Introduction/Aim: High-grade prostate cancer (PCa) hasbeen reported in association with metabolic syndrome(MS). In a previous study we found no significantcorrelation between body mass index (BMI) and prevalenceof high Gleason score at biopsy (1). BMI could be not anaccurate marker of the endocrine activity of visceraladipose tissue responsible of high plasmatic levels ofadipokines promoting PCa aggressiveness. We estimatedvisceral adiposity dysfunction by the visceral adiposityindex (VAI) considering waist circumference (WC), BMI,triglycerides (TG) and high density lipoproteins (HDL) plasma levels of each patient (2). The aim was to correlateVAI values with PCa detection rate and Gleason patterns 4and 5 at biopsy. Patients and Methods: Patients whounderwent prostate biopsy for suspicious digital rectalexamination and/or elevated PSA levels were enrolled.After informed consent, a transrectal prostate biopsy, 12cores at least (24 in case of re-biopsy), was performed. VAIwas expressed as: WC/[39.68 + (1.88 × BMI)] × TG/1.03× 1.31/HDL, assuming VAI=1 in healthy, non obese menwith TG and HDL levels within normal limits. PCadetection at biopsy, Gleason score patterns, VAI and BMIwere statistically analyzed using the Mann Whitney U-test.Results: Ninety-five patients were entered with a medianage of 67 years (range=47-79). The median BMI was 27kg/m2 (range=17.4-40) and the median VAI was 4.47(range=1.3-15.6). Median PSA was 7.9 ng/ml (range=0.47-53). A prostate nodule was palpable in 27 (28.4%) patients.Ten patients (10.5%) had a previous negative biopsy. Aprostate cancer was diagnosed in 43 (45.2%) patients,Gleason patterns 4 and 5 were detected in 18 (41.8%)patients. Median BMI and VAI were 27.4 Kg/m2 and 26.3Kg/m2 (p=0.53) and 4.25 and 4.66 (p=0.28) in patientswith positive and negative biopsy, respectively. MedianBMI and VAI resulted 27.7 Kg/m2 and 27.3 Kg/m2 and 4.78and 3.98 in patients with and without Gleason patterns 4 or5, respectively. No statistically significant difference washighlighted for VAI (p=0.37) or BMI (p=0.85). Discussionand Conclusion: The identification of patients harboring anaggressive PCa remains an important goal. To date therelation between MS and PCa remains contradictory.Moreover, an accurate marker of MS has not yet beendetermined (3). VAI might be a more accurate marker thanBMI in indicating the activity of visceral fat. In spite ofVAI adoption, our analysis does not reveal any statisticallysignificant correlation between VAI, PCa detection rate andincidence of Gleason patterns 4 or 5 at biopsy. Diet, raceand other environmental and genetic factors, playing apromoting or protective role in PCa, should be alsoconsidered in further studies.The statistical support of the GSTU Foundation is acknowledged.1 Serretta V, Caruana G, Sommatino F, et al: Does exist Acorrelation between BMI and Gleason patterns 4 and 5 atprostate biopsy? J Cytol Histol 4: 182, 2013.2 Amato MC, Giordano C, Galia M et al: Visceral AdiposityIndex: a reliable indicator of visceral fat functionassociated with cardiometabolic risk. Diabetes Care 33:920, 2010.3 Bhindi B, Locke J, Alibhai SM et al: Dissecting theassociation between metabolic syndrome and prostatecancer risk: analysis of a large clinical cohort. Eur Urol67(1): 64-70, 2015. Epub 2014 Feb 14.
|Numero di pagine||1|
|Stato di pubblicazione||Published - 2015|