Abstract
BackgroundThe role of metabolic syndrome (MetS) in prostate cancer risk is still debated. We investigated it in a large population-based case–control study.MethodsCases were 1937 men with incident prostate cancer, aged ≤75 years, diagnosed across French hospitals in the Montreal area between 2005 and 2009. Concurrently, 1995 population controls from the same residential area and age distribution were randomly selected from electoral list of French-speaking men. Detailed lifestyle and medical histories, and anthropometric measures, were collected during in-person interviews. Prevalence of MetS components (type 2 diabetes, high blood pressure, dyslipidemia and abdominal obesity) was estimated at 2 years before diagnosis for cases/ interview for controls, and at ages 20, 40, 50 and 60. Logistic regression was used to estimate odds ratios (OR) and 95 % confidence intervals for the association between MetS and prostate cancer risk.ResultsA history of MetS (≥3 components vs <3) was associated with a reduced risk of prostate cancer (OR = 0.70 [0.60, 0.82]) after considering potential confounders. The negative association was particularly pronounced with a young age (≤40 years) at MetS onset (OR = 0.38 [0.16-0.89]), did not vary according to prostate cancer aggressiveness, and was only partly explained by the presence of type 2 diabetes. A risk decrease was observed with the number of MetS components, suggesting a synergistic interaction of the components.DiscussionThe observed negative association, consistent with results from other North American populations undergoing regular prostate cancer screening, underlines the importance of considering PSA-testing when studying the MetS-prostate cancer association.ConclusionsFindings from this study are consistent with an inverse association between MetS and prostate cancer risk.
Highlights
The role of metabolic syndrome (MetS) in prostate cancer risk is still debated
Findings from this study are consistent with an inverse association between MetS and prostate cancer risk
Dyslipidemia (29.7 % among cases vs 36.4 % among controls, p < 0.01), hypertension (37.9 % vs 42.3 %, p < 0.01) and type 2 diabetes (T2D) (10.6 % vs 17.4 %, p < 0.01) were less frequent among cases, especially when diabetes was diagnosed more than four years before the index date or treated with metformin
Summary
The role of metabolic syndrome (MetS) in prostate cancer risk is still debated. We investigated it in a large population-based case–control study. Methods: Cases were 1937 men with incident prostate cancer, aged ≤75 years, diagnosed across French hospitals in the Montreal area between 2005 and 2009. Prevalence of MetS components (type 2 diabetes, high blood pressure, dyslipidemia and abdominal obesity) was estimated at 2 years before diagnosis for cases/ interview for controls, and at ages 20, 40, 50 and 60. The only established risk factors (age, family history of PCa and ancestry) are not modifiable [2]. Metabolic syndrome (MetS), defined as a cluster of metabolic disorders associated with insulin resistance and visceral adiposity, was first used to identify subjects at increased risk of type 2 diabetes (T2D) and cardiovascular diseases. MetS represents a growing public health concern given its high prevalence worldwide [8], especially
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