Visceral Fat Accumulation as a Risk Factor for Prostate Cancer

Abstract

VON HAFE, PEDRO, FRANCISCO PINA, ANA PÉ REZ, MARGARIDA TAVARES, AND HENRIQUE BARROS. Visceral fat accumulation as a risk factor for prostate cancer. Obes Res. 2004;12:1930 -1935. Objective: No clear association between obesity or body fat distribution and prostate cancer has been shown. We investigated the relation between visceral fat accumulation as measured by computed tomography (CT) and the occurrence of prostate cancer. Research Methods and Procedures:We compared body fat distribution assessed by a direct method (CT) in 63 prostate cancer cases with 63 age-matched healthy community controls. A CT scan at the level of the fourth lumbar vertebra was performed in all participants. Results: Patients presented a significantly higher mean total abdominal fat area (509.2 Ϯ 226.1 vs. 334.3 Ϯ 132.9 cm 2 , p Ͻ 0.001), mostly because of a higher mean visceral fat area (VF; 324.7 Ϯ 145.6 vs. 177.4 Ϯ 88.4 cm 2 , p Ͻ 0.001) and a significantly higher mean ratio between visceral and subcutaneous fat areas (V/S ratio; 1.8 Ϯ 0.4 vs. 1.2 Ϯ 0.4, p Ͻ 0.001). A significantly higher risk of prostate cancer was found for participants with higher VF (odds ratio ϭ 4.6; 95% confidence interval ϭ 2.6 to 8.2 per SD increase) and V/S ratio (odds ratio ϭ 6.0; 95% confidence interval ϭ 2.3 to 11.0 per SD increase). Discussion: These results suggest a role for visceral obesity, quantified by CT, as a risk factor for prostate cancer. The action of the adipocytokines secreted by visceral fat cells, steroid hormone disturbances, and increased levels of insulin or other hormones noted in visceral obesity may explain this association.

Prognostic impact of abdominal adiposity, waist circumference and body mass index in patients with intermediate-risk prostate cancer treated with radiotherapy

“…Recent epidemiological studies have found that abdominal adiposity, in particular the presence of a large VAT compartment, is an important risk factor for cancer development and results in poor prognosis. [16][17][18][19][20] These findings suggest therefore that adipose tissue distribution may be an independent prognostic factor in patients treated curatively for localized prostate cancer. The prognostic significance of abdominal fat distribution in patients with prostate cancer treated with EBRT on Gleason score (GS), prostate-specific antigen (PSA) or clinical stage and outcomes, has not yet been studied.…”

The link between obesity and prostate cancer: the leptin pathway and therapeutic perspectives

“…There are contradictory results from several studies using body mass index (BMI) to evaluate adiposity. [24][25][26][27][28][29] However, studies using abdominal adiposity measurement, either by waist-to-hip ratio 30 or CT scan, 31 found an increased risk for PCa.…”

Association between prostate-specific antigen and leptin, adiponectin, HbA1c or C-peptide among African-American and Caucasian men

“…For example, several studies report that obesity is associated with the stage of cancer at detection, 11,12 and a metaanalysis from MacInnis and English estimated that each 5-unit increase in BMI was associated with an approximate 5% increase in the risk of developing advanced prostate cancer. 12 Furthermore, clinical prostate cancer risk has been associated with the metabolic syndrome, 13,14 centralized obesity, 15 leptin levels [16][17][18] and insulin resistance. 19,20 However, several studies report no evidence of an association, [21][22][23][24][25][26][27] while others report that BMI is associated with reduced risk of prostate cancer, particularly low-grade tumors.…”