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Clinical Research

Metabolic syndrome, dyslipidemia and prostate cancer recurrence after primary surgery or radiation in a veterans cohort

Prostate Cancer and Prostatic Diseases volume 18, pages 190–195 (2015)Cite this article

Subjects

Abstract

BACKGROUND:

Metabolic syndrome (MetS) has been hypothesized to be associated with cancer, including prostate cancer (PCa), but the relationship is not well characterized. We analyze the relationship between MetS features and localized PCa recurrence after treatment.

METHODS:

Men having primary treatment for localized PCa were included from a multi-site regional veteran network. Recurrence was defined as nadir PSA +2 ng ml−1 (radiation) or PSA⩾0.2 ng ml−1 (prostatectomy). MetS was based on consensus professional society guidelines from the American Heart Association and International Diabetes Federation (three of: hypertension >130/85 mm Hg, fasting blood glucose ⩾100 mg dl−1, waist circumference >102 cm, high-density lipoprotein <40 mg dl−1, triglycerides ⩾150 mg dl−1). Closely related abnormality in low-density lipoprotein (LDL; >130 mg dl−1) was also examined. Analysis of PCa recurrence risk included multivariable Cox proportional hazards regression with propensity adjustment.

RESULTS:

Of the 1706 eligible men, 279 experienced recurrence over a median follow-up period of 41 months (range 1–120 months). Adjustment variables associated with PCa recurrence included: index PSA, Gleason, and tumor stage. Independent variables of interest associated with PCa recurrence were hyperglycemia and elevated LDL. Elevated LDL was associated with PCa recurrence (multivariable hazard ratio (HR) 1.34, 95% confidence interval (CI) 1.03, 1.74; propensity adjusted HR 1.33, 95% CI 1.03, 1.72). There was also an association between impaired fasting glucose and PCa recurrence in (multivariable HR 1.54, 95% CI 1.10, 2.15; propensity adjusted HR 1.41, 95% CI 1.01, 1.95). MetS was not associated with PCa recurrence (multivariable: HR 0.96, 95% CI 0.61, 1.50; propensity adjusted HR 1.04, 95% CI 0.67, 1.62).

CONCLUSIONS:

PCa recurrence is not associated with MetS but is associated with elevated LDL and impaired fasting glucose. If confirmed, these data may help provide modifiable targets in preventing recurrence of PCa.

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Acknowledgements

This work was supported by an NIH Grant: P50CA097186 from the National Cancer Institute, with additional support and resources from the Fred Hutchinson Cancer Research Center and VA Puget Sound Health Care system.

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Authors and Affiliations

  1. Department of Urology, University of Washington School of Medicine, Seattle, WA, USA

    L C Macleod, L J Chery, S K Holt, D W Lin, M P Porter, J L Gore & J L Wright

  2. Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA

    E Y C Hu, S B Zeliadt, D W Lin, M P Porter & J L Wright

  3. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    D W Lin, J L Gore & J L Wright

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  1. L C Macleod
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Correspondence to L C Macleod.

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Macleod, L., Chery, L., Hu, E. et al. Metabolic syndrome, dyslipidemia and prostate cancer recurrence after primary surgery or radiation in a veterans cohort. Prostate Cancer Prostatic Dis 18, 190–195 (2015). https://doi.org/10.1038/pcan.2015.12

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