Metabolically Abnormal Obesity Increases the Risk of Advanced Prostate Cancer in Chinese Patients Undergoing Radical Prostatectomy

Abstract

Wen Liu,1 Wenxian Li,1 Zhankun Wang,2 Yao Zhu,3 Dingwei Ye,3 Guiming Zhang1 1Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China; 2Department of Urology, Qingdao Eighth People’s Hospital, Qingdao, People’s Republic of China; 3Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of ChinaCorrespondence: Guiming ZhangDepartment of Urology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Qingdao 266003, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected]: To investigate the pathological risk of prostate cancer (PCa) according to the obesity and metabolic status of Chinese patients undergoing radical prostatectomy.Materials and Methods: We performed a retrospective cross-sectional study of 1016 patients with PCa who underwent radical prostatectomy and whose metabolic status and body mass index were examined. Multivariate logistic regression analysis was performed to examine the relationship between different metabolic obesity phenotypes and the pathological outcomes of PCa.Results: Among 1016 men, 551 (54.2%), 106 (10.4%), 238 (23.4%), and 121 (11.9%) were assigned to the metabolically healthy and normal weight (MHNW) group, metabolically abnormal but normal weight (MANW) group, metabolically healthy but overweight or obese (MHO) group, and metabolically abnormal and overweight or obese (MAO) group, respectively. Compared with the MHNW group, the MAO group had a significantly greater risk of a higher prostatectomy Gleason score [odds ratio (OR), 1.907; 95% confidence interval (95% CI), 1.144– 3.182], pathological stage (OR, 1.606; 95% CI, 1.035– 2.493), and seminal vesicle invasion (OR, 1.673; 95% CI, 1.041– 2.687). In contrast, the ORs were not increased in the MHO or MANW group. In the context of normal weight, metabolic disorders were associated with lymph node involvement. The metabolic status and body mass index were not associated with extracapsular extension or surgical margins in any of the four groups.Conclusion: The MAO phenotype is associated with aggressive PCa, including a higher prostatectomy Gleason score, pathological stage, and seminal vesicle invasion and might also be associated with disease progression. Obesity and metabolic disorders act synergistically to increase the pathological risk of PCa.Keywords: prostate cancer, obesity, metabolic syndrome, pathology, Gleason score

Keywords

• prostate cancer
• obesity
• metabolic syndrome
• pathology
• gleason score