OBJECTIVES: Inconsistent evidence exists on whether obesity is associated with an increased risk of prostate cancer death post-radical prostatectomy.
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We examined data from three large health plans to evaluate if an increased body mass index (BMI) at prostate cancer diagnosis is related to prostate cancer mortality
SUBJECTS AND METHODS: This population-based case-control study included 751 men with prostate cancer who underwent radical prostatectomy. Cases were men who died due to prostate cancer (N=323) and matched controls (N=428). We used multivariable logistic regression models to assess the association between BMI at diagnosis and prostate cancer mortality, adjusted for Gleason score, PSA, tumour characteristics, and matching factors.
RESULTS: Study subjects were classified into the following BMI (kg/m(2)) categories: healthy (18.5-24.9), overweight (25-29.9) and obese (≥30). Nearly 43% of the participants had a BMI ≥25 at diagnosis. A higher fraction of cases (30%) were obese compared to controls (22%). Overall, obese men had more than a 50% increase in prostate cancer mortality (adjusted odds ratio=1.50 (95% CI, 1.03-2.19)) when compared to men with healthy BMI. After stratifying by Gleason score, the odds of mortality generally rose with increasing BMI. The strongest effect was observed in the Gleason score 8+ category (2.37, 95% CI: 1.11-5.09). These associations persisted after adjusting for PSA at diagnosis and other tumour characteristics.
CONCLUSIONS: These results suggest that BMI at diagnosis is strongly correlated with prostate cancer mortality, and that men with aggressive disease have a markedly greater odds of death if they are overweight or obese.
Haque R, Van Den Eeden SK, Wallner LP, Richert-Boe K, Kallakury B, Wang R, Weinmann S. Are you the author?
Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States; Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States; Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States; Georgetown University, Department of Pathology, Washington, DC, United States.
Reference: Obes Res Clin Pract. 2014 Jul-Aug;8(4):e374-81.