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Metabolic syndrome‐like components and prostate cancer risk: results from the Reduction by Dutasteride of Prostate Cancer Events ( REDUCE ) study
Author(s) -
Sourbeer Katharine N.,
Howard Lauren E.,
Andriole Gerald L.,
Moreira Daniel M.,
CastroSantamaria Ramiro,
Freedland Stephen J.,
Vidal Adriana C.
Publication year - 2015
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12843
Subject(s) - prostate cancer , dutasteride , medicine , metabolic syndrome , prostate biopsy , prostate , oncology , cancer , confounding , body mass index , prostate specific antigen , urology , gynecology , obesity
Objective To evaluate the relationship between number of metabolic syndrome ( MetS )‐like components and prostate cancer diagnosis in a group of men where nearly all biopsies were taken independent of prostate‐specific antigen ( PSA ) level, thus minimising any confounding from how the various MetS ‐like components may influence PSA levels. Subjects/Patients and Methods We analysed data from 6426 men in the Reduction by Dutasteride of Prostate Cancer Events ( REDUCE ) study with at least one on‐study biopsy. REDUCE compared dutasteride vs placebo on prostate cancer risk among men with an elevated PSA level and negative pre‐study biopsy and included two on‐study biopsies regardless of PSA level at 2 and 4 years. Available data for MetS ‐like components included data on diabetes, hypertension, hypercholesterolaemia, and body mass index. The association between number of these MetS ‐like components and prostate cancer risk and low‐grade ( G leason sum <7) or high‐grade ( G leason sum >7) vs no prostate cancer was evaluated using logistic regression.Results In all, 2171 men (34%) had one MetS ‐like component, 724 (11%) had two, and 163 (3%) had three or four. Men with more MetS ‐like components had lower PSA levels ( P = 0.029). One vs no MetS ‐like components was protective for overall prostate cancer ( P = 0.041) and low‐grade prostate cancer ( P = 0.010). Two ( P = 0.69) or three to four ( P = 0.15) MetS ‐like components were not significantly related to prostate cancer. While one MetS ‐like component was unrelated to high‐grade prostate cancer ( P = 0.97), two ( P = 0.059) or three to four MetS ‐like components ( P = 0.02) were associated with increased high‐grade prostate cancer risk, although only the latter was significant. Conclusion When biopsies are largely PSA level independent, men with an initial elevated PSA level and a previous negative biopsy, and multiple MetS ‐like components were at an increased risk of high‐grade prostate cancer, suggesting the link between MetS ‐like components and high‐grade prostate cancer is unrelated to a lowered PSA level.