Racial Differences in Risk of Prostate Cancer Associated With Metabolic Syndrome

OBJECTIVES To perform a case-control study to test the association between metabolic syndrome features and prostate cancer. The metabolic syndrome refers to a cluster of conditions serving as risk factors for cardiovascular disease. The metabolic syndrome is prevalent in the United States, and the spectrum of specific features has been shown to differ by race and ethnicity. A number of recent reports have linked metabolic syndrome to prostate cancer; however, Most Studies have not had racially diverse populations to explore differences in risk. METHODS A case-control study was conducted to test the association between metabolic syndrome features and prostate cancer among 637 patients and 244 controls, with African-American men constituting 43% of the study population. RESULTS Metabolic syndrome, defined using a modified version of the Adult Treatment Panel III criteria, was marginally associated with an increased risk of prostate cancer in African-American men (odds ratio [OR] 1.71, 95% confidence interval [CI] 0.97-3.01), but not in white men (OR 1.02, 95% CI 0.64-1.62). After stratifying the patients by stage at diagnosis, African-American men with organ-confined disease were more likely to have a history of metabolic syndrome than were the controls (OR 1.82; 95% CI 1.02-3.23), but no association was observed among those with advanced-stage disease (OR 0.93; 95% CI 0.31-2.77). When evaluating the specific features of the metabolic syndrome, obesity was inversely related to prostate cancer among white men (OR 0.51, 95% CI 0.33-0.80) but unrelated to risk among African-American men (OR 1.15, 95% CI 0.70-1.89). CONCLUSIONS In the present investigation, the metabolic syndrome was associated with prostate cancer risk in African-American men, but not in white men. The prevalence of this syndrome, Coupled with the racial disparity in prostate cancer incidence and outcomes after diagnosis, warrant additional investigation UROLOGY. 74: 185-190, 2009. (c) 2009 Elsevier Inc.