The Impact of Obesity on Benign and Malignant Urologic Conditions

Abstract

Obesity, defined as a body mass index ≥ 30 kg/m² in adults by the National Institutes of Health, is associated with an increased risk for a number of health conditions, including hypertension, unfavorable lipid level, and diabetes mellitus. During the past 2 decades of the twentieth century, the prevalence of obesity has increased in the United States. In 2009 to 2010, 36% of adults were obese, including 41 million women and > 37 million men. In addition, the prevalence of metabolic syndrome (MetS), which is a constellation of interrelated cardiac risk factors including visceral obesity, impaired insulin action (ie, insulin resistance), atherogenic dyslipidemia, endothelial dysfunction, and systemic inflammation, has been increasing in the United States. More recently, there has been greater interest in the effects of obesity and MetS on a variety of benign and malignant urologic conditions. Obesity/MetS has been shown to have an effect on urolithiasis; benign prostatic hyperplasia and lower urinary tract symptoms; female incontinence and pelvic prolapse; male hypogonadism; and male sexual function and infertility. These urologic diseases have a considerable impact on patients' quality of life. From a urologic cancer standpoint, obesity/MetS has been demonstrated to play a role in prostate cancer and in renal cell cancer; its role in bladder cancer remains ill defined. Furthermore, dietary or lifestyle modifications may improve outcomes in many of these urologic disease processes. Thus, it is imperative for physicians to understand these relationships in order to better screen obese patients and be aware of the potential impact of weight loss on affected benign and malignant urologic conditions.

An increased body mass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer

“…The association of obesity with a poor clinical outcome in T1G3 NMIBC could be explained on the basis of several factors. In particular, it is well known that obesity is characterized by insulin resistance and low-grade systemic inflammation, which may affect the oncological outcomes of NMIBC patients as a result of insulin, IGF-1, cytokines and growth factors' effects [13]. In this regard, obese subjects showed increased levels of insulin and IGF-1 [14].…”

Current and Future Applications of Genetic Prostate Cancer Screening In the Urologic Clinic

“…Nutri tion and hormones, including insulin-like growth factor level, may influence the risk of developing prostate cancer (Key, 2014). Obesity and a prevalence of metabolic syndrome have been proven to be associated with prostate cancer (Chu, Rotker, & Ellsworth, 2013). Recent research has also shown an increased risk of prostate cancer with Agent Orange exposure (Ansbaugh, Shannon, Mori, Farris, & Garzotto, 2013).…”

Metabesity and urological cancers

“…[17,[22][23][24][25] Development of renal cancer due to these conditions has been associated with inflammation, insulin, and insulin-like growth factor-1, renal hypoxia, hyperfiltration, and lipid peroxidation. [11,26] However in a study performed by Haggstrom et al [27] all components of metabolic syndrome have been correlation with the development of renal cancer. Increased body mass index, hypertension, hyperglycemia and hypertriglyceridemia especially in men and increased body mass index especially in women have been found to be important adverse factors.…”

“…However, various studies performed have detected an association between metabolic syndrome and infertility, stone disease, overactive bladder, female urinary incontinence, benign prostatic hyperplasia, prostate cancer and renal cancer. [9][10][11] In the light of the data obtained, the association between metabolic syndrome, and development of malignity has attracted attention of many researchers. In a recent review article this issue has been analyzed in detail.…”