title: The uncertain relationship between obesity and prostate cancer: an Italian biopsy cohort analysis.
abstract: BACKGROUND
  The study aims to investigate the relationship between obesity and prostate cancer diagnosis at biopsy.
  
  
  METHODS
  From 2005 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 enrolled. Before the biopsy, patients underwent a physical examination, including height and weight measurement. Obesity was defined as body mass index (BMI) ≥30 kg/m(2). Blood samples were drawn from all patients and analyzed for total PSA and testosterone.
  
  
  RESULTS
  885 patients were enrolled with a median age and PSA of 67 years (range 37-95) and 6.4 ng/ml (range 1-30) respectively. Median BMI was 27.1 kg/m(2) (range 18-46.6) with 185 patients classified as obese. 363 patients had cancer at biopsy; 76 were obese. PSA was independently associated with a higher risk of cancer (OR 1.09 per 1 unit PSA, p = 0.01). On multivariate analysis, the BMI was not significantly associated with an increased prostate cancer risk (p = 0.19). Out of 363 patients with prostate cancer, 154 had a Gleason score 6 (23 were obese) and 209 a Gleason score ≥7 (53 were obese). Among men with cancer, a higher BMI on univariate (p = 0.001) and multivariate analysis (p = 0.005) was associated with high-grade disease (Gleason ≥ 7).
  
  
  CONCLUSIONS
  In our single center study and less aggressively screened cohort, obesity is associated with an increased risk of a high-grade Gleason score when prostate cancer is diagnosed at biopsy.
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy. cosimodenunzio@virgilio.it
authors.forename: C
authors.initials: C
authors.lastname: De Nunzio
authors.forename: S J
authors.initials: SJ
authors.lastname: Freedland
authors.forename: L
authors.initials: L
authors.lastname: Miano
authors.forename: E
authors.initials: E
authors.lastname: Finazzi Agrò
authors.forename: L
authors.initials: L
authors.lastname: Bañez
authors.forename: A
authors.initials: A
authors.lastname: Tubaro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D015992:Body Mass Index; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D013739:Testosterone / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D013739:Testosterone; D017430:Prostate-Specific Antigen