VISCERAL FAT TISSUE ACTIVITY DOES NOT CORRELATE TO HIGH GRADE PROSTATE CANCER RISK AT BIOPSY
- Autori: Scurria, S.; Siracusano, S.; Giacalone, N.; Cangemi, A.; Caruso, S.; Allegro, R.; Russo, A.; Colombo, R.; Serretta, V.
- Anno di pubblicazione: 2015
- Tipologia: Proceedings (TIPOLOGIA NON ATTIVA)
- Parole Chiave: Metabolic syndrome, visceral fat, prostate cancer, leptin,
- OA Link: http://hdl.handle.net/10447/210672
Introduction/Aim: High-grade prostate cancer (PCa) has been reported in association with metabolic syndrome (MS). In a previous study we found no significant correlation between body mass index (BMI) and prevalence of high Gleason score at biopsy (1). BMI could be not an accurate marker of the endocrine activity of visceral adipose tissue responsible of high plasmatic levels of adipokines promoting PCa aggressiveness. We estimated visceral adiposity dysfunction by the visceral adiposity index (VAI) considering waist circumference (WC), BMI, triglycerides (TG) and high density lipoproteins (HDL) plasma levels of each patient (2). The aim was to correlate VAI values with PCa detection rate and Gleason patterns 4 and 5 at biopsy. Patients and Methods: Patients who underwent prostate biopsy for suspicious digital rectal examination and/or elevated PSA levels were enrolled. After informed consent, a transrectal prostate biopsy, 12 cores at least (24 in case of re-biopsy), was performed. VAI was expressed as: WC/[39.68 + (1.88 × BMI)] × TG/1.03 × 1.31/HDL, assuming VAI=1 in healthy, non obese men with TG and HDL levels within normal limits. PCa detection at biopsy, Gleason score patterns, VAI and BMI were statistically analyzed using the Mann Whitney U-test. Results: Ninety-five patients were entered with a median age of 67 years (range=47-79). The median BMI was 27 kg/m2 (range=17.4-40) and the median VAI was 4.47 (range=1.3-15.6). Median PSA was 7.9 ng/ml (range=0.47- 53). A prostate nodule was palpable in 27 (28.4%) patients. Ten patients (10.5%) had a previous negative biopsy. A prostate cancer was diagnosed in 43 (45.2%) patients, Gleason patterns 4 and 5 were detected in 18 (41.8%) patients. Median BMI and VAI were 27.4 Kg/m2 and 26.3 Kg/m2 (p=0.53) and 4.25 and 4.66 (p=0.28) in patients with positive and negative biopsy, respectively. Median BMI and VAI resulted 27.7 Kg/m2 and 27.3 Kg/m2 and 4.78 and 3.98 in patients with and without Gleason patterns 4 or 5, respectively. No statistically significant difference was highlighted for VAI (p=0.37) or BMI (p=0.85). Discussion and Conclusion: The identification of patients harboring an aggressive PCa remains an important goal. To date the relation between MS and PCa remains contradictory. Moreover, an accurate marker of MS has not yet been determined (3). VAI might be a more accurate marker than BMI in indicating the activity of visceral fat. In spite of VAI adoption, our analysis does not reveal any statistically significant correlation between VAI, PCa detection rate and incidence of Gleason patterns 4 or 5 at biopsy. Diet, race and other environmental and genetic factors, playing a promoting or protective role in PCa, should be also considered in further studies. The statistical support of the GSTU Foundation is acknowledged. 1 Serretta V, Caruana G, Sommatino F, et al: Does exist A correlation between BMI and Gleason patterns 4 and 5 at prostate biopsy? J Cytol Histol 4: 182, 2013. 2 Amato MC, Giordano C, Galia M et al: Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 33: 920, 2010. 3 Bhindi B, Locke J, Alibhai SM et al: Dissecting the association between metabolic syndrome and prostate cancer risk: analysis of a large clinical cohort. Eur Urol 67(1): 64-70, 2015. Epub 2014 Feb 14.