<p>Metabolically Abnormal Obesity Increases the Risk of Advanced Prostate Cancer in Chinese Patients Undergoing Radical Prostatectomy</p>

Abstract

Background: To investigate the pathological risk of prostate cancer (PCa) according to the obesity and metabolic status of Chinese patients undergoing radical prostatectomy. Materials and Methods: We performed a retrospective cross-sectional study of 1016 patients with PCa who underwent radical prostatectomy and whose metabolic status and body mass index were examined. Multivariate logistic regression analysis was performed to examine the relationship between different metabolic obesity phenotypes and the pathological outcomes of PCa. Results: Among 1016 men, 551 (54.2%), 106 (10.4%), 238 (23.4%), and 121 (11.9%) were assigned to the metabolically healthy and normal weight (MHNW) group, metabolically abnormal but normal weight (MANW) group, metabolically healthy but overweight or obese (MHO) group, and metabolically abnormal and overweight or obese (MAO) group, respectively. Compared with the MHNW group, the MAO group had a significantly greater risk of a higher prostatectomy Gleason score [odds ratio (OR), 1.907; 95% confidence interval (95% CI), 1.144-3.182], pathological stage (OR, 1.606; 95% CI, 1.035-2.493), and seminal vesicle invasion (OR, 1.673; 95% CI, 1.041-2.687). In contrast, the ORs were not increased in the MHO or MANW group. In the context of normal weight, metabolic disorders were associated with lymph node involvement. The metabolic status and body mass index were not associated with extracapsular extension or surgical margins in any of the four groups. Conclusion: The MAO phenotype is associated with aggressive PCa, including a higher prostatectomy Gleason score, pathological stage, and seminal vesicle invasion and might also be associated with disease progression. Obesity and metabolic disorders act synergistically to increase the pathological risk of PCa.

Effect of obesity on the prognosis and recurrence of prostate cancer after radical prostatectomy: a meta-analysis

“…A total of 14 articles regarding obesity and postoperative recurrence and prognosis were included (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). As shown in Figure 2, a significant heterogeneity among the studies was identified (I 2 =71.0%, P=0.000), so the REM was used.…”

“…A total of five articles were included to report the PSM condition of patients (12)(13)(14)17,21). Firstly, obvious heterogeneity was identified among the studies (I 2 =50.9%, P<0.001) (Figure 6A), so the REM was used for meta-analysis.…”

Metabolic obesity phenotypes and obesity‐related cancer risk in the National Health and Nutrition Examination Survey

“…These results were similar to our overall results and did not change after adjusting for waist circumference (Table S2). Other prior studies used the MetS definition, excluding waist circumference (to separate other metabolic parameters from obesity) and observed stronger associations with the metabolically unhealthy phenotypes 11,19,20,23,39 . This suggests that other components of metabolic dysfunction, such as hyperglycaemia, hypertension and dyslipidaemia, may be driving the higher risk of ORC in the MUNW phenotype.…”

Metabolically healthy obesity is associated with increased risk of lower urinary tract symptoms secondary to benign prostatic hyperplasia: A cohort study of Chinese elderly males

“…13 Considerable insights have been acquired in the association between MHO and the risks of chronic kidney disease 14 and prostate cancer. 15 However, studies on the association between MHO and LUTS/ BPH risk are few. Whether the risk of LUTS/BPH varies among different MetS-BMI phenotypes remains to be determined.…”

“…In the past decade, controversy has surrounded the hypothesis that whether the unique MHO/MHOW phenotype is a harmless condition for adverse health outcomes 13 . Considerable insights have been acquired in the association between MHO and the risks of chronic kidney disease 14 and prostate cancer 15 . However, studies on the association between MHO and LUTS/BPH risk are few.…”