Abstract：
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has been reported to be helpful to identify high-risk individuals of developing prostate cancer. Our aim is to investigate the relationship between NAFLD and biochemical recurrence in metastatic prostate cancer patients.
METHODS: We retrospectively investigated 602 patients with metastatic prostate cancer receiving the androgen deprivation therapy. Liver fat was estimated with liver-to-spleen ratio by computed tomography (CT) scans. The relationship between NAFLD and biochemical recurrence was investigated with Cox models. The model for biochemical recurrence was adjusted for multiple variables.
RESULTS: NAFLD was significantly associated with biochemical recurrence in patients with Gleason score ≥4+3 when adjusting for each of body mass index (hazards ratio [HR] = 1.38; 95% confidence interval [CI] = 1.08-1.77; p = 0.01), visceral adipose tissue (HR = 1.36; 95% CI = 1.07-1.74; p = 0.01), hypertension (HR = 1.41; 95% CI = 1.10-1.80; p = 0.01), and diabetes mellitus (HR = 1.42; 95% CI = 1.11-1.82; p = 0.01), using age and prostate-specific antigen level as potential confounder. The 2-year biochemical recurrence rate in the Gleason score ≥4+3 patients with and without NAFLD was 84.0% (100/119) and 72.2% (130/180), respectively (p = 0.018). The median biochemical recurrence free survival of the Gleason score ≥4+3 patients with and without NAFLD were 17 and 21 months, respectively (p = 0.005).
CONCLUSIONS: NAFLD is an independent risk factor for biochemical recurrence in patients with high-grade metastatic prostate cancer. If validated in prospective studies, future research should test whether treatment of NAFLD can lead to better prognosis.
METHODS: We retrospectively investigated 602 patients with metastatic prostate cancer receiving the androgen deprivation therapy. Liver fat was estimated with liver-to-spleen ratio by computed tomography (CT) scans. The relationship between NAFLD and biochemical recurrence was investigated with Cox models. The model for biochemical recurrence was adjusted for multiple variables.
RESULTS: NAFLD was significantly associated with biochemical recurrence in patients with Gleason score ≥4+3 when adjusting for each of body mass index (hazards ratio [HR] = 1.38; 95% confidence interval [CI] = 1.08-1.77; p = 0.01), visceral adipose tissue (HR = 1.36; 95% CI = 1.07-1.74; p = 0.01), hypertension (HR = 1.41; 95% CI = 1.10-1.80; p = 0.01), and diabetes mellitus (HR = 1.42; 95% CI = 1.11-1.82; p = 0.01), using age and prostate-specific antigen level as potential confounder. The 2-year biochemical recurrence rate in the Gleason score ≥4+3 patients with and without NAFLD was 84.0% (100/119) and 72.2% (130/180), respectively (p = 0.018). The median biochemical recurrence free survival of the Gleason score ≥4+3 patients with and without NAFLD were 17 and 21 months, respectively (p = 0.005).
CONCLUSIONS: NAFLD is an independent risk factor for biochemical recurrence in patients with high-grade metastatic prostate cancer. If validated in prospective studies, future research should test whether treatment of NAFLD can lead to better prognosis.
摘要：
背景：据报道，非酒精性脂肪性肝病（NAFLD）有助于识别患前列腺癌的高危个体。我们的目的是研究转移性前列腺癌患者NAFLD与生化复发之间的关系。
方法：我们回顾性调查了602例接受雄激素剥夺治疗的转移性前列腺癌患者。通过计算机断层扫描（CT）扫描以肝脏与脾脏的比率估计肝脏脂肪。用Cox模型研究NAFLD与生化复发之间的关系。针对多个变量调整生化复发模型。
结果：当调整每个体重指数时，Gleason评分≥4+3的患者的NAFLD与生化复发显着相关（风险比[HR]=1.38;95％置信区间[CI]=1.08-1.77;p=0.01），内脏脂肪组织（HR=1.36;95%CI=1.07-1.74;p=0.01），高血压（HR=1.41;95％CI=1.10-1.80;p=0.01），和糖尿病（HR=1.42;95％CI=1.11-1.82;p=0.01），使用年龄和前列腺特异性抗原水平作为潜在的混杂因素。Gleason评分≥4+3的NAFLD患者2年生化复发率分别为84.0%(100/119)和72.2%(130/180),分别(p=0.018)。Gleason评分≥4+3例伴和不伴NAFLD患者的中位无生化复发生存期分别为17个月和21个月,分别(p=0.005)。
结论：NAFLD是高级别转移性前列腺癌患者生化复发的独立危险因素。如果在前瞻性研究中得到验证，未来的研究应该测试NAFLD的治疗是否可以导致更好的预后.
方法：我们回顾性调查了602例接受雄激素剥夺治疗的转移性前列腺癌患者。通过计算机断层扫描（CT）扫描以肝脏与脾脏的比率估计肝脏脂肪。用Cox模型研究NAFLD与生化复发之间的关系。针对多个变量调整生化复发模型。
结果：当调整每个体重指数时，Gleason评分≥4+3的患者的NAFLD与生化复发显着相关（风险比[HR]=1.38;95％置信区间[CI]=1.08-1.77;p=0.01），内脏脂肪组织（HR=1.36;95%CI=1.07-1.74;p=0.01），高血压（HR=1.41;95％CI=1.10-1.80;p=0.01），和糖尿病（HR=1.42;95％CI=1.11-1.82;p=0.01），使用年龄和前列腺特异性抗原水平作为潜在的混杂因素。Gleason评分≥4+3的NAFLD患者2年生化复发率分别为84.0%(100/119)和72.2%(130/180),分别(p=0.018)。Gleason评分≥4+3例伴和不伴NAFLD患者的中位无生化复发生存期分别为17个月和21个月,分别(p=0.005)。
结论：NAFLD是高级别转移性前列腺癌患者生化复发的独立危险因素。如果在前瞻性研究中得到验证，未来的研究应该测试NAFLD的治疗是否可以导致更好的预后.
