Open AccessBMI trajectories and risk of overall and grade‐specific prostate cancer: An observational cohort study among men seen for prostatic conditions
Author(s) -
Wang Kai,
Chen Xinguang,
Gerke Travis A.,
Bird Victoria Y.,
Ghayee Hans K.,
Prosperi Mattia
Publication year - 2018
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.1747
Subject(s) - medicine , interquartile range , hazard ratio , body mass index , prostate cancer , overweight , confidence interval , proportional hazards model , cohort , cohort study , odds ratio , medical record , demography , cancer , sociology
Background Dynamic longitudinal patterns in body mass index ( BMI ) have been suggested to better predict health outcomes than static measures. Effects of BMI trajectories on prostate cancer ( PC a) risk have not been thoroughly explored. Methods Cohort data were derived from electronic medical records of patients who were admitted to a tertiary‐care hospital in the Southeastern USA during 1994‐2016. Patients with a history of urologic clinic visit because of any prostatic condition and with repeatedly measured BMI (n = 4857) were included. BMI trajectories prior to PC a diagnosis were assessed using the developmental trajectory analysis method. Cox proportional hazards regression modeling was used to estimate adjusted hazard ratio ( aHR ) with 95% confidence intervals ( CI s) for overall and grade‐specific PC a. Results The median age (interquartile range, IQR ) of the participants at baseline was 63 (54, 72) years. Over a median follow‐up ( IQR ) of 8.0 (2.0, 13.0) years, 714 (14.7%, 714/4857) were diagnosed with PC a. Men with growing BMI trajectory progressing from normal weight to overweight/obese had a 76% increased PC a risk ( aHR = 1.76; 95% CI : 1.25, 2.48), and men being obese and experiencing progressive weight gain had 3.72‐fold increased PC a risk ( aHR = 3.72; 95% CI : 1.60, 8.66), compared to men with persistently normal BMI . The associations were more pronounced for PC a with Gleason score ≥7. No significant association of decreasing BMI trajectory progressing from obese to normal BMI was found with PC a risk. Conclusions Progressively body weight gain during middle‐to‐late adulthood was associated with increased PCa risk for both normal weight and overweight men. Further studies are warranted to confirm this finding.