SIU 2017: Different Incidence of Prostate Cancer According to Metabolic Health Status: A Nationwide Cohort Study

Lisbon, Portugal ( While many prior papers have looked at the effect of obesity and BMI with prostate cancer incidence and prognosis, within the field of metabolic health, there is now an understanding that patients with normal weight can still have metabolic syndrome. These patients with “metabolically obese, normal weight” have a high visceral/subcutaneous fat ratio and other metabolic derangements associated with metabolic syndrome. Recent studies have also demonstrated that in Asian patients, diabetes and heart disease may be more prevalent even in the absence of obesity.

With prostate cancer incidence rising in Korea, the authors assess the incidence of prostate cancer using the National Health Check-ups (NHC) database. There were 11.8 million men who participated between 2009 and 2012, amongst which there were 56,552 newly diagnosed cases of prostate cancer. Obesity was defined as patients with BMI > 25 in this study (though historically it is >30). Metabolically Obese (MO) was defined as anyone have >= 3 components of metabolic syndrome. This resulted in 4 categories: metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy and obese (MHO) and metabolically obese and obese (MOO). MV regression analysis was used to identify predictors of prostate cancer incidence. 

While MHNW predominated the number of cases (6.1 million), there were 1.2 million MONW, and 2 million each of the obese patients. Importantly, MONW patients and MOO patients were older than their metabolically healthy counterparts. Diabetes, HTN, and HLP were all higher as expected in the metabolically obese and obese patients. Median follow-up was similar for all groups, approximately 5.3 years.

Compared to MHNW patients, all the other categories had a higher age-adjusted and multi-variable adjusted risk of prostate cancer. HR were 1.143 (MONW), 1.09 (MHO) and 1.25 (MOO). Interestingly, MONW were at higher risk than MHO, suggesting it is not obesity alone that increases risk. 

As the number of metabolic components increased, so did the risk of developing prostate cancer!

Presented by: Hong Seok Park
Affiliation: Korea University, South Korea

Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, Twitter: @tchandra_uromd at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal