Metabolic syndrome is associated with high grade Gleason score when prostate cancer is diagnosed on biopsy

Prostate. 2011 Oct 1;71(14):1492-8. doi: 10.1002/pros.21364. Epub 2011 Feb 25.

Abstract

Background: To evaluate the association between metabolic syndrome (MS) and prostate cancer diagnosis and grade in patients undergoing prostate biopsy.

Methods: From 2009 onwards, a consecutive series of patients undergoing 12-core prostate biopsy for PSA value ≥4 ng/ml and/or positive digital rectal examination (DRE) were prospectively enrolled. Body mass index (BMI), waist circumferences, and blood pressure were measured before the biopsy. Blood samples were tested for: PSA, fasting glucose, triglycerides, and cholesterol HDL. MS presence was defined according to Adult Treatment Panel III criteria.

Results: One hundred ninety five patients were enrolled with a median age and PSA of 69 years and 5.6 ng/ml respectively. Median BMI was 27.6 kg/m(2) with 64 patients (33%) being classified as obese (BMI ≥ 30 kg/m(2) ). Eighty-six patients (44%) had MS. Eighty-three patients (43%) had cancer on biopsy; 37 (45%) with MS and 46 (55%) without (P = 0.48). PSA was independently associated with higher risk of cancer (OR 1.12/1 U PSA, P = 0.01). Out of 83 patients with prostate cancer, 42 (51%) had Gleason score 6 (12 (28.5%) presented a MS) and 41 (49%) a Gleason score ≥7 (25 (61%) presented a MS). The presence of MS was not associated with an increased risk prostate cancer (OR: 0.97, P = 0.94) but with an increased risk of Gleason ≥7 (OR: 3.82; P = 0.013).

Conclusions: In our single center study, MS is associated with an increased risk of high grade Gleason score when prostate cancer is diagnosed on biopsy. However, these results should be confirmed in a larger multicenter study. .

Keywords: Gleason score; metabolic syndrome; needle biopsy; obesity; prostate cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biopsy
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Mass Index
  • Cholesterol, HDL / blood
  • Digital Rectal Examination
  • Humans
  • Kallikreins / blood
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / metabolism
  • Metabolic Syndrome / pathology*
  • Middle Aged
  • Neoplasm Grading
  • Neostigmine
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / complications*
  • Prostatic Neoplasms / metabolism
  • Prostatic Neoplasms / pathology*
  • Risk Assessment
  • Triglycerides / blood
  • Waist Circumference

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Triglycerides
  • Neostigmine
  • Kallikreins
  • kallikrein-related peptidase 3, human
  • Prostate-Specific Antigen