Association of Obesity and Diabetes With Prostate Cancer Risk Groups in a Multiethnic Population.

Abstract

Obesity and diabetes mellitus (DM) have been associated with prostate cancer (PCa) risk, but data examining their combined effects on aggressive PCa are sparse, particularly among non-Hispanic Black and Hispanic men. We investigated the associations of obesity and DM inrelation to National Comprehensive Cancer Network (NCCN) PCa risk groups in a racially-diverse patient population. We abstracted demographic and clinical data from men who underwent radical prostatectomy at our institution between 2005 and 2019. Patients were classified into three NCCN PCa risk-groups: low, intermediate and high-risk. Logistic regression models were used to examine the independent and combined associations of body mass index (BMI)/obesity and DM with risks of intermediate and high-risk PCa, adjusting for age and race/ethnicity. A total of 1303 men with PCa (average age 60 ± 6.9 years) were analyzed. The majority were non-Hispanic Black (N=493, 38%) or Hispanic (N=407, 31%). The prevalence of obesity (BMI ≥ 30 kg/m2) and DM was 29.3% (N=382) and 28.3% (N=369), respectively. In multivariate analyses, obesity was independently associated with an odds ratio (OR)=2.21 of high-risk PCa (95% CI: 1.28-3.81), while DM was associated with an OR=1.49 (95% CI: 1.05-2.11) of intermediate-risk PCa. Compared to non-obese men without diabetes, men with BMI ≥ 30 and DM had increased risks of both intermediate (OR=1.93; 95% CI 1.12-3.43) and high-risk PCa (OR=2.40; 95% CI 1.22-4.73). Interestingly, most of the association of high-risk PCa was driven by obesity. In this multiethnic population both obesity and DM were independently associated with intermediate- and high-risk PCa; however, most of the association for high-risk cancer was driven by obesity. Our results corroborate findings that obesity increases the risk of aggressive PCa; however, results regarding DM need to be confirmed in other large multiethnic populations.