首页 | 本学科首页   官方微博 | 高级检索  
     


Obesity Is Associated with Increased Prostate Growth and Attenuated Prostate Volume Reduction by Dutasteride
Authors:Roberto L. Muller  Leah Gerber  Daniel M. Moreira  Gerald Andriole Jr.  Robert J. Hamilton  Neil Fleshner  J. Kellogg Parsons  Stephen J. Freedland
Affiliation:1. Division of Urologic Surgery, Department of Surgery, Duke University School of Medicine, Durham, NC, USA;2. Urology Section, Veterans Affairs Medical Center, Durham, NC, USA;3. Department of Pathology, Duke University School of Medicine, Durham, NC, USA;4. The Arthur Smith Institute for Urology, North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA;5. Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA;6. Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada;g Division of Urologic Oncology, Moores Comprehensive Cancer Center and Section of Urology, San Diego Veterans Affairs Medical Center, University of California, San Diego, La Jolla, CA, USA
Abstract:

Background

Although obesity has been associated with larger prostate volumes (PV), few studies have actually investigated whether obesity enhances PV growth, especially among men using 5α-reductase inhibitors.

Objective

To examine whether obesity is associated with enhanced PV growth measured by serial transrectal ultrasound (TRUS) measurements.

Design, setting, and participants

We conducted a secondary analysis of the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial, which was originally aimed at cancer risk reduction among high-risk men with a single negative prestudy biopsy.

Intervention

Per-protocol randomization to placebo or dutasteride and mandatory TRUS-guided biopsies at 2 yr and 4 yr.

Outcome measurements and statistical analysis

Percentage change in PV at 2 yr and 4 yr from baseline. We tested its association with baseline body mass index (BMI) groups of <25, 25–29.9, and ≥30 kg/m2 using multivariable linear regression. Secondarily, we tested whether BMI was associated with the likelihood of having no PV reduction among men randomized to dutasteride using multivariable logistic regression.

Results and limitations

Of 8122 participants, we analyzed 71.8% and 54.5% with complete 2-yr and 4-yr PV data, respectively. In multivariable analysis, men on placebo with BMI ≥30 versus <25 kg/m2 had enhanced PV growth from baseline (at 2 yr: 17.0% vs 10.7%, p < 0.001; at 4 yr: 29.4% vs 20.1%; p = 0.001). Men on dutasteride with BMI ≥30 versus <25 kg/m2 had attenuated PV reduction from baseline (at 2 yr: −14.3% vs −18.5%; p = 0.002; at 4 yr: −13.2% vs −19.3%; p = 0.001) and higher likelihood of having no PV reduction (at 2 yr: odds ratio [OR]: 1.44; 95% confidence interval [CI], 1.08–1.93; p = 0.014; at 4 yr: OR: 1.62; 95% CI, 1.18–2.22; p = 0.003). We found no significant interactions between BMI and dutasteride on PV change at 2 yr and 4 yr (p interaction ≥0.36). No clinical outcomes or effects of weight change were assessed.

Conclusions

Obesity enhanced PV growth and attenuated PV reduction by dutasteride. The null interaction between obesity and dutasteride for PV change implies that the effect of obesity on dutasteride-treated men is likely a combination of dutasteride-driven PV reduction with obesity-driven PV growth rather than decreased dutasteride efficacy.

ClinicalTrials.gov identifier

NCT00056407.
Keywords:Prostate   Growth and development   Obesity   Dutasteride   5α-reductase inhibitors   Prostatic hyperplasia   Ultrasonography
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号