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Is Body Mass Index the Best Adiposity Measure for Prostate Cancer Risk? Results From a Veterans Affairs Biopsy Cohort

      Objective

      To test multiple adiposity measures and prostate cancer (PC) risk in men undergoing prostate biopsy. We hypothesized that body mass index (BMI), body fat, and waist circumference would be highly correlated, and all would be associated with aggressive PC, but not overall risk.

      Subjects and Methods

      A case (483)-control (496) study among men undergoing prostate biopsy from 2007 to 2016 was conducted at the Durham Veterans Affairs Medical Center. Anthropometric and self-reported measurements were taken. Percent body fat was measured. Associations between adiposity measures and PC risk and high-grade PC (Gleason ≥7) were examined using logistic regression.

      Results

      BMI, percent body fat, and waist circumference were highly correlated (ρ ≥ .79) (P < .001). On multivariable analysis, BMI (P = .011) was associated with overall PC risk, but percent body fat (P = .16) and waist circumference (P = .19) were not. However, all adiposity measurements were associated with high-grade disease (P < .001). We found a strong relationship between self-reported and measured weight (ρ = .97) and height (ρ = .92).

      Conclusion

      BMI, body fat, and waist circumference were all highly correlated and associated with aggressive PC. This study supports the idea that higher adiposity is selectively associated with high-grade PC and reinforces the continued use of self-reported BMI as a measure of obesity in epidemiologic studies of PC.
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      References

