Periprostatic adipose inflammation & PCa.

[pjoshea13]

New study below.

It is probably well-known now that obesity is associated with poorer PCa outcome. However, it appears that visceral fat is the culprit. One can be on a 10% fat Dean Ornish type diet & be impressively lean, but high-carb diets are associated with elevated triglycerides & invisible (except via a scan) visceral fat accumulation. The problem is that fat around the internal organs act as a gland in the endocrine system.

The new study examined fat around the prostate. It looked at inflammation, rather than secreted hormones, although there is mention of leptin & adiponectin.

"Periprostatic fat was collected from 169 men (median age 62 years; median BMI 28.3). Periprostatic {white adipose tissue} inflammation was identified in 49.7% of patients and associated with higher BMI .., larger adipocyte size ... and Gleason grade groups IV/V tumors"

White adipose tissue "inflammation correlated with higher circulating levels of insulin, triglycerides, and leptin/adiponectin ratio, and lower high density lipoprotein cholesterol, compared to those without {white adipose tissue} inflammation".

Unbalanced carbs will elevate glucose, which leads to elevated insulin (a PCa growth factor), elevated triglycerides (preferentially stored as visceral fat), increase in the fat hormone leptin, with a concomitant decrease in the prostate-protective fat hormone adiponectin. Visceral fat also secretes estradiol, which can lead to a reduction in testosterone production.

Removal of the prostate eliminates periprostatic fat, but visceral fat elsewhere remains a problem.

-Patrick

ncbi.nlm.nih.gov/pubmed/286...

Prostate Cancer Prostatic Dis. 2017 Jun 27. doi: 10.1038/pcan.2017.31. [Epub ahead of print]

Periprostatic adipose inflammation is associated with high-grade prostate cancer.

Gucalp A1,2, Iyengar NM1,2, Zhou XK3, Giri DD4, Falcone DJ5, Wang H3, Williams S1, Krasne MD1, Yaghnam I2, Kunzel B6, Morris PG1, Jones LW1,2, Pollak M7, Laudone VP6, Hudis CA1,2, Scher HI1,2, Scardino PT6, Eastham JA6, Dannenberg AJ2.

Author information

1

Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

2

Department of Medicine, Weill Cornell Medical College, New York, NY, USA.

3

Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.

4

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

5

Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.

6

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

7

Departments of Medicine and Oncology, McGill University, Montreal, Quebec, Canada.

Abstract

BACKGROUND:

Obesity, a cause of subclinical inflammation, is associated with increased risk of high-grade prostate cancer (PC) and poor outcomes. Whether inflammation occurs in periprostatic white adipose tissue (WAT), and contributes to the negative impact of obesity on PC aggressiveness, is unknown.

METHODS:

In a single-center, cross-sectional design, men with newly diagnosed PC undergoing radical prostatectomy were eligible for study participation. The primary objective was to examine the prevalence of periprostatic WAT inflammation defined by the presence of crown-like structures (CLS-P) as detected by CD68 immunohistochemistry. Secondary objectives were to explore the clinical and systemic correlates of periprostatic WAT inflammation. Tumor characteristics and host factors including BMI, adipocyte diameter, and circulating levels of lipids, adipokines, and other metabolic factors were measured. Wilcoxon rank-sum, Chi-square, or Fisher's exact tests, and generalized linear regression were used to examine the association between WAT inflammation and tumor and host characteristics.

RESULTS:

Periprostatic fat was collected from 169 men (median age 62 years; median BMI 28.3). Periprostatic WAT inflammation was identified in 49.7% of patients and associated with higher BMI (P=0.02), larger adipocyte size (P=0.004) and Gleason grade groups IV/V tumors (P=0.02). The relationship between WAT inflammation and high Gleason grade remained significant after adjusting for BMI (P=0.04). WAT inflammation correlated with higher circulating levels of insulin, triglycerides, and leptin/adiponectin ratio, and lower high density lipoprotein cholesterol, compared to those without WAT inflammation (P's <0.05).

CONCLUSION:

Periprostatic WAT inflammation is common in this cohort of men with PC and is associated with high-grade PC.Prostate Cancer and Prostatic Diseases advance online publication, 27 June 2017; doi:10.1038/pcan.2017.31.

PMID: 28653675 DOI: 10.1038/pcan.2017.31