Bechtel Misty D, Michel Carrie, Srinivasan Pugazhendhi, Chalise Prabhakar, Parker William P, Mirza Moben, Thrasher Brantley, Gibbs Heather D, DiGiovanni John, Hamilton-Reeves Jill
Department of Urology, University of Kansas Medical Center, Kansas City, Kansas.
Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas.
J Urol. 2024 Apr;211(4):552-562. doi: 10.1097/JU.0000000000003849. Epub 2024 Feb 1.
Excess body and visceral fat increase the risk of death from prostate cancer (PCa). This phase II study aimed to test whether weight reduction by > 5% total body weight counteracts obesity-driven PCa biomarkers.
Forty men scheduled for prostatectomy were randomized into intervention (n = 20) or control (n = 20) arms. Intervention participants followed a weight management program for 4 to 16 weeks before and 6 months after surgery. Control participants received standardized educational materials. All participants attended visits at baseline, 1 week before surgery, and 6 months after surgery. Circulating immune cells, cytokines, and chemokines were evaluated. Weight loss, body composition/distribution, quality of life, and nutrition literacy were assessed. Prostate tissue samples obtained from biopsy and surgery were analyzed.
From baseline to surgery (mean = 5 weeks), the intervention group achieved 5.5% of weight loss (95% CI, 4%-7%). Compared to the control, the intervention also reduced insulin, total cholesterol, LDL cholesterol, leptin, leptin:adiponectin ratio, and visceral adipose tissue. The intervention group had reduced c-peptide, plasminogen-activator-inhibitor-1, and T cell count from baseline to surgery. Myeloid-derived suppressor cells were not statistically different by group. Intervention group anthropometrics improved, including visceral and overall fat loss. No prostate tissue markers changed significantly. Quality of life measures of general and emotional health improved in the intervention group. The intervention group maintained or kept losing to a net loss of 11% initial body weight (95% CI, 8%-14%) at the study end.
Our study demonstrated improvements in body composition, PCa biomarkers, and quality of life with a weight management intervention.
身体和内脏脂肪过多会增加前列腺癌（PCa）导致的死亡风险。这项II期研究旨在测试总体重减轻超过5%是否能抵消肥胖驱动的PCa生物标志物。
40名计划接受前列腺切除术的男性被随机分为干预组（n = 20）或对照组（n = 20）。干预组参与者在手术前4至16周以及手术后6个月遵循体重管理计划。对照组参与者收到标准化教育材料。所有参与者在基线、手术前1周和手术后6个月进行随访。评估循环免疫细胞、细胞因子和趋化因子。评估体重减轻、身体成分/分布、生活质量和营养素养。对从活检和手术中获得的前列腺组织样本进行分析。
从基线到手术（平均 = 5周），干预组体重减轻了5.5%（95%CI，4%-7%）。与对照组相比，干预还降低了胰岛素、总胆固醇、低密度脂蛋白胆固醇、瘦素、瘦素：脂联素比值和内脏脂肪组织。从基线到手术，干预组的C肽、纤溶酶原激活物抑制剂-1和T细胞计数降低。两组之间髓源性抑制细胞无统计学差异。干预组的人体测量指标有所改善，包括内脏和总体脂肪减少。前列腺组织标志物无显著变化。干预组的总体和情绪健康生活质量指标有所改善。在研究结束时，干预组维持减重或继续减重，最终体重减轻了初始体重的11%（95%CI，8%-14%）。
我们的研究表明，体重管理干预可改善身体成分、PCa生物标志物和生活质量。
