1. Obesity as a Risk Factor for Prostate Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of 280,199 Patients
- Author
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Rivera-Izquierdo, Mario, Pérez de Rojas, Javier, Martínez-Ruiz, Virginia, Pérez-Gómez, Beatriz, Sánchez, María-José, Khan, Khalid Saeed, Jiménez-Moleón, José Juan, [Rivera-Izquierdo,M, Pérez de Rojas,J, Martínez-Ruiz,V, Sánchez,MJ, Khan,KS, Jiménez-Moleón,JJ] Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain. [Rivera-Izquierdo,M, Jiménez-Moleón,JJ] Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain. [Martínez-Ruiz,V, Pérez-Gómez,B, and Jiménez-Moleón,JJ] Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Pérez-Gómez,B] National Centre for Epidemiology, Department of Epidemiology of Chronic Diseases, Instituto de Salud Carlos III, Madrid, Spain. [Sánchez,MJ] Escuela Andaluza de Salud Pública (EASP), Granada, Spain.
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Causation ,Neoplasias de la próstata ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies [Medical Subject Headings] ,Revisión sistemática ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Meta-Analysis as Topic [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Mass Index [Medical Subject Headings] ,Outcomes ,Índice de masa corporal ,All-cause mortality ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings] ,Causalidad ,Diseases::Nutritional and Metabolic Diseases::Nutrition Disorders::Overnutrition::Obesity [Medical Subject Headings] ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Diseases::Male Urogenital Diseases::Urogenital Neoplasms::Genital Neoplasms, Male::Prostatic Neoplasms [Medical Subject Headings] ,Information Science::Information Science::Data Collection::Vital Statistics::Mortality [Medical Subject Headings] ,Mortalidad ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings] ,Prostate cancer specific mortality ,Resultado del tratamiento ,Metaanálisis ,Body mass index - Abstract
The aim of this study was to systematically review all evidence evaluating obesity as a prognostic factor for PC mortality. Cohort and case-control studies reporting mortality among PC patients stratified by body mass index (BMI) were included. The risk of mortality among obese patients (BMI ≥ 30) was compared with the risk for normal weight (BMI < 25) patients, pooling individual hazard ratios (HR) in random-effects meta-analyses. Reasons for heterogeneity were assessed in subgroup analyses. Dose-response associations for BMI per 5 kg/m2 change were assessed. Among 7278 citations, 59 studies (280,199 patients) met inclusion criteria. Obesity was associated with increased PC-specific mortality (HR: 1.19, 95% CI: 1.10-1.28, I2: 44.4%) and all-cause mortality (HR: 1.09, 95% CI: 1.00-1.18, I2: 43.9%). There was a 9% increase (95% CI: 5-12%, I2: 39.4%) in PC-specific mortality and 3% increase (95% CI: 1-5%, I2: 24.3%) in all-cause mortality per 5 kg/m2 increase in BMI. In analyses restricted to the higher quality subgroup (NOS ≥ 8), obesity was associated with increased PC-specific mortality (HR: 1.24, 95% CI: 1.14-1.35, I2: 0.0%) and maintained the dose-response relationship (HR: 1.11 per 5 kg/m2 increase in BMI, 95% CI: 1.07-1.15, I2: 26.6%). Obesity had a moderate, consistent, temporal, and dose-response association with PC mortality. Weight control programs may have a role in improving PC survival. Yes
- Published
- 2021