Impact of Weight Management on Obesity-Driven Biomarkers of Prostate Cancer Progression.

William P Parker, Misty D Bechtel, Prabhakar Chalise, Moben Mirza, Heather D Gibbs, Carrie Michel, Jill Hamilton-Reeves, John DiGiovanni, Pugazhendhi Srinivasan, Brantley Thrasher

Journal: The Journal of urology 2024;211(4):552-562

PMID: 38299570

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Plain Language Summary

Central adiposity is associated with an increased risk of death from prostate cancer (PCa). This randomised control trial of 40 men aimed to determine how weight management affects certain obesity-associated biological markers related to prostate cancer (PCa) progression in men with obesity.

The results showed that the men in the weight management group lost an average of 5.5% of their body weight. This weight loss was associated with a reduction in insulin levels. Cholesterol and visceral adipose tissue were also reduced as was the hormone leptin.

It was concluded that weight management may improve body composition, obesity-associated biomarkers associated with PCa development, and quality of life in obese men with PCa. This study could be used by healthcare professionals to understand the potential benefits of weight loss on prostate cancer biomarkers in men with obesity.

Abstract

PURPOSE

Excess body and visceral fat increase the risk of death from prostate cancer (PCa). This phase II study aimed to test whether weight reduction by > 5% total body weight counteracts obesity-driven PCa biomarkers.

MATERIALS AND METHODS

Forty men scheduled for prostatectomy were randomized into intervention (n = 20) or control (n = 20) arms. Intervention participants followed a weight management program for 4 to 16 weeks before and 6 months after surgery. Control participants received standardized educational materials. All participants attended visits at baseline, 1 week before surgery, and 6 months after surgery. Circulating immune cells, cytokines, and chemokines were evaluated. Weight loss, body composition/distribution, quality of life, and nutrition literacy were assessed. Prostate tissue samples obtained from biopsy and surgery were analyzed.

RESULTS

From baseline to surgery (mean = 5 weeks), the intervention group achieved 5.5% of weight loss (95% CI, 4%-7%). Compared to the control, the intervention also reduced insulin, total cholesterol, LDL cholesterol, leptin, leptin:adiponectin ratio, and visceral adipose tissue. The intervention group had reduced c-peptide, plasminogen-activator-inhibitor-1, and T cell count from baseline to surgery. Myeloid-derived suppressor cells were not statistically different by group. Intervention group anthropometrics improved, including visceral and overall fat loss. No prostate tissue markers changed significantly. Quality of life measures of general and emotional health improved in the intervention group. The intervention group maintained or kept losing to a net loss of 11% initial body weight (95% CI, 8%-14%) at the study end.

CONCLUSIONS

Our study demonstrated improvements in body composition, PCa biomarkers, and quality of life with a weight management intervention.

Address: Department of Urology, University of Kansas Medical Center, Kansas City, Kansas.; Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas.; Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas.; Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, Texas.; Center for Molecular Carcinogenesis and Toxicology, The University of Texas at Austin, Austin, Texas.; Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, Texas.

DOI: 10.1097/JU.0000000000003849