The impact of obesity on prostate cancer recurrence observed after exclusion of diabetics

Ilir Agalliu, Steve Williams, Brandon Adler, Lagu Androga, Michael Siev, Juan Lin, Xiaonan (Nan) Xue, Gloria Huang, Howard Strickler, Reza Ghavamian

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: Although overall there is a positive association between obesity and risk of prostate cancer (PrCa) recurrence, results of individual studies are somewhat inconsistent. We investigated whether the failure to exclude diabetics in prior studies could have increased the likelihood of conflicting results. Methods: A total of 610 PrCa patients who underwent radical prostatectomy between 2005 and 2012 were followed for recurrence, defined as a rise in serum PSA ≥ 0.2 ng/ml following surgery. Body mass index (BMI) and history of type 2 diabetes were documented prior to PrCa surgery. The analysis was conducted using Cox proportional hazard models. Results: Obesity (25.6 %) and diabetes (18.7 %) were common in this cohort. There were 87 (14.3 %) recurrence events during a median follow-up of 30.8 months after surgery among the 610 patients. When analyzed among all PrCa patients, no association was observed between BMI/obesity and PrCa recurrence. However, when analysis was limited to non-diabetics, obese men had a 2.27-fold increased risk (95 % CI 1.17–4.41) of PrCa recurrence relative to normal weight men, after adjusting for age and clinical/pathological tumor characteristics. Conclusions: This study found a greater than twofold association between obesity/BMI and PrCa recurrence in non-diabetics. We anticipated these results because the relationship between BMI/obesity and the biologic factors that may underlie the PrCa recurrence–BMI/obesity association, such as insulin, may be altered by the use of anti-diabetes medication or diminished beta-cell insulin production in advanced diabetes. Studies to further assess the molecular factors that explain the BMI/obesity–PrCa recurrence relationship are warranted.

Original languageEnglish (US)
Article number554
Pages (from-to)821-830
Number of pages10
JournalCancer Causes and Control
Volume26
Issue number6
DOIs
StatePublished - Mar 14 2015

Fingerprint

Prostatic Neoplasms
Obesity
Recurrence
Body Mass Index
Insulin
Biological Factors
Prostatectomy
Proportional Hazards Models
Type 2 Diabetes Mellitus
Weights and Measures
Serum
Neoplasms

Keywords

  • Diabetes
  • Insulin signaling
  • Obesity
  • Prostate cancer
  • Recurrence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

The impact of obesity on prostate cancer recurrence observed after exclusion of diabetics. / Agalliu, Ilir; Williams, Steve; Adler, Brandon; Androga, Lagu; Siev, Michael; Lin, Juan; Xue, Xiaonan (Nan); Huang, Gloria; Strickler, Howard; Ghavamian, Reza.

In: Cancer Causes and Control, Vol. 26, No. 6, 554, 14.03.2015, p. 821-830.

Research output: Contribution to journalArticle

Agalliu, Ilir ; Williams, Steve ; Adler, Brandon ; Androga, Lagu ; Siev, Michael ; Lin, Juan ; Xue, Xiaonan (Nan) ; Huang, Gloria ; Strickler, Howard ; Ghavamian, Reza. / The impact of obesity on prostate cancer recurrence observed after exclusion of diabetics. In: Cancer Causes and Control. 2015 ; Vol. 26, No. 6. pp. 821-830.
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abstract = "Purpose: Although overall there is a positive association between obesity and risk of prostate cancer (PrCa) recurrence, results of individual studies are somewhat inconsistent. We investigated whether the failure to exclude diabetics in prior studies could have increased the likelihood of conflicting results. Methods: A total of 610 PrCa patients who underwent radical prostatectomy between 2005 and 2012 were followed for recurrence, defined as a rise in serum PSA ≥ 0.2 ng/ml following surgery. Body mass index (BMI) and history of type 2 diabetes were documented prior to PrCa surgery. The analysis was conducted using Cox proportional hazard models. Results: Obesity (25.6 {\%}) and diabetes (18.7 {\%}) were common in this cohort. There were 87 (14.3 {\%}) recurrence events during a median follow-up of 30.8 months after surgery among the 610 patients. When analyzed among all PrCa patients, no association was observed between BMI/obesity and PrCa recurrence. However, when analysis was limited to non-diabetics, obese men had a 2.27-fold increased risk (95 {\%} CI 1.17–4.41) of PrCa recurrence relative to normal weight men, after adjusting for age and clinical/pathological tumor characteristics. Conclusions: This study found a greater than twofold association between obesity/BMI and PrCa recurrence in non-diabetics. We anticipated these results because the relationship between BMI/obesity and the biologic factors that may underlie the PrCa recurrence–BMI/obesity association, such as insulin, may be altered by the use of anti-diabetes medication or diminished beta-cell insulin production in advanced diabetes. Studies to further assess the molecular factors that explain the BMI/obesity–PrCa recurrence relationship are warranted.",
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AU - Agalliu, Ilir

