title: Metabolic syndrome is associated with high grade Gleason score when prostate cancer is diagnosed on biopsy.
abstract: BACKGROUND
  To evaluate the association between metabolic syndrome (MS) and prostate cancer diagnosis and grade in patients undergoing prostate biopsy.
  
  
  METHODS
  From 2009 onwards, a consecutive series of patients undergoing 12-core prostate biopsy for PSA value ≥4 ng/ml and/or positive digital rectal examination (DRE) were prospectively enrolled. Body mass index (BMI), waist circumferences, and blood pressure were measured before the biopsy. Blood samples were tested for: PSA, fasting glucose, triglycerides, and cholesterol HDL. MS presence was defined according to Adult Treatment Panel III criteria.
  
  
  RESULTS
  One hundred ninety five patients were enrolled with a median age and PSA of 69 years and 5.6 ng/ml respectively. Median BMI was 27.6 kg/m(2) with 64 patients (33%) being classified as obese (BMI ≥ 30 kg/m(2) ). Eighty-six patients (44%) had MS. Eighty-three patients (43%) had cancer on biopsy; 37 (45%) with MS and 46 (55%) without (P = 0.48). PSA was independently associated with higher risk of cancer (OR 1.12/1 U PSA, P = 0.01). Out of 83 patients with prostate cancer, 42 (51%) had Gleason score 6 (12 (28.5%) presented a MS) and 41 (49%) a Gleason score ≥7 (25 (61%) presented a MS). The presence of MS was not associated with an increased risk prostate cancer (OR: 0.97, P = 0.94) but with an increased risk of Gleason ≥7 (OR: 3.82; P = 0.013).
  
  
  CONCLUSIONS
  In our single center study, MS is associated with an increased risk of high grade Gleason score when prostate cancer is diagnosed on biopsy. However, these results should be confirmed in a larger multicenter study. .
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University "La Sapienza," Roma, Italy. cosimodenunzio@virgilio.it.
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Freedland
authors.forename: Roberto
authors.initials: R
authors.lastname: Miano
authors.forename: Alberto
authors.initials: A
authors.lastname: Trucchi
authors.forename: Andrea
authors.initials: A
authors.lastname: Cantiani
authors.forename: Alfonso
authors.initials: A
authors.lastname: Carluccini
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D051517:Digital Rectal Examination; D006801:Humans; D007610:Kallikreins / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009388:Neostigmine; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D018570:Risk Assessment; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides; D009388:Neostigmine; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen