Increased Low Density Lipoprotein and Increased Likelihood of Positive Prostate Biopsy in Black Americans
Received 16 March 2009 published online 16 September 2009.
Purpose
Differences in prostate cancer incidence, grade and stage at diagnosis, and survival in black vs nonblack men are well documented. Recent studies indicate that lipids may have a role in oncogenesis, including that of prostate cancer. We investigated the relationship between circulating lipids in black and nonblack patients, and newly diagnosed prostate cancer.
Materials and Methods
The study population included consecutive patients who underwent prostate biopsy for increased prostate specific antigen and/or abnormal digital rectal examination at Atlanta Veterans Affairs Medical Center. Age, race, prostate specific antigen, prostate volume, body mass index, family history, high and low density lipoprotein, triglyceride and cholesterol lowering medications were included in data analysis.
Results
A total of 1,775 men with complete information were included in data analysis. A total of 521 black and 451 white men had positive biopsies. Using 100 mg/dl or less as the referent the adjusted OR reflecting the association of low density lipoprotein and prostate cancer diagnosis in black men was 1.49 (95% CI 1.04–2.13, p = 0.031), 1.51 (95% CI 0.96–2.39, p = 0.076) and 3.24 (95% CI 1.59–6.92, p = 0.002) for low density lipoprotein greater than 100 to 130, greater than 130 to 160 and greater than 160 mg/dl, respectively. Corresponding results in nonblack men showed no significant association.
Conclusions
Increased serum low density lipoprotein is associated with an increased likelihood of prostate cancer diagnosis in black men but not in nonblack men. This association is strongest in the highest low density lipoprotein risk category. The reasons for the racial differences are unknown but may include genetic, dietary or other environmental factors.
aDepartment of Urology, Atlanta Veterans Affairs Medical Center, Emory University School of Medicine, Emory University, Atlanta, Georgia
bDepartment of Urology, Emory University School of Medicine, Emory University, Atlanta, Georgia
cDepartment of Pathology and Laboratory Medicine, Emory University School of Medicine, Emory University, Atlanta, Georgia
dDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
Correspondence: Department of Urology, Atlanta Veterans Affairs Medical Center (112), 1670 Clairmont Rd., Northeast, Decatur, Georgia 30033 (telephone: 404-728-4144; FAX: 404-329-2201)
Study received approval from the Atlanta VA Medical Center research and development committee, and Emory University institutional review board.
⁎ Financial interest and/or other relationship with American Urological Association.
ABSTRACT