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Role of serum cholesterol and statin use in the risk of prostate cancer detection and tumor aggressiveness.

ABSTRACT: The aim of this study was to analyze the relationship between statin use along with serum cholesterol levels and prostate cancer (PCa) detection and aggressiveness. Statin users of three years or more and serum cholesterol levels (SC) were assessed in 2408 men scheduled for prostate biopsy. SC was classified as normal (NSC: <200 mg/dL) or high (HSC: >200 mg/dL). High-grade PCa (HGPCa) was considered if the Gleason score was greater than 7. Statin users comprised 30.9% of those studied. The PCa detection rate was 31.2% of men on statins and 37% of non-statin users (p<0.006). The PCa detection rate was 26.3% in men with NSC and 40.6% in those with HSC (p<0.001). In the subset of NSC men, the PCa rate was 26.5% for statin users and 26.2% for non-users (p=0.939), while in men with HSC, the PCa rate was 36.4% for statin users and 42.0% for non-statin users (p=0.063). The HGPCa rate was 41.8% for statin users and 32.5% for non-users (p=0.012). NSC men had a 53.8% rate of HGPCa, while the rate was only 27.6% in HSC men (p<0.001). NSC men on statins had an HGPCa rate of 70.2%, while non-statin users had a rate of 41.2% (p<0.001). The HGPCa rate for HSC men on statins was 18.8%, while the rate was 30.0% (p=0.011) for non-users. Logistic regression analysis suggested that serum cholesterol levels could serve as an independent predictor of PCa risk, OR 1.87 (95% CI 1.56-2.24) and HGPCa risk, OR 0.31 (95% CI 0.23-0.44), while statin usage could not. Statin treatment may prevent PCa detection through serum cholesterol-mediated mechanisms. A disturbing increase in the HGPCa rate was observed in statin users who normalized their serum cholesterol.

SUBMITTER: Morote J

PROVIDER: S-EPMC4159814 | biostudies-other | 2014

REPOSITORIES: biostudies-other

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Role of serum cholesterol and statin use in the risk of prostate cancer detection and tumor aggressiveness.

Morote Juan J Celma Anna A Planas Jacques J Placer José J de Torres Inés I Olivan Mireia M Carles Juan J Reventós Jaume J Doll Andreas A

International journal of molecular sciences 20140806 8

The aim of this study was to analyze the relationship between statin use along with serum cholesterol levels and prostate cancer (PCa) detection and aggressiveness. Statin users of three years or more and serum cholesterol levels (SC) were assessed in 2408 men scheduled for prostate biopsy. SC was classified as normal (NSC: <200 mg/dL) or high (HSC: >200 mg/dL). High-grade PCa (HGPCa) was considered if the Gleason score was greater than 7. Statin users comprised 30.9% of those studied. The PCa d ...[more]

PMID: 25101846

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Project description:Importance:The use of statins (hydroxymethylglutaryl coenzyme A inhibitors) has been associated with a lower risk of primary open-angle glaucoma (POAG); however, results have been conflicting, and little is known about the association between high cholesterol levels and POAG. Objective:To assess the association of elevated cholesterol levels and statin use with incident POAG. Design, Setting, and Participants:This study used data collected biennially from participants aged 40 years or older who were free of glaucoma and reported eye examinations, within 3 population-based cohorts: the Nurses' Health Study (N?=?50?710; followed up from 2000 to 2014), the Nurses' Health Study 2 (N?=?62?992; 1999-2015), and the Health Professionals Follow-up Study (N?=?23?080; 2000-2014). Incident cases of POAG were confirmed by medical record review. The analyses were performed in January 2019. Exposures:Biennially updated self-reported information on elevated cholesterol level status, serum cholesterol levels, and duration of statin use. Main Outcomes and Measures:Multivariable-adjusted relative risks (RRs) and 95% CIs were estimated using Cox proportional hazards regression models on pooled data, with stratification by cohort. Results:Among the 136?782 participants in the 3 cohorts (113?702 women and 23?080 men), 886 incident cases of POAG were identified. Every 20-mg/dL increase in total serum cholesterol was associated with a 7% increase in risk of POAG (RR, 1.07 [95% CI, 1.02-1.11]; P?=?.004). Any self-reported history of elevated cholesterol was also associated with a higher risk of POAG (RR, 1.17 [95% CI, 1.00-1.37]). A history of any statin use was associated with a 15% lower risk of POAG (RR, 0.85 [95% CI, 0.73-0.99]). Use of statins for 5 or more years vs never use of statins was associated with a 21% lower risk of POAG (RR, 0.79 [95% CI, 0.65-0.97]; P?=?.02 for linear trend). The association between use of statins for 5 or more years vs never use of statins and risk of POAG was more inverse in those who were older (?65 years: RR, 0.70 [95% CI, 0.56-0.87] vs <65 years: RR, 1.05 [95% CI, 0.68-1.63]; P?=?.01 for interaction). Conclusions and Relevance:Among adults aged 40 years or older, higher serum cholesterol levels were associated with higher risk of POAG, while 5 or more years of statin use compared with never use of statins was associated with a lower risk of POAG.

Project description:To assess the incremental value of diffusion-weighted (DW) magnetic resonance (MR) imaging over T2-weighted MR imaging at 3 T for prostate cancer detection and to investigate the use of the apparent diffusion coefficient (ADC) to characterize tumor aggressiveness, with whole-mount step-section pathologic analysis as the reference standard.The Internal Review Board approved this HIPAA-compliant retrospective study and waived informed consent. Fifty-one patients with prostate cancer (median age, 58 years; range, 46-74 years) underwent T2-weighted MR imaging and DW MR imaging (b values: 0 and 700 sec/mm(2) [n = 20] or 0 and 1000 sec/mm(2) [n = 31]) followed by prostatectomy. The prostate was divided into 12 regions; two readers provided a score for each region according to their level of suspicion for the presence of cancer on a five-point scale, first using T2-weighted MR imaging alone and then using T2-weighted MR imaging and the ADC map in conjunction. Areas under the receiver operating characteristic curve (AUCs) were estimated to evaluate performance. Generalized estimating equations were used to test the ADC difference between benign and malignant prostate regions and the association between ADCs and tumor Gleason scores.For tumor detection, the AUCs for readers 1 and 2 were 0.79 and 0.76, respectively, for T2-weighted MR imaging and 0.79 and 0.78, respectively, for T2-weighted MR imaging plus the ADC map. Mean ADCs for both cancerous and healthy prostatic regions were lower when DW MR imaging was performed with a b value of 1000 sec/mm(2) rather than 700 sec/mm(2). Regardless of the b value used, there was a significant difference in the mean ADC between malignant and benign prostate regions. A lower mean ADC was significantly associated with a higher tumor Gleason score (mean ADCs of [1.21, 1.10, 0.87, and 0.69] × 10(-3) mm(2)/sec were associated with Gleason score of 3 + 3, 3 + 4, 4 + 3, and 8 or higher, respectively; P = .017).Combined DW and T2-weighted MR imaging had similar performance to T2-weighted MR imaging alone for tumor detection; however, DW MR imaging provided additional quantitative information that significantly correlated with prostate cancer aggressiveness.

Dataset Information

Role of serum cholesterol and statin use in the risk of prostate cancer detection and tumor aggressiveness.

Publications

Role of serum cholesterol and statin use in the risk of prostate cancer detection and tumor aggressiveness.

Similar Datasets

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