Ngowi Bartholomeo Nicholaus, Mremi Alex, Seif Mshangama, Bright Frank, Lyimo Godrule, Uggh Innocent, Mitao Modesta Paschal, Nyongole Obadia, Mbwambo Orgeness Jasper, Gill Harcharan, Nyindo Mramba, Mteta Kien Alfred, Mmbaga Blandina Theophil
Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240, Moshi, Tanzania.
Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania.
Ecancermedicalscience. 2025 Apr 23;19:1898. doi: 10.3332/ecancer.2025.1898. eCollection 2025.
The association between body mass index (BMI) and prostate cancer (Pca) remains a controversial subject. Despite Pca being common in Tanzania, there is a scarcity of data on the role of BMI on Pca risk. This study aimed to assess the association between Pca and BMI among African men in Tanzania.
This analysis included Tanzanian men aged ≥40 years who underwent prostate biopsy for the elevated prostate-specific antigen of >4 ng/mL during community-based Pca screening. Gleason scores of all Pca cases were determined by an experienced pathologist. BMI was calculated by dividing weight in kilograms by height in metre square. Participants were categorised into four BMI categories as follows: underweight (<18.5 kg/m), normal weight (18.5-24.9 kg/m), overweight (25.0-29.9 kg/m) and obese (≥30 kg/m). A high Gleason score refers to any score of ≥4+3. Logistic regression was used to estimate the odd ratio of each BMI category for the risk of Pca and high Gleason score.
A total of 572 men underwent prostate biopsy after being found to have an elevated prostate-specific antigen of >4 ng/mL during screening. Of these, normal BMI accounted for 233 (40.7%), while overweight and obesity accounted for 153 (26.7%) and 141 (24.7%), respectively. In multivariate analysis, overweight men had significantly higher odds of being diagnosed with Pca (OR 6.95, 95% CI; 3.43-14.06) as compared to their normal-weight counterparts. The strength of the association became stronger among obese participants (OR 23.65, 95%CI; 11.45-48.87). Similarly, there was a significant increase in the odds of being diagnosed with high Gleason score Pca among obese men (OR 3.63, 95%CI; 1.52-8.70).
Tanzanian men with elevated prostate-specific antigen and a high BMI have a significant risk of being diagnosed with Pca, mostly with a high Gleason score. Normal BMI maintenance might help in reducing the risk of developing Pca.
体重指数（BMI）与前列腺癌（Pca）之间的关联仍是一个有争议的话题。尽管前列腺癌在坦桑尼亚很常见，但关于BMI在前列腺癌风险中的作用的数据却很匮乏。本研究旨在评估坦桑尼亚非洲男性中前列腺癌与BMI之间的关联。
该分析纳入了年龄≥40岁的坦桑尼亚男性，这些男性在基于社区的前列腺癌筛查中因前列腺特异性抗原升高至>4 ng/mL而接受了前列腺活检。所有前列腺癌病例的 Gleason 评分由一位经验丰富的病理学家确定。BMI 通过将体重（千克）除以身高（米）的平方来计算。参与者被分为以下四个BMI类别：体重过轻（<18.5 kg/m²）、正常体重（18.5 - 24.9 kg/m²）、超重（25.0 - 29.9 kg/m²）和肥胖（≥30 kg/m²）。高 Gleason 评分是指任何≥4 + 3的评分。使用逻辑回归来估计每个BMI类别患前列腺癌和高 Gleason 评分风险的比值比。
共有572名男性在筛查中被发现前列腺特异性抗原升高至>4 ng/mL后接受了前列腺活检。其中，正常BMI者占233人（40.7%），超重和肥胖者分别占153人（26.7%）和141人（24.7%）。在多变量分析中，与正常体重的男性相比，超重男性被诊断为前列腺癌的几率显著更高（比值比6.95，95%置信区间；3.43 - 14.06）。在肥胖参与者中，这种关联的强度更强（比值比23.65，95%置信区间；11.45 - 48.87）。同样，肥胖男性被诊断为高 Gleason 评分前列腺癌的几率也显著增加（比值比3.63，95%置信区间；1.52 - 8.70）。
前列腺特异性抗原升高且BMI高的坦桑尼亚男性有被诊断为前列腺癌的显著风险，且大多为高 Gleason 评分。维持正常BMI可能有助于降低患前列腺癌的风险。
