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Klinische und histopathologische Parameter des Prostatakarzinoms

Einfluss anthropometrischer Indizes

Clinical and histopathological parameters of prostate cancer

Influence of anthropometric indices

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Zusammenfassung

Hintergrund

Das Fettgewebe wird immer mehr als endokrin aktives Organ betrachtet und könnte auch Einfluss auf die Entstehung und Progression des Prostatakrebses (PCA) haben. Eine ungünstige Körperfettverteilung bei Adipositas ist als Risikofaktor für kardiovaskuläre Erkrankungen gesichert. Der „Body Mass Index“ (BMI) als Parameter für Adipositas erfasst die Körperfettverteilung allerdings nicht.

Fragestellung

Ziel der Arbeit ist es, anthropometrische Indizes, die eine bessere Aussage über die Körperfettverteilung ermöglichen, auf ihren Zusammenhang mit klinischen und histopathologischen Parametern beim PCA zu untersuchen.

Patienten und Methoden

Bei Patienten vor radikaler Prostatektomie erfolgte die Messung von Körpergröße, Gewicht, Bauch- (BU) und Hüftumfang. Daraus wurden BMI, „waist-to-hip ratio“ (WHR) und „waist-to-height ratio“ (WHtR) berechnet. Ein möglicher Zusammenhang von Körpermaßen, anthropometrischen Indizes mit histopathologischen, laborchemischen und klinischen Befunden wurde statistisch uni- und multivariabel untersucht.

Ergebnisse

Im Zeitraum von März 2011 bis März 2013 wurden 668 Patienten erfasst. Die Prävalenz der Adipositas definiert als BMI ≥ 30, WHR ≥ 1 oder WHtR ≥ 0,6 lag bei 22,8 %, 50,6 % bzw. 30,2 %. In der univariaten Analyse korrelierten BU und WHtR ≥ 0,6 mit prostataspezifischem Antigen (PSA) und Tumorvolumen (TV, p < 0,05). BU und WHtR waren unabhängige Prädiktoren eines TV ≥ 2,1 cm2 (p < 0,05) und ein WHtR ≥ 0,6 war unabhängiger Prädiktor eines TV ≥ 2,1 cm2 [p < 0,018; relatives Risiko (RR) 1,506; 95 %-Konfidenzintervall (-KI) 1,072–2,115].

Schlussfolgerung

Unabhängig vom verwendeten anthropometrischen Index scheint ein Zusammenhang von Adipositas und höherem Tumorvolumen des PCA zu bestehen. Ob anthropometrische Indizes, insbesondere die WHtR, prognostische Bedeutung haben, muss im Follow-up geklärt werden.

Abstract

Background

Adipose tissue is increasingly considered as an endocrinal active organ and may have an influence on the development and progression of prostate cancer. Adverse body fat distribution, considered a risk factor for cardiovascular disease, is not reflected by the body mass index (BMI).

Objective

The purpose of this work was to assess anthropometric indices which provide a better estimate of body fat distribution and to evaluate their association with clinical and histopathological parameters of prostate cancer.

Patients and methods

In patients scheduled for radical prostatectomy between March 2011 and March 2013, height, weight, waist circumference (WC) and hip circumference were measured, then the BMI, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. The relationships between anthropometric measures and indices and clinical and histopathological features of PCA were evaluated with uni- and multivariate analyses.

Results

In 668 patients available for evaluation, obesity rates were 22.8 %, 50.6% and 30.2 % as defined by BMI ≥ 30, WHR ≥ 1 and WHtR ≥ 0.6, respectively. On univariate analysis, WC and WHtR ≥ 0.6 correlated with tumor volume (TV) > 2.1 cm2 (p < 0.05), respectively. WC and WHtR were independent predictors of a TV ≥ 2.1 cm2 (p < 0.05) and a WHtR ≥ 0.6 was an independent predictor of a TV ≥ 2.1 cm2 (p < 0.018, risk ratio 1.506, 95 % confidence interval 1.072–2.115).

Conclusion

In general a higher degree of adiposity seems to correlate with a higher tumor volume. Whether anthropometric indices have prognostic impact needs to be clarified during follow-up.

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Einhaltung ethischer Richtlinien

Interessenkonflikt: B. Löppenberg, F. Roghmann, M. Brock, C. von Bodmann, C.J. Michels, J. Noldus und J. Palisaar geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Correspondence to Dr. B. Löppenberg.

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Löppenberg, B., Roghmann, F., Brock, M. et al. Klinische und histopathologische Parameter des Prostatakarzinoms. Urologe 54, 22–27 (2015). https://doi.org/10.1007/s00120-014-3700-4

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Schlüsselwörter

  • Adipositas
  • Anthropometrie
  • Körperfettverteilung
  • Tumorvolumen
  • Prostatektomie, radikale

Keywords

  • Obesity
  • Anthropometry
  • Body fat distribution
  • Tumor volume
  • Prostatectomy, radical