Metabolic Alterations, Aggressive Hormone-Naïve Prostate Cancer and Cardiovascular Disease: A Complex Relationship

Abstract

Background: Epidemiological studies suggest a possible relationship between metabolic alterations, cardiovascular disease and aggressive prostate cancer, however, no clear consensus has been reached. Objective: The aim of the study was to analyze the recent literature and summarize our experience on the association between metabolic disorders, aggressive hormone-naïve prostate cancer and cardiovascular disease. Method: We identified relevant papers by searching in electronic databases such as Scopus, Life Science Journals, and Index Medicus/Medline. Moreover, we showed our experience on the reciprocal relationship between metabolic alterations and aggressive prostate cancer, without the influence of hormone therapy, as well the role of coronary and carotid vasculopathy in advanced prostate carcinoma. Results: Prostate cancer cells have an altered metabolic homeostatic control linked to an increased aggressivity and cancer mortality. The absence of discrimination of risk factors as obesity, systemic arterial hypertension, diabetes mellitus, dyslipidemia and inaccurate selection of vascular diseases as coronary and carotid damage at initial diagnosis of prostate cancer could explain the opposite results in the literature. Systemic inflammation and oxidative stress associated with metabolic alterations and cardiovascular disease can also contribute to prostate cancer progression and increased tumor aggressivity. Conclusions: Metabolic alterations and cardiovascular disease influence aggressive and metastatic prostate cancer. Therefore, a careful evaluation of obesity, diabetes mellitus, dyslipidemia, systemic arterial hypertension, together with a careful evaluation of cardiovascular status, in particular coronary and carotid vascular disease, should be carried out after an initial diagnosis of prostatic carcinoma.

Aberrant gene expression pattern in the glycolysis-cholesterol synthesis axis is linked with immune infiltration and prognosis in prostate cancer: A bioinformatics analysis

“…[ 43 ] The metabolic balance control of PCa cells was changed, and the biosynthesis of endogenous cholesterol was increased, which accumulated in tumor cells. [ 44 ] PCa and obesity adipose tissue is an active endocrine tissue that can regulate the metabolic activity of the prostate and affect cancer, especially the development of tumors. Both PCa and obese adipose tissue were relatively active endocrine tissues, which can regulate the metabolic activity of the prostate and affect the development of cancer, especially the development of tumors.…”

GSTP1 rs1138272 Polymorphism Affects Prostate Cancer Risk

“…Regarding a possible gene-environment interaction, it is important to note that, in our cohort of PC patients, the presence of diabetes and hypertension was significantly higher in comparison to that of the controls. It has been suggested that these confounding factors might influence aggressive and metastatic PC, as well as have some impact on the outcome after different therapeutic treatments, including androgen-deprivation therapy [3,49]. Although data on modifying the effect of GST genetic variations at risk to diabetes and hypertension are inconsistent [8,50], we made an adjustment in order to exclude the potential bias related to these confounding factors.…”

Predictors of Lymph Node Invasion in Patients with Clinically Localized Prostate Cancer Who Undergo Radical Prostatectomy and Extended Pelvic Lymph Node Dissection: The Role of Obesity

“…Obesity is a major health concern in Western countries, and its association with aggressive PCa is an emerging critical issue [8, 24]. In the last few years, the prevalence of PCa has mirrored the spread of obesity, reflecting potential shared risk factors.…”