title: Visceral fat accumulation as a risk factor for prostate cancer.
abstract: OBJECTIVE
  No clear association between obesity or body fat distribution and prostate cancer has been shown. We investigated the relation between visceral fat accumulation as measured by computed tomography (CT) and the occurrence of prostate cancer.
  
  
  METHODS
  We compared body fat distribution assessed by a direct method (CT) in 63 prostate cancer cases with 63 age-matched healthy community controls. A CT scan at the level of the fourth lumbar vertebra was performed in all participants.
  
  
  RESULTS
  Patients presented a significantly higher mean total abdominal fat area (509.2 +/- 226.1 vs. 334.3 +/- 132.9 cm2, p < 0.001), mostly because of a higher mean visceral fat area (VF; 324.7 +/- 145.6 vs. 177.4 +/- 88.4 cm2, p < 0.001) and a significantly higher mean ratio between visceral and subcutaneous fat areas (V/S ratio; 1.8 +/- 0.4 vs. 1.2 +/- 0.4, p < 0.001). A significantly higher risk of prostate cancer was found for participants with higher VF (odds ratio = 4.6; 95% confidence interval = 2.6 to 8.2 per SD increase) and V/S ratio (odds ratio = 6.0; 95% confidence interval = 2.3 to 11.0 per SD increase).
  
  
  CONCLUSIONS
  These results suggest a role for visceral obesity, quantified by CT, as a risk factor for prostate cancer. The action of the adipocytokines secreted by visceral fat cells, steroid hormone disturbances, and increased levels of insulin or other hormones noted in visceral obesity may explain this association.
authors.affiliation: Department of Medicine, Hospital S. João, Porto, Portugal. mop15514@mail.telepac.pt
authors.forename: Pedro
authors.initials: P
authors.lastname: von Hafe
authors.forename: Francisco
authors.initials: F
authors.lastname: Pina
authors.forename: Ana
authors.initials: A
authors.lastname: Pérez
authors.forename: Margarida
authors.initials: M
authors.lastname: Tavares
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
mesh_terms: D000273:Adipose Tissue; D000368:Aged; D001823:Body Composition; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000000981:diagnostic imaging; D011471:Prostatic Neoplasms / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014781:Viscera