Association of serum lipid levels and prostate cancer severity among Hispanic Puerto Rican men

Abstract

BackgroundWhile obesity and fat intake have been associated with an increased risk of prostate cancer (PCa) aggressiveness and mortality, the association between lipid levels and PCa phenotype remains unclear. Previous reports evaluating this association are inconsistent and highly variable when considering different racial/ethnic groups. There are scarce data regarding this association among Hispanics, and specifically Puerto Rico’s Hispanic men, a population with a higher burden of PCa, metabolic syndrome and overweight. This population has a different ancestry profile than other Hispanics from Central and South America. Due to the above the researchers inquired if there is a relationship between serum lipid levels and PCa phenotype in this understudied population using a cohort of patients treated with radical prostatectomy as their first treatment.MethodsWe performed an exploratory retrospective medical record review study of 199 PCa patients who underwent radical prostatectomy between 2005 and 2012. Variables analyzed included age at PCa diagnosis, Body Mass Index (BMI), preoperative serum prostate-specific antigen (PSA), lipid levels, and clinical parameters such as prostatectomy pathologic stage and Gleason Score (GS). PCa severity was defined using pathologic stage and GS. Unadjusted and adjusted logistic regression models were fitted to estimate the odds ratios (ORs) with 95 % confidence intervals (CI) to define the relationship among clinical characteristics and PCa severity.ResultsMean age for the cohort was 58.8 years (range: 40–75), 78.9 % were overweight or obese, 36.7 % had hypertriglyceridemia, and 35.2 % had low HDL levels. In the unadjusted logistic regression model, hypertriglyceridemia (OR: 2.11, 95 % CI = 1.13–3.93), low HDL (OR: 1.90, 95 % CI = 1.02–3.56-), and age (OR: 2.34, 95 % CI 1.25–4.40) were significantly associated with a diagnosis of high severity of PCa.ConclusionsIn Puerto Rican men with PCa, elevated hypertriglyceridemia, low HDL levels, and age were statistically associated with high grade PCa on bivariate analysis. Total cholesterol level was not associated with severity of disease. Associations lost significance upon multivariate adjustment. These data generate important hypotheses regarding the potential relationship between lipid pathways and PCa development and underscore the need to perform larger scale and longitudinal studies to sort out whether, hypertriglyceridemia is associated with PCa phenotype and development.

Impact of FTO SNPs rs9930506 and rs9939609 in Prostate Cancer Severity in a Cohort of Puerto Rican Men

“…In our cohort, the mean age at PCa diagnosis was 58 years old, particularly in the overweight group, which could suggest an agreement with Hussein [53]. We cannot conclude that FTO is responsible for PCa development at early age in PR, but the poor dietary patterns in this population [29,34,55] may influence the FTO effect on obesity and hence in PCa. Studies in other populations with a high European heritage had suggested that consumption of animal protein, milk and dairy protein might increase the PCa risk by hormonal changes [17,56].…”

“…Previous work in our laboratory established that in Puerto Rican overweight men with PCa there was an increased risk for more severe disease and a higher prevalence (2.9 fold) of metastatic disease in those individuals with higher BMI [33]. In addition, in another study, we also found a positive association between PCa severity in Puerto Rican patients and high triglycerides levels [34]. …”

“…This would suggest that rs9939609 “A” allele may be implicated in the phenotype of PCa and the male population in PR could have a more severe PCa if they have the “A” genotype, thus contributing to the high mortality rate from the disease. Our results prompt us to inquire if patients with high grade PCa at an early age and the FTO mutated rs9939609 will also have high triglycerides levels, given that in a previous work our group found that age and high triglycerides levels are related to high grade PCa [34]. This premise remains unclear in the literature.…”

Association of serum lipids and severity of epithelial ovarian cancer: an observational cohort study of 349 Chinese patients

“…When we analyzed the correlation of TG and EOC severity, our data suggest that elevated TG levels refer to high cancer severity. Similarly, a previous study found a positive association between triglycerides and prostate cancer severity [ 30 ] . Cancer cells are closely related to lipid molecules, particularly fatty acids, as membrane structures, energy sources and structural regions of related signaling molecules [ 31 ] .…”

Serum lipids might improve prostate-specific antigen sensitivity in patients undergoing transrectal ultrasonography-guided biopsy for suspected prostate cancer: A pilot study

“…A handful of studies have shown a close link between obesity, serum lipids and prostate cancer [3,4]. Elevated triglycerides (TGs) and low highdensity lipoprotein (HDL) levels were significantly associated with high-grade prostate cancer, albeit this relationship was not consistent between reports [5][6][7][8]. Moreover, low HDL was associated with adverse pathological findings after radical prostatectomy (RP) [9].…”