Abstract

association between obesity and prostate cancer, yieldinginconsistent results. Metabolic syndrome has been suggestedto promote aggressive prostate tumors. In a previous study wefailed to detect a relation between Body Mass Index (BMI)and prostate cancer Gleason score (1). BMI, althoughroutinely adopted to measure obesity, has low sensitivity andspecificity. A novel sex-specific obesity index, based on waistcircumference (WC), BMI, triglycerides (TGs) and highdensity lipoproteins (HDL), the Visceral Adiposity Index(VAI), has been proposed to estimate the visceral adipositydysfunction (2). The aim of our preliminary research was tocorrelate VAI and BMI with the presence of prostate cancerand the Gleason score at biopsy. Patients and Methods:Patients, undergoing prostate biopsy for palpable prostatenodule and/or elevated PSA levels, entered the study. Afterinformed consent a transrectal prostate biopsy, 12 cores atleast, was performed. The number of cores increased in rebiopsies(18-24 cores). A database including clinical,biochemical and pathological data was created. Prostate cancerdetection at biopsy, Gleason score (6 or less versus 7 orhigher), VAI, BMI and PSA values were statistically analyzedwith Wilcoxon rank sum test. Results: Fifty-one patients wereevaluated. The median age was 66 years (range 47-80). Twopatients (3.9%) had a previous negative biopsy. The medianBMI was 27.7 kg/m2 (range 18.7-40) and the median VAI was4.4 (range: 1.6-15.6). Median PSA was 8.5 ng/ml (range 3.2-53). A prostate nodule was palpable in 9 (17.6%) patients. Themedian prostate volume was 48 cc (range: 14-106). A prostatecancer was detected in 24 (47%) patients, with a Gleasonpattern 6 in 14 (58.3%) patients and 7 or higher in theremaining 10 (41.7%). Among patients with positive prostatebiopsy, median PSA BMI and VAI were 10.2 ng/ml, 27.8Kg/m2 and 5.8, respectively. Among patients with negativeprostate biopsy, median PSA BMI and VAI were 7.0 ng/ml,26.8 Kg/m2 and 5.5, respectively. Only PSA levels wereslightly related to biopsy positivity (p-value=0.08), nodifference was detected for VAI (p-value=0.89) and BMI (pvalue=0.19). Median PSA, BMI and VAI resulted 9.2 ng/ml,27.8 Kg/m2 and 5.6, respectively in patients with Gleasonscore of 6 or less, and 10.9 ng/ml, 27.7 Kg/m2 and 5.8,respectively, in patients with Gleason score >6. Even in thiscase PSA levels were slightly related to prostate canceraggressiveness (p-value=0.12), while no difference washighlighted for VAI (p-value=0.6665) and BMI (pvalue=0.6394). Discussion and Conclusion: The identificationof patients harboring an aggressive prostate cancer remains animportant goal. The contradictory results on the relationbetween obesity and prostate cancer could be due to the lowaccuracy of BMI as a marker of metabolic syndrome. VAI hasbeen recommended as an accurate indicator of adipose tissueactivity. Nevertheless, our preliminary results do not detect anysignificant correlation between VAI, BMI, positivity ofprostate biopsy and Gleason score
Lingua originaleEnglish
Pagine2636-2637
Numero di pagine2
Stato di pubblicazionePublished - 2014

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