Obesity worsens the prognosis in prostate cancer
With an increased BMI or C-peptide levels, the risk of death is significantly larger, a new American study. And after a featured on the German urologists Congress 2008 investigation increases with BMI, the aggressiveness of the tumor.
In the U.S. study, the data of an earlier, very large health study were evaluated (Physicians' Health Study). Included were men who have prostate cancer was detected during the 24-year follow-up. In 2,546 of them at the beginning of the BMI (Body Mass Index, a measure of obesity) was measured at 827 and the C-peptide blood levels (measure of insulin-education; longer to see two notes below ).
Of the 2,546 men with available BMI of 38.8% were moderately overweight (BMI 25.0-29.9 kg / m) and 3.4% were obese (obese, BMI of 30 kg / m²), and 11% died within the follow-up to her tumor. It was found that the mortality rate from prostate cancer was significantly increased in overweight: In moderate overweight on a half times (1.47) and in obese even two and a half times (2.66), irrespective of tumor stage and Gleason grade (degree for the malignancy of the tumor, see also Gleason score ).
Of the 827 men with available C-peptide value 14% died from prostate cancer. Was the blood level in the top quarter of the measured values ("high C-peptide"), the risk of death was more than twice as high (2.38-fold) at a level as in the lowest quartile ("low C-peptide").
The combination of both factors was found to be particularly risky: Compared to normal weight (BMI less than 25 kg / sq m) with low C-peptide had of important (a BMI of 25 kg / sq m) with high C-peptide is a four times greater risk of death (4, 12-fold), independent of clinical risk factors (eg tumor stage).
Both obesity and an increased C-peptide blood levels so zoom in men who later become ill from prostate cancer, the probability of dying from the tumor. Come both factors together, the risk is particularly high. To confirm their findings, the authors feel that further studies necessary.
More aggressive tumors in overweight
In the second study 796 men were included with prostate cancer who had undergone radical prostatectomy in Munich between 2004 and 2006. Thereafter, no correlation could be detected between overweight (a BMI of 25 kg / sq m) and a high Gleason score (from 8) or positive resection margins (R1 resection, tumor is not completely removed).
However, had overweight compared to normal weight, the higher the risk for a PSA value from 20ng/ml before the operation (2.7-fold), for a locally advanced tumor (1.6-fold) and of an infection of the lymph nodes (1 0.4-fold). The authors concluded that a BMI is associated from 25 kg / sqm with a higher tumor aggressiveness.
Comments
Among overweight is generally understood to an increase in body fat mass. It can be approximated most easily using the BMI (Body Mass Index) indicate the calculated as the ratio of body weight (in kg) and the square of height (in m). C-peptide is in the formation of insulin (blood glucose-lowering hormone) removed therefrom and can be determined in the blood.Elevated levels can therefore conclude that the pancreas produces more insulin than normal and the blood gives off (hyperinsulinemia). This happens especially when the cells respond poorly to insulin. Such insulin resistance is considered the precursor of type 2 diabetes mellitus ("sugar age") and is very often associated with obesity, dyslipidemia and hypertension. In this case one speaks also of the metabolic syndrome, in which the blood sugar so it can still be normal.
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