The metabolic syndrome (MS) refers to the combination of several metabolic abnormalities, including central obesity, dyslipidemia, hypertension, insulin resistance and glucose intolerance. Since 2008, consecutive men undergoing 12-core prostate biopsy at one center in Italy were enrolled into a prospective database. Body mass index (BMI), as well as waist and hip circumferences were measured before the biopsy. Blood samples collected before biopsy were measured for total and free PSA, fasting glucose, triglycerides and HDLs. Blood pressure was also recorded. They evaluated the association between metabolic syndrome defined according to Adult Treatment Panel III (ATPIII) and CaP risk and biopsy Gleason score.
One hundred ninety-five men were enrolled; median age 69 years and PSA 5.6 ng/ml. Median BMI was 27.6 k/m2 with 64 patients (33%) being classified as obese. 86 patients (44%) had MS. Eighty-three patients (43%) had CaP on biopsy; 37 (45%) with MS and 46 (55%) without (p= 0.48). PSA was independently associated with a higher risk of CaP (OR 1.12 per 1 unit PSA, p=0.01). Out of 83 patients with CaP, 42 (51%) had Gleason score 6 (12 (28.5%) presented with MS) and 41 (49%) a Gleason score ≥7 (25 (61%) presented with MS). The presence of MS was not associated with an increased risk of CaP (OR: 0.97, p=0.94), but it was associated with an increased risk of Gleason ≥7 (OR: 3.82; p= 0.013) among patients with CaP on biopsy. The investigators conclude that MS is highly prevalent in a prostate biopsy population and it is associated with an increased risk of high-grade disease among patients with a positive prostate biopsy.
Presented by Cosimo De Nunzio, MD, PhD, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria