Is Body Mass Index the Best Adiposity Measure for Prostate Cancer Risk? Results From a Veterans Affairs Biopsy Cohort

Abstract

Objectives To test multiple adiposity measures and prostate cancer (PC) risk in men undergoing prostate biopsy. We hypothesized that BMI, body fat and waist circumference would be highly correlated and all would be associated with aggressive PC, but not overall risk. Subjects and methods A case (483) –control (496) study among men undergoing prostate biopsy from 2007–2016 was conducted at the Durham Veterans Affairs Medical Center. Anthropometric measurements and self-reported were taken. Percent body fat was measured. Associations between adiposity measures and PC risk and high-grade PC (Gleason ≥7) were examined using logistic regression. Results BMI, percent body fat, and waist circumference were highly correlated (ρ ≥0.79) (p<0.001). On multivariable analysis, BMI (p=0.011) was associated with overall PC risk, but percent body fat (p=0.16) and waist circumference (p=0.19) were not. However, all adiposity measurements were associated with high-grade disease (p<0.001). We found a strong relationship between self-reported and measured weight (ρ=0.97) and height (ρ=0.92). Conclusions BMI, body fat and waist circumference were all highly correlated and associated with aggressive PC. This study supports the idea that higher adiposity is selectively associated with high-grade PC and reinforces the continued use of self-reported BMI as a measure of obesity in epidemiological studies of PC.

Body fat distribution on computed tomography imaging and prostate cancer risk and mortality in the AGES‐Reykjavik study

“…Percent body fat, assessed with bioelectric impedance, has been associated with high-grade prostate cancer in case-control studies. 26,27 In contrast, we found no association between prospectively measured percent body fat and high-grade disease. A prospective analysis of 10,564 initially cancer-free men in the Malmö Diet and Cancer cohort similarly found no association between percent body fat and the risk of aggressive prostate cancer (≥cT3 or N1 or M1, Gleason grade ≥8, or pretreatment prostate-specific antigen [PSA] level ≥50 ng/mL).…”

“…Percent body fat, assessed with bioelectric impedance, has been associated with high‐grade prostate cancer in case‐control studies . In contrast, we found no association between prospectively measured percent body fat and high‐grade disease.…”

Body shape and pants size as surrogate measures of obesity among males in epidemiologic studies

“…The correlation between professionally-measured waist circumference and pants size observed was 0.66, in accordance with previous findings (0.64 – 0.87), either using self-reported ( Hughes et al, 2009 , Battram et al, 2011 , Moy et al, 2018 ) or professionally-measured circumference ( Han et al, 2005 ). We also observed a strong correlation between waist or hip circumference and the other anthropometric variables (weight, BMI and silhouettes), similarly to others ( Fowke et al, 2012 , Guerrios-Rivera et al, 2017 ), where ρ was superior to 0.7. This suggests that these anthropometric variables are often interlinked.…”

Obese patients with castration‐resistant prostate cancer may be at a lower risk of all‐cause mortality: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database

“…Height and weight data were abstracted from medical records, which were recorded in real‐time. While we do not know if the values were measured or self‐reported, we have previously shown a very high correlation between measured and self‐reported heights and weights within the VA system . However, not all men had height and weight data at the exact time of CRPC diagnosis.…”