Metabolic factors did not increase the risk of prostate cancer but modestly raised the risk of prostate cancer mortality, results of a large cohort study showed.
Blood pressure, body mass index (BMI), and cholesterol level had no association with prostate cancer, nor did the composite z-score for combined metabolic risk factors.
Higher levels of glucose and triglycerides were associated with a reduced risk of prostate cancer compared with men who had the lowest glucose and triglyceride values.
High blood pressure, BMI, and composite metabolic score did predict the risk of dying of prostate cancer, raising the odds by 13% to 62%, as reported online in Cancer.
?The results of the current study add further evidence to support the hypothesis that high levels of metabolic factors, separately or combined, are not related to the development of prostate cancer but are related to an increased risk of disease progression, but with no evidence of synergy between the metabolic factors,? wrote Christel H?ggstr?m, MSc, of Ume? University in Sweden.
?Thus, from a public health perspective, the data from the current study will add some further motivation to control metabolic factors to decrease the risk of cardiovascular disease, diabetes, and, to some degree, prostate cancer death.?
Several studies have demonstrated a modest association between excess body weight (expressed as BMI) and prostate cancer. Obesity and higher BMI have a stronger association with prostate cancer mortality.
Relatively few studies have examined relationships between specific metabolic factors and prostate cancer, and most investigations have involved small numbers of patients, the authors noted in their introduction. The effect of combined metabolic factors on prostate cancer risk has a mixed history in the literature.
To expand the investigation of metabolic factors and prostate cancer risk, H?ggstr?m and colleagues analyzed data from the ongoing Metabolic Syndrome and Cancer Project (Me-Can), which has a database comprising 289,866 men from Sweden, Norway, and Austria.
The Me-Can database contains records of study participants? blood pressure, lipids, glucose, height, weight, and other clinical and demographic characteristics. Investigators grouped the men into quintiles on the basis of metabolic parameters and calculated relative risk for individual parameters and a cumulative risk score.
Analysis of baseline characteristics for all 289,866 study participants showed a mean age of 44 at recruitment and that:
- 44% were overweight (BMI 25 to 30)
- 11% were obese (BMI ?30)
- 38% had hypertension (?140/90 mm Hg)
- 7% had impaired fasting glucose (?110 to 126 mg/dL)
- 4% had diabetes (?126 mg/dL)
- 32% had fasting hypercholesterolemia (?250 mg/dL)
- 27% had fasting hypertriglyceridemia (?150 mg/dL)
- 34% were current smokers
During a mean follow-up of 12 years, 6,673 men developed prostate cancer, and 961 study participants died of prostate cancer. Comparing highest versus lowest quintiles for each metabolic parameter, the investigators found that neither the individual parameters nor the composite risk score predicted an increased risk of prostate cancer.
Two risk factors were associated with a lower risk of prostate cancer: fasting glucose (RR 0.82, P=0.03 for trend) and triglycerides (RR 0.88, P=0.001 for trend).
Analysis of associations between risk factors and prostate cancer mortality identified three parameters that predicted an increased risk: BMI (RR 1.36, P=0.013 for trend), systolic blood pressure (RR 1.62, P=0.001 for trend), and diastolic blood pressure (RR 1.24, P=0.001 for trend). Additionally, the adjusted composite score (z score) predicted an increased prostate cancer mortality risk (RR 1.13 for trend).
The investigators also examined associations between risk factors and prostate cancer/prostate cancer mortality. They found stronger associations for cases diagnosed before 1997, which they speculated was a reflection of the introduction of PSA testing and subsequent diagnosis of more early-stage cancers.
The study was supported by the Woorld Cancer Research Fund and the Swedish Cancer Foundation.
The authors had no relevant disclosures.
Primary source: Cancer
Source reference:
H?ggstr?m C et al. ?Prospective study on metabolic factors and risk of prostate cancer? Cancer 2012; DOI: 10.1002/cncr.27677.
Charles Bankhead
Staff Writer
Working from Houston, home to one of the world?s largest medical complexes, Charles Bankhead has more than 20 years of experience as a medical writer and editor. His career began as a science and medical writer at an academic medical center. He later spent almost a decade as a writer and editor for Medical World News, one of the leading medical trade magazines of its era. His byline has appeared in medical publications that have included Cardio, Cosmetic Surgery Times, Dermatology Times, Diagnostic Imaging, Family Practice, Journal of the National Cancer Institute, Medscape, Oncology News International, Oncology Times, Ophthalmology Times, Patient Care, Renal and Urology News, The Medical Post, Urology Times, and the International Medical News Group newspapers. He has a BA in journalism and MA in mass communications, both from Texas Tech University.
Source: http://cancerkick.com/2012/10/22/bmi-bp-dont-up-prostate-cancer-risk/
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