AUA 2017: Statin Use, Serum Lipid Levels and Prostate Inflammation; Results from the Reduce Study

Boston, MA ( Statin use has been shown to be associated with lower risk of advanced prostate cancer (PCa), due to unknown mechanisms. In addition to cholesterol-lowering, statins also have systemic anti-inflammatory properties, but the effect of serum cholesterol levels and statin use on benign prostate inflammation has not been explored. The authors aimed to examine the associations between serum lipid levels, statin use, and histological prostate inflammation among men with a negative prostate biopsy.

The authors performed a retrospective analysis of data from 6,655 men with a negative baseline prostate biopsy in the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial. Statin use and serum lipid levels [triglycerides, total cholesterol, low and high density lipoprotein (LDL and HDL, respectively)] were assessed at baseline. Prostate inflammation was classified as chronic (lymphocytes, macrophages) or acute (neutrophils) following central histological review of negative baseline prostate biopsies. Multinomial logistic regression analysis was used to examine the effect of serum lipid levels and statin use on presence and extent of chronic and acute prostate inflammation [none, moderate (<20% biopsy cores), severe (≥20% biopsy cores)], adjusting for potential confounders.

Chronic and acute prostate inflammation was found in 5,151 (77%) and 1,005 (15%) men, respectively. Serum lipid levels were found not to be associated with the presence or extent of chronic prostate inflammation. Total cholesterol, LDL and triglycerides were not associated with presence or extent of acute prostate inflammation. However, men with high HDL (≥60 vs. <40 mg/dl) had reduced presence of any acute inflammation (OR 0.79; 95% CI 0.63-0.99), and were less likely to have severe acute inflammation (OR 0.66; 95% CI 0.45-0.97). Statin users had reduced presence of any chronic prostate inflammation (OR 0.81; 95% CI 0.69-0.95), and were less likely to have severe chronic inflammation and severe acute inflammation (OR 0.80; 95% CI 0.68-0.95 and OR 0.73; 95% CI 0.53-1.00, respectively), compared to non-users.

In a cohort of men with a negative prostate biopsy, those with high HDL had reduced rates of acute prostate inflammation, while statin users had reduced presence and extent of chronic and acute inflammation. These findings support an effect of HDL and statin use on benign prostate inflammation. Due to the fact that inflammation has been shown to be correlated with prostate cancer risk, this study suggests a mechanism linking serum lipid levels, statins and prostate cancer risk.

Presented By: Emma Allott, Chapel Hill, NC

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre
Twitter: @Goldberghanan

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA