A prospective Swedish study on body size, body composition, diabetes, and prostate cancer risk

Abstract

Obesity may be associated with increased risk of prostate cancer (PCa). According to one hypothesis, obesity could lower the risk of non-aggressive tumours, while simultaneously increasing the risk of aggressive cancer. Furthermore, central adiposity may be independently associated with PCa risk; it is also associated with diabetes, which itself may influence risk of PCa. We studied the associations between height, body composition, and fat distribution, diabetes prevalence and risk of total, aggressive, and nonaggressive PCa in 10 564 initially cancer-free men (aged 45 -73 years) of the population-based Malmö Diet and Cancer cohort. Anthropometric and body composition measurements, including bioelectrical impedance for estimation of fat mass, were performed by study nurses. Diabetes prevalence was self-reported. Cancer cases and clinical characteristics were ascertained through national and regional registry data. Dietary and other background data were obtained through a modified diet history method and an extensive questionnaire. During a mean follow-up of 11.0 years, 817 incidental PCa cases were diagnosed. Of these, 281 were classified as aggressive. There were 202 cases occurring before 65 years of age. Height was positively associated with total and nonaggressive PCa risk. Waist -hip ratio (WHR), a measure of central adiposity, was positively associated with PCa before age 65, and less strongly, with total PCa. This association was independent of body mass index (BMI) and other potential confounders. General adiposity, expressed as BMI or body fat percentage, and prevalent diabetes were not associated with PCa risk. In this study, WHR and body height were stronger PCa predictors than general adiposity.

Diabetes Mellitus Reduces Prostate Cancer Risk - No Function of Age at Diagnosis or Duration of Disease

“…A total of 13 relevant studies on the association between DM and PCa have been published since 2006, consisting of 8 prospective studies (Calton et al, 2007;Velicer et al, 2007;Leitzmann et al, 2008;Kasper et al, 2009;Wallstrom et al, 2009;Waters et al, 2009;Li et al, 2010;Lee et al, 2012) and 5 retrospective ones (Gong et al, 2006;Pierce et al, 2008;Baradaran et al, 2009;Pelucchi et al, 2011;Turner et al, 2011). With more than 30,000 additional PCa cases, we aimed to re-analyze this relationship further by conducting an updated detailed meta-analysis with focusing on the effect of time, namely the duration since DM was diagnosed and the age of patient when DM was diagnosed.…”

Obesity and Prostate Cancer Aggressiveness among African and Caucasian Americans in a Population-Based Study

“…Similarly, a clinical cohort of 2,687 patients who underwent treatment for low and intermediate grade of prostate cancer found no association between BMI and biochemical failure after at least of 2-year follow-up (6). Another population-based cohort study of 10,564 men in Sweden suggested that height is associated with total and nonaggressive prostate cancer risk but not with aggressive cancer (7). BMI was not associated with either aggressive or nonaggressive prostate cancer.…”

Influence of abdominal adiposity, waist circumference, and body mass index on clinical and pathologic findings in patients treated with radiotherapy for localized prostate cancer

“…A recent large prospective cohort study found that central adiposity was a stronger predictor of prostate cancer than general obesity measured by BMI. 37 As observed in 1 population-based study, higher abdominal adiposity was associated with an increased risk of high-grade and advanced prostate cancer, especially among men with low BMI. 38 Patients with higher VAT amounts were also at greater risk of being diagnosed with prostate cancer.…”