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American Journal of Epidemiology Advance Access published online on September 12, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj320
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received January 27, 2006
Accepted April 20, 2006

ORIGINAL CONTRIBUTIONS

The Metabolic Syndrome Is Associated with Reduced Risk of Prostate Cancer

Aaron J. Tande 1, Elizabeth A. Platz 2, and Aaron R. Folsom 1 *

1 Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

* To whom correspondence should be addressed.
Aaron R. Folsom, E-mail: folsom{at}epi.umn.edu


  Abstract

Diabetes is associated with reduced risk of prostate cancer, but whether the metabolic syndrome is associated with prostate cancer is not established. The authors assessed this association in the Atherosclerosis Risk in Communities (ARIC) Study, comprising 6,429 men in four US communities initially with no history of cancer and aged 45-64 years. Metabolic syndrome and other risk factors were assessed in 1987-1989. Follow-up for prostate cancer incidence (n = 385 through 2000) was accomplished through cancer registry and hospital linkage. At baseline, 1,871 men (29.5%) had the metabolic syndrome. After the authors adjusted for other risk factors, men with the metabolic syndrome (≥3 components) were significantly less likely to develop prostate cancer (relative risk = 0.77, 95% confidence interval: 0.60, 0.98) than men without the metabolic syndrome. Diabetes was negatively associated with prostate cancer, although the confidence interval included 1 (relative risk = 0.73, 95% confidence interval: 0.51, 1.05). When diabetic participants were excluded, the inverse association between metabolic syndrome and prostate cancer incidence was slightly strengthened. In this study, the metabolic syndrome was associated with decreased prostate cancer incidence. The authors hypothesize that this finding reflects a decrease in bioavailable (free and albumin-bound) testosterone with the metabolic syndrome and a concomitant reduction in prostate cancer risk.

Keywords: diabetes mellitus; metabolic syndrome X; prospective studies; prostatic neoplasms.
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