1736 OBESITY IS ASSOCIATED WITH INCREASED PROSTATE GROWTH AND ATTENUATED PROSTATE VOLUME REDUCTION BY DUTASTERIDE
Bibliographic record
Abstract
You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology and Natural History/Evaluation and Markers1 Apr 20121736 OBESITY IS ASSOCIATED WITH INCREASED PROSTATE GROWTH AND ATTENUATED PROSTATE VOLUME REDUCTION BY DUTASTERIDE Roberto Muller, Leah Gerber, Daniel Moreira, Gerald Andriole, J. Kellogg Parsons, Neil Fleshner, and Stephen Freedland Roberto MullerRoberto Muller Durham, NC More articles by this author , Leah GerberLeah Gerber Durham, NC More articles by this author , Daniel MoreiraDaniel Moreira New Hyde Park, NY More articles by this author , Gerald AndrioleGerald Andriole Saint Louis, MO More articles by this author , J. Kellogg ParsonsJ. Kellogg Parsons San Diego, CA More articles by this author , Neil FleshnerNeil Fleshner Toronto, Canada More articles by this author , and Stephen FreedlandStephen Freedland Durham, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1697AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Many recent studies focused on modifiable risk factors for BPH