Abstract
Obesity is associated with an increased risk of advanced, recurrent and fatal prostate cancer. Adipokines may mediate this relationship. We conducted a systematic review and meta-analysis of associations of leptin and adiponectin with overall and aggressive prostate cancer. Bibliographic databases were systematically searched up to 1st April 2017. Log Odds Ratios (ORs) per 2.5 unit increase in adiponectin or leptin levels were derived and pooled. All analyses were stratified by study type (cross-sectional/prospective). 746 papers were retrieved, 34 eligible studies identified, 31 of these could be included in the meta-analysis. Leptin was not consistently associated with overall prostate cancer (pooled OR 1.00, 95%CI 0.98–1.02, per 2.5 ng/ml increase, prospective study OR 0.97, 95%CI 0.95–0.99, cross-sectional study OR 1.19, 95%CI 1.13–1.26) and there was weak evidence of a positive association with aggressive disease (OR 1.03, 95%CI 1.00–1.06). There was also weak evidence of a small inverse association of adiponectin with overall prostate cancer (OR 0.96, 95%CI 0.93–0.99, per 2.5 µg/ml increase), but less evidence of an association with aggressive disease (OR 0.98, 95%CI 0.94–1.01). The magnitude of any effects are small, therefore levels of circulating adiponectin or leptin alone are unlikely to be useful biomarkers of risk or prognosis.
Highlights
Obesity is associated with an increased risk of advanced, recurrent and fatal prostate cancer
We hypothesise that leptin is positively associated with risk of overall and aggressive prostate cancer and adiponectin is inversely associated with risk of overall and aggressive prostate cancer
Studies were eligible for inclusion if they: presented original peer-reviewed data, included measures of adiponectin and/or leptin in human blood, included data from men with prostate cancer and included a comparison group
Summary
Obesity is associated with an increased risk of advanced, recurrent and fatal prostate cancer. We conducted a systematic review and meta-analysis of associations of leptin and adiponectin with overall and aggressive prostate cancer. Leptin was not consistently associated with overall prostate cancer (pooled OR 1.00, 95%CI 0.98–1.02, per 2.5 ng/ml increase, prospective study OR 0.97, 95%CI 0.95–0.99, cross-sectional study OR 1.19, 95%CI 1.13–1.26) and there was weak evidence of a positive association with aggressive disease (OR 1.03, 95%CI 1.00–1.06). In meta-analyses of observational studies, body mass index (BMI) is associated with a modest increased risk of advanced and fatal prostate cancer, and of biochemical recurrence (8–21% increase in risk per 5 kg/m2 increment in BMI)[7,8,9]. BMI to be associated with risk of advanced or high grade disease but did find weak evidence of an association with lower prostate cancer risk[10]
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