OBJECTIVES: To evaluate the relationship between number of metabolic syndrome (MetS)-like components and prostate cancer (PC) diagnosis in a group of men where nearly all biopsies were performed independent of PSA, thus minimizing any confounding from how the various MetS-like components may influence PSA levels.
SUBJECTS/PATIENTS AND METHODS: We analyzed data from 6,426 men in REDUCE with at least one on-study biopsy. REDUCE compared dutasteride vs. placebo on PC risk among men with an elevated PSA and negative pre-study biopsy and included two on-study biopsies regardless of PSA at two and four years. Available data for MetS-like components included data on diabetes, hypertension, hypercholesterolemia, and body mass index (BMI). The association between number of these MetS-like components and PC risk and low-grade (Gleason< 6) or high-grade (Gleason>7) vs. no PC was evaluated using logistic regression.
RESULTS: 2,171 men (34%) had one MetS-like component, 724 (11%) had two, and 163 (3%) had three or four. Men with more MetS-like components had lower PSAs (p=0.029). One vs. no MetS-like components was protective for overall PC (p=0.041) and low-grade PC (p=0.010). Two (p=0.69) or three to four (p=0.15) MetS-like components were not significantly related to PC. While one MetS-like component was unrelated to high-grade (p=0.97), two (p=0.059) or three to four MetS-like components (p=0.02) were associated with increased high-grade risk, though only the latter was significant.
CONCLUSION: When biopsies are largely PSA-independent, men with an elevated PSA and a previous negative biopsy and multiple MetS-like components were at an increased risk of high-grade PC, suggesting the link between MetS-like and high-grade PC is unrelated to lowered PSA.
Written by:
Sourbeer KN, Howard LE, Andriole GL, Moreira DM, Castro-Santamaria R, Freedland SJ, Vidal AC. Are you the author?
Urology Section, Veterans Affairs Medical Center, Durham, NC; Duke Prostate Center, Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, NC.
Reference: BJU Int. 2014 Jun 16. Epub ahead of print.
doi: 10.1111/bju.12843
PubMed Abstract
PMID: 24931061
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