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Cancer. 2019 Aug 15;125(16):2877-2885. doi: 10.1002/cncr.32167. Epub 2019 Jun 10.

Body fat distribution on computed tomography imaging and prostate cancer risk and mortality in the AGES-Reykjavik study.

Author information

1
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
2
Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland.
3
Icelandic Cancer Registry, Reykjavik, Iceland.
4
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
5
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
6
Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
7
Icelandic Heart Association, Kopavogur, Iceland.
8
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
9
Department of Education and Prevention, Icelandic Cancer Society, Reykjavik, Iceland.
10
Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, Maryland.
11
Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio.

Abstract

BACKGROUND:

The World Cancer Research Fund classifies as "strong evidence" the link between obesity and the risk of advanced prostate cancer. In light of the different hormonal profiles associated with where adipose is stored, this study investigated the role of objectively measured body fat distribution and the risk of clinically relevant prostate cancer.

METHODS:

This was a prospective study of 1832 men in the Age, Gene/Environment Susceptibility-Reykjavik study. From 2002 to 2006, participants underwent baseline computed tomography imaging of fat deposition, bioelectric impedance analysis, and measurement of body mass index (BMI) and waist circumference. Men were followed through linkage with nationwide cancer registries for the incidence of total (n = 172), high-grade (Gleason grade ≥8; n = 43), advanced (≥cT3b/N1/M1 at diagnosis or fatal prostate cancer over follow-up; n = 41), and fatal prostate cancer (n = 31) through 2015. Cox regression was used to evaluate the association between adiposity measures and prostate cancer outcomes.

RESULTS:

Among all men, visceral fat (hazard ratio [HR], 1.31 per 1-standard deviation [SD] increase; 95% confidence interval [CI], 1.00-1.72) and thigh subcutaneous fat (HR, 1.37 per 1-SD increase; 95% CI, 1.00-1.88) were associated with risk of advanced and fatal disease, respectively. Among men who were leaner based on BMI, visceral fat was associated with both advanced and fatal disease. BMI and waist circumference were associated with a higher risk of advanced and fatal disease. No adiposity measures were associated with total or high-grade disease.

CONCLUSIONS:

Specific fat depots as well as BMI and waist circumference were associated with the risk of aggressive prostate cancer, which may help to elucidate underlying mechanisms and target intervention strategies.

KEYWORDS:

adiposity; cohort; computed tomography; fat distribution; obesity; prostate cancer; visceral fat

PMID:
31179538
PMCID:
PMC6663585
[Available on 2020-08-15]
DOI:
10.1002/cncr.32167

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