Clinical and metabolic implications of obesity in prostate cancer: is testosterone a missing link?

Abstract

Objectives: To assess sex hormones in men with obesity and prostate cancer (PCa) and to study association between androgens and the pathogenesis biology of PCa in vitro. Subjects and methods: One hundred and eighty-one men older than 45 years selected from of a population attending to Urology departments screening for PCa, (78 participants without PCa and 103 patients with PCa). All participants were assessed for body mass index (BMI), age, Gleason score, and PSA. Endocrine profile was determined for LH, total testosterone (TT), 17bestradiol (E2), prolactin and leptin. Biochemical profile (HbA1c, triacylglycerols and lipoproteins) was also determined. In vitro experiments were also performed, involving the study of 5adihydrotestosterone (DHT) and E2 in the presence of adipocyte-conditioned medium (aCM). Results: All variables were continuous and described a Gaussian distribution unless mentioned. To determine the relation of aggressiveness, variable were transformed into categories. Thus, PCa aggressiveness is associated with the increase of age and BMI (p < .0001) but with is decreased with TT and E2 (p < .05). Moreover, adipocyte-secreted molecules increase aggressiveness of PCa cells in vitro. Lastly, DTH but not E2 enables invasiveness in vitro. Conclusions: It was observed a coexistence of hormone axis profile alteration with sex hormones and BMI in PCa patients, in accordance with the new perspective of PCa pathogenesis.

Assessment of Periprostatic and Subcutaneous Adipose Tissue Lipolysis and Adipocyte Size from Men with Localized Prostate Cancer

“…Prostate cancer (PCa) is the most commonly diagnosed cancer in men in developed countries and the second most common cancer worldwide [ 1 ]. Several studies have reported that PCa pathobiology is influenced by obesity, specifically, more aggressive carcinoma, poorer treatment outcomes, and increased cancer-specific mortality in obese men [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. A range of systemic mechanisms has been proposed to underpin this association, including altered adipokine and inflammatory profiles, hyperinsulinemia, and dyslipidemia [ 10 , 11 , 12 ].…”

Assessment of expression levels of leptin and leptin receptor as potential biomarkers for risk of prostate cancer development and aggressiveness

“…Risks and associated factors of PCa include age, high androgen levels, overweight, and obesity 2 . In fact, obesity has globally increased to an epidemic level and has been recognized as major health concern; aside from being related to diabetes, hypertension, and cardiovascular disease, it is linked to the development and progression of numerous types of cancers such as ovarian, pancreatic, endometrial, colon, postmenopausal breast, and prostate 3‐5 . Additionally, obesity has been associated with aggressive cancer, bad prognosis, poor outcome, and poor survival rate of cancer patients 6‐8 .…”

Relationship among CT-based abdominal adipose tissue areas and pancreatic ductal adenocarcinoma in male

“…Epidemiological studies have shown that obesity can be a risk factor for many types of cancer, including PDAC [29,30]. It is also known that anatomically different fat areas show different tissue characterization and metabolic activity.…”