Higher body mass index increases the risk for biopsy-mediated detection of prostate cancer in Chinese men

PLoS One. 2015 Apr 10;10(4):e0124668. doi: 10.1371/journal.pone.0124668. eCollection 2015.

Abstract

Objective: To investigate the relationship between body mass index (BMI) and prostate cancer (PCa) risk at biopsy in Chinese men.

Patients and methods: We retrospectively reviewed the records of 1,807 consecutive men who underwent initial multicore (≥10) prostate biopsy under transrectal ultrasound guidance between Dec 2004 and Feb 2014. BMI was categorised based on the Asian classification of obesity as follows: <18.5 (underweight), 18.5-22.9 (normal weight), 23-24.9 (overweight), 25-29.9 (moderately obese), and ≥30 kg/m2 (severely obese). The odds ratios (OR) of each BMI category for risk of PCa and high-grade prostate cancer (HGPCa, Gleason score ≥4+3) detection were estimated in crude, age-adjusted and multivariate-adjusted models. Prevalence ratios and accuracies of PSA predicted PCa were also estimated across BMI groups.

Results: In total, PCa was detected by biopsy in 750 (45.4%) men, and HGPCa was detected in 419 (25.4%) men. Compared with men of normal weight, underweight men and obese men were older and had higher prostate specific antigen levels. The risk of overall PCa detection via biopsy presented an obvious U-shaped relationship with BMI in crude analysis. Overall, 50.0%, 37.4%, 45.6% 54.4% and 74.1% of the men in the underweight, normal weight, overweight, moderately obese and severely obese groups, respectively, were diagnosed with PCa via biopsy. In multivariate analysis, obesity was significantly correlated with a higher risk of PCa detection (OR = 1.17, 95%CI 1.10-1.25, P<0.001). However, higher BMI was not correlated with HGPCa detection (OR = 1.03, 95%CI 0.97-1.09, P = 0.29). There were no significant differences in the accuracy of using PSA to predict PCa or HGPCa detection across different BMI categories.

Conclusion: Obesity was associated with higher risk of PCa detection in the present Chinese biopsy population. No significant association was detected between obesity and HGPCa.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asian People
  • Biopsy
  • Body Mass Index*
  • China / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Grading
  • Obesity / complications
  • Odds Ratio
  • Overweight / complications
  • Prevalence
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / etiology*
  • Prostatic Neoplasms / pathology*
  • Retrospective Studies
  • Risk Factors

Grants and funding

This study was supported by the National Natural Science Foundation of China (Grant No. 81272835, received by HWJ, www.nsfc.gov.cn) and Program for New Century Excellent Talents in University, China (NCET-13-0136, received by HWJ, http://www.moe.edu.cn). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.