Metabolic Syndrome Is Associated with Aggressive Prostate Cancer Risk Regardless of Race

Purpose A recent meta-analysis suggested a link between Metabolic Syndrome (MS) and high-grade prostate cancer (PC), though few black men were included. We tested the link between MS and PC risk in a population of black and white men undergoing prostate biopsy. We hypothesized MS would be linked with aggressive PC, regardless of race. Methods Among men undergoing prostate biopsy at the Durham Veterans Affairs Hospital, we abstracted history of or treatment for hypertension (≥130/85 mmHg), dyslipidemia (HDL<40 mg/dL), hypertriglyceridemia (≥150 mg/dL), diabetes/impaired fasting glucose (fasting glucose≥100ml/dL), and obesity (waist circumference ≥40 inches) in the year prior to biopsy. Biopsy grade group (GG) was categorized as low (GG1) or high-grade (GG2-5). Multinomial logistic regression was used to examine MS (3-5 components) vs. no MS (0-2 components) and risk of high-grade and low-grade vs. no PC adjusting for key confounders. Interactions between race and MS were tested. Results Of 1,051 men (57% black), 532 (51%) had MS. Men with MS were older, more likely to be non-black, and had larger prostate volumes (all p≤0.011). On multivariable analysis, MS was associated with high-grade PC (OR=1.73, 95%CI 1.21-2.48, p=0.003), but not overall PC (OR=1.17, 95%CI 0.88-1.57, p=0.29) or low-grade (OR=0.87, 95%CI 0.62-1.21, p=0.39). Results were similar in black and non-black men (all p-interactions>0.25). Conclusion Regardless of race, MS was associated with aggressive PC, but not overall PC risk. If confirmed in other studies, our data suggest that prevention of MS may reduce the risk of developing aggressive PC in both black and non-black men.