AU - Williams, Steve

AU - Adler, Brandon

AU - Androga, Lagu

AU - Siev, Michael

AU - Lin, Juan

AU - Xue, Xiaonan (Nan)

AU - Huang, Gloria

AU - Strickler, Howard

AU - Ghavamian, Reza

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N2 - Purpose: Although overall there is a positive association between obesity and risk of prostate cancer (PrCa) recurrence, results of individual studies are somewhat inconsistent. We investigated whether the failure to exclude diabetics in prior studies could have increased the likelihood of conflicting results. Methods: A total of 610 PrCa patients who underwent radical prostatectomy between 2005 and 2012 were followed for recurrence, defined as a rise in serum PSA ≥ 0.2 ng/ml following surgery. Body mass index (BMI) and history of type 2 diabetes were documented prior to PrCa surgery. The analysis was conducted using Cox proportional hazard models. Results: Obesity (25.6 %) and diabetes (18.7 %) were common in this cohort. There were 87 (14.3 %) recurrence events during a median follow-up of 30.8 months after surgery among the 610 patients. When analyzed among all PrCa patients, no association was observed between BMI/obesity and PrCa recurrence. However, when analysis was limited to non-diabetics, obese men had a 2.27-fold increased risk (95 % CI 1.17–4.41) of PrCa recurrence relative to normal weight men, after adjusting for age and clinical/pathological tumor characteristics. Conclusions: This study found a greater than twofold association between obesity/BMI and PrCa recurrence in non-diabetics. We anticipated these results because the relationship between BMI/obesity and the biologic factors that may underlie the PrCa recurrence–BMI/obesity association, such as insulin, may be altered by the use of anti-diabetes medication or diminished beta-cell insulin production in advanced diabetes. Studies to further assess the molecular factors that explain the BMI/obesity–PrCa recurrence relationship are warranted.

AB - Purpose: Although overall there is a positive association between obesity and risk of prostate cancer (PrCa) recurrence, results of individual studies are somewhat inconsistent. We investigated whether the failure to exclude diabetics in prior studies could have increased the likelihood of conflicting results. Methods: A total of 610 PrCa patients who underwent radical prostatectomy between 2005 and 2012 were followed for recurrence, defined as a rise in serum PSA ≥ 0.2 ng/ml following surgery. Body mass index (BMI) and history of type 2 diabetes were documented prior to PrCa surgery. The analysis was conducted using Cox proportional hazard models. Results: Obesity (25.6 %) and diabetes (18.7 %) were common in this cohort. There were 87 (14.3 %) recurrence events during a median follow-up of 30.8 months after surgery among the 610 patients. When analyzed among all PrCa patients, no association was observed between BMI/obesity and PrCa recurrence. However, when analysis was limited to non-diabetics, obese men had a 2.27-fold increased risk (95 % CI 1.17–4.41) of PrCa recurrence relative to normal weight men, after adjusting for age and clinical/pathological tumor characteristics. Conclusions: This study found a greater than twofold association between obesity/BMI and PrCa recurrence in non-diabetics. We anticipated these results because the relationship between BMI/obesity and the biologic factors that may underlie the PrCa recurrence–BMI/obesity association, such as insulin, may be altered by the use of anti-diabetes medication or diminished beta-cell insulin production in advanced diabetes. Studies to further assess the molecular factors that explain the BMI/obesity–PrCa recurrence relationship are warranted.

KW - Diabetes

KW - Insulin signaling

KW - Obesity

KW - Prostate cancer

KW - Recurrence

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