        • Calle E.E.
        • Rodriguez C.
        • Walker-Thurmond K.
        • Thun M.J.
        Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults.
        N Engl J Med. 2003; 348: 1625-1638
        • Reeves G.K.
        • Pirie K.
        • Beral V.
        • et al.
        Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study.
        BMJ. 2007; 335: 1134
        • Renehan A.G.
        • Tyson M.
        • Egger M.
        • Heller R.F.
        • Zwahlen M.
        Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies.
        Lancet. 2008; 371: 569-578
        • Giles G.
        • Ireland P.
        Diet, nutrition and prostate cancer.
        Int J Cancer. 1997; : 13-17
        • MacInnis R.J.
        • English D.R.
        Body size and composition and prostate cancer risk: systematic review and meta-regression analysis.
        Cancer Causes Control. 2006; 17: 989-1003
        • Gong Z.
        • Neuhouser M.L.
        • Goodman P.J.
        • et al.
        Obesity, diabetes, and risk of prostate cancer: results from the prostate cancer prevention trial.
        Cancer Epidemiol Biomarkers Prev. 2006; 15: 1977-1983
        • Rodriguez C.
        • Freedland S.J.
        • Deka A.
        • et al.
        Body mass index, weight change, and risk of prostate cancer in the Cancer Prevention Study II Nutrition Cohort.
        Cancer Epidemiol Biomarkers Prev. 2007; 16: 63-69
        • Discacciati A.
        • Orsini N.
        • Wolk A.
        Body mass index and incidence of localized and advanced prostate cancer—a dose-response meta-analysis of prospective studies.
        Ann Oncol. 2012; 23: 1665-1671
        • Kyle U.G.
        • Genton L.
        • Pichard C.
        Body composition: what's new?.
        Curr Opin Clin Nutr Metab Care. 2002; 5: 427-433
        • Garn S.M.
        • Leonard W.R.
        • Hawthorne V.M.
        Three limitations of the body mass index.
        Am J Clin Nutr. 1986; 44: 996-997
        • Nomura A.M.
        Body size and prostate cancer.
        Epidemiol Rev. 2001; 23: 126-131
        • Visscher T.L.
        • Seidell J.C.
        • Molarius A.
        • van der Kuip D.
        • Hofman A.
        • Witteman J.C.
        A comparison of body mass index, waist-hip ratio and waist circumference as predictors of all-cause mortality among the elderly: the Rotterdam study.
        Int J Obes Relat Metab Disord. 2001; 25: 1730-1735
        • Koster A.
        • Leitzmann M.F.
        • Schatzkin A.
        • et al.
        Waist circumference and mortality.
        Am J Epidemiol. 2008; 167: 1465-1475
        • Fowke J.H.
        • Motley S.S.
        • Concepcion R.S.
        • Penson D.F.
        • Barocas D.A.
        Obesity, body composition, and prostate cancer.
        BMC Cancer. 2012; 12: 23
        • World Cancer Research Fund International/American Institute for Cancer Research
        Continuous update project report: diet, nutrition, physical activity, and prostate cancer.
        (Available at:)
        • Allott E.H.
        • Masko E.M.
        • Freedland S.J.
        Obesity and prostate cancer: weighing the evidence.
        Eur Urol. 2013; 63: 800-809
        • Boehm K.
        • Sun M.
        • Larcher A.
        • et al.
        Waist circumference, waist-hip ratio, body mass index, and prostate cancer risk: results from the North-American case-control study Prostate Cancer & Environment Study.
        Urol Oncol. 2015; 33 (e1-7): 494
        • Wallström P.
        • Bjartell A.
        • Gullberg B.
        • Olsson H.
        • Wirfält E.
        A prospective Swedish study on body size, body composition, diabetes, and prostate cancer risk.
        Br J Cancer. 2009; 100: 1799-1805
        • Chalfin H.J.
        • Lee S.B.
        • Jeong B.C.
        • et al.
        Obesity and long-term survival after radical prostatectomy.
        J Urol. 2014; 192: 1100-1104
        • Cao Y.
        • Ma J.
        Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis.
        Cancer Prev Res (Phila). 2011; 4: 486-501
        • Freedland S.J.
        • Aronson W.J.
        • Kane C.J.
        • et al.
        Impact of obesity on biochemical control after radical prostatectomy for clinically localized prostate cancer: a report by the Shared Equal Access Regional Cancer Hospital database study group.
        J Clin Oncol. 2004; 22: 446-453
        • Roberts D.L.
        • Dive C.
        • Renehan A.G.
        Biological mechanisms linking obesity and cancer risk: new perspectives.
        Annu Rev Med. 2010; 61: 301-316
        • Williams G.
        Aromatase up-regulation, insulin and raised intracellular oestrogens in men, induce adiposity, metabolic syndrome and prostate disease, via aberrant ER-α and GPER signalling.
        Mol Cell Endocrinol. 2012; 351: 269-278
        • Huang C.-Y.
        • Yu H.-S.
        • Lai T.-Y.
        • et al.
        Leptin increases motility and integrin up-regulation in human prostate cancer cells.
        J Cell Physiol. 2011; 226: 1274-1282
        • Giovannucci E.
        • Rimm E.B.
        • Liu Y.
        • et al.
        Body mass index and risk of prostate cancer in U.S. health professionals.
        J Natl Cancer Inst. 2003; 95: 1240-1244
        • Freedland S.J.
        • Terris M.K.
        • Platz E.A.
        • Presti J.C.
        Body mass index as a predictor of prostate cancer: development versus detection on biopsy.
        Urology. 2005; 66: 108-113
        • Banez L.L.
        • Hamilton R.J.
        • Partin A.W.
        • et al.
        Obesity-related plasma hemodilution and PSA concentration among men with prostate cancer.
        J Am Med Assoc. 2007; 298: 2275-2280
        • Choi Y.J.
        • Kim J.K.
        • Kim H.J.
        • Cho K.S.
        Interobserver variability of transrectal ultrasound for prostate volume measurement according to volume and observer experience.
        AJR Am J Roentgenol. 2009; 192: 444-449
        • Wallner L.P.
        • Morgenstern H.
        • McGree M.E.
        • et al.
        The effects of body mass index on changes in prostate-specific antigen levels and prostate volume over 15 years of follow-up: implications for prostate cancer detection.
        Cancer Epidemiol Biomarkers Prev. 2011; 20: 501-508
        • Sutcliffe C.G.
        • Schultz K.
        • Brannock J.M.
        • Giardiello F.M.
        • Platz E.A.
        Do people know whether they are overweight? Concordance of self-reported, interviewer-observed, and measured body size.
        Cancer Causes Control. 2015; 26: 91-98