title: Elevated C-Peptides, Abdominal Obesity, and Abnormal Adipokine Profile are Associated With Higher Gleason Scores in Prostate Cancer.
abstract: Prostate cancer development is associated with numerous lifestyle factors (i.e., physical activity, nutrition intake) and metabolic perturbations. These factors have been studied independently; here, we used an integrative approach to characterize these lifestyle and metabolic parameters in men undergoing diagnostic prostate biopsies.
  
  
  
  We prospectively evaluated 51 consecutive men for body composition, metabolic factors including glucose- and lipid-related measures, as well as lifestyle factors prior to prostate biopsy. Evaluations were performed in a blinded manner and were subsequently related to biopsy outcomes for: (i) presence or absence of cancer; and (ii) where cancer was present, Gleason score.
  
  
  
  Serum C-peptide concentrations were significantly greater in participants with Gleason scores ≥4 + 3 (2.8 ± 1.1 ng/ml) compared to those with Gleason 3 + 3 (1.4 ± 0.6 ng/ml) or Gleason 3 + 4 (1.3 ± 0.8 ng/ml, P = 0.002), suggesting greater insulin secretion despite lack of differences in fasting glucose concentrations. Central adiposity, measured by waist circumference, was significantly greater in participants with Gleason ≥4 + 3 (110.1 ± 7.4 cm) compared to those with Gleason 3 + 4 (102.0 ± 9.5 cm, P = 0.028). Men with Gleason ≥4 + 3 also had significantly greater leptin concentrations than those with lower Gleason scores (Gleason ≥4 + 3: 15.6 ± 3.3 ng/ml vs. Gleason 3 + 4: 8.1 ± 8.1 ng/ml, P < 0.05) and leptin:adiponectin ratio (Gleason ≥4 + 3: 9.7 ± 6.1 AU, Gleason 3 + 4: 2.9 ± 3.2, Gleason 3 + 3: 2.4 ± 2.1 AU, P = 0.013).
  
  
  
  We profiled a cluster of obesity-related metabolic perturbations (C-peptide, central adiposity, leptin, and leptin:adiponectin ratios) which may associate with more aggressive prostate cancer histology. Prostate 77:211-221, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Katie M
authors.initials: KM
authors.lastname: Di Sebastiano
authors.affiliation: Department of Surgery, Division of Urology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Jehonathan H
authors.initials: JH
authors.lastname: Pinthus
authors.affiliation: Department of Surgery, Division of Urology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Wilhelmina C M
authors.initials: WC
authors.lastname: Duivenvoorden
authors.affiliation: Department of Surgery, Division of Urology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Laurel
authors.initials: L
authors.lastname: Patterson
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.|Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Joel A
authors.initials: JA
authors.lastname: Dubin
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Marina
authors.initials: M
authors.lastname: Mourtzakis
mesh_terms: D054392:Adipokines / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001823:Body Composition / Q000502:physiology; D002096:C-Peptide / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D056128:Obesity, Abdominal / Q000097:blood* / Q000175:diagnosis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D012307:Risk Factors; D055105:Waist Circumference / Q000502:physiology
chemical_list: D054392:Adipokines; D014408:Biomarkers, Tumor; D002096:C-Peptide
keywords: adiponectin; central obesity; insulin; leptin; waist circumference