VIENNA—Metabolic syndrome is associated with an increased risk of high-grade prostate cancer (PCa) among men with a positive prostate biopsy, a study found.

Although the finding needs to be confirmed in future studies and the underlying mechanism for the association remains to elucidated, the presence of metabolic syndrome in a man with an elevated PSA level should prompt clinicians to consider that the patient has an increased likelihood of high-grade PCa, said investigator Cosimo De Nunzio, MD, PhD, of Ospedale Sant’Andrea, Univesrity “La Sapienza” in Rome, who presented study findings at 26th Annual Congress of the European Association of Urology.

He and his colleagues enrolled 195 patients undergoing a 12-core biopsy because of a PSA level of 4 ng/mL or above and/or a positive digital rectal examination. Prior to biopsy, investigators measured body mass index as well as waist and hip circumference. Of the 195 men, 83 (33%) had cancer discovered on biopsy: 37 (45%) with metabolic syndrome and 46 (55%) without, a nonsignificant difference between the groups.

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Forty-two (51%) of the 83 men with PCa had a Gleason score of 6 and 41 (49%) had a Gleason score of 7 or higher. A significantly higher proportion of men with Gleason 7 or higher disease had metabolic syndrome than those with Gleason 6 disease (61% vs. 28.5%). Although the presence of metabolic syndrome was not associated with an increased PCa risk overall, it was associated with a 3.8 times increased risk of high-grade PCa.

In addition, the researchers found that PSA was independently associated with increased PCa risk. Each 1 unit increment in PSA was associated with a 12% increased risk.