title: Obesity and prostate cancer aggressiveness among African and Caucasian Americans in a population-based study.
abstract: BACKGROUND
  This study evaluated obesity and prostate cancer aggressiveness relationship in a population-based incident prostate cancer study.
  
  
  METHODS
  The North Carolina-Louisiana Prostate Cancer Project includes medical records data for classification of prostate cancer aggressiveness at diagnosis by using clinical criteria for 1,049 African American (AA) and 1,083 Caucasian American (CA) participants. An association between prostate cancer aggressiveness and obesity, measured using body mass indices (BMI) and waist-to-hip ratio (WHR), was assessed using ORs and 95% CIs adjusted for confounders.
  
  
  RESULTS
  A significantly positive association was found between prostate cancer aggressiveness and obesity. The ORs for high aggressive prostate cancer among prediagnosis obese and severely obese were 1.48 (95% CI = 1.02-2.16) and 1.98 (95% CI = 1.31-2.97), respectively, compared with normal weight research subjects. Race-stratified results suggested the association is stronger among CAs. Interaction model showed that normal weight AAs had more aggressive prostate cancer than normal weight CAs (OR = 2.69, 95% CI = 1.36-5.30); severe obesity was associated with aggressive disease in AAs (OR = 3.90, 95% CI = 1.97-7.75). WHR > 0.98 among all research subjects adjusted for race was significantly associated with high aggressive prostate cancer (OR = 1.42, 95% CI = 1.00-2.00) when compared with WHR < 0.90. The stratified result is less clear among AAs.
  
  
  CONCLUSIONS
  This study shows a positive association between obesity and aggressive prostate cancer. AAs have more aggressive prostate cancer in general than CAs even at normal weight. Therefore, the association between obesity and aggressiveness is not as evident in AAs as in CAs.
  
  
  CONCLUSIONS
  This study provides a unique opportunity to examine impact of race on obesity and high aggressive prostate cancer relationship.
authors.affiliation: Louisiana State University Health Sciences Center, School of Public Health, New Orleans, Louisiana, USA. sulj@mail.nih.gov
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Su
authors.forename: Lenore
authors.initials: L
authors.lastname: Arab
authors.forename: Susan E
authors.initials: SE
authors.lastname: Steck
authors.forename: Elizabeth T H
authors.initials: ET
authors.lastname: Fontham
authors.forename: Jane C
authors.initials: JC
authors.lastname: Schroeder
authors.forename: Jeannette T
authors.initials: JT
authors.lastname: Bensen
authors.forename: James L
authors.initials: JL
authors.lastname: Mohler
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D006801:Humans; D015994:Incidence; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D009765:Obesity / Q000150:complications*; D011203:Poverty / Q000706:statistics & numerical data*; D015995:Prevalence; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D049629:Waist-Hip Ratio; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D017430:Prostate-Specific Antigen