抗原（PSA）检测发现的局限性无症状 PCa 病例风险（每增加 10cm 的 HR 为 0.87，95%CI 0.81-0.94）。WC 与晚期 PCa 风险（每增加 10cm 的 HR 为 1.02，95%CI 0.93-1.14）或 PCa 特异性死亡率（每增加 10cm 的 HR 为 1.04，95%CI 0.92-1.19）无关。ABSI 与 PCa 风险或 PCa 特异性死亡率无关。虽然 WC 与局限性 PCa 风险之间的负相关部分是由 PSA 检测到的 PCa 病例驱动的，但在我们的人群中，腹部肥胖与临床表现明显的 PCa 之间没有关联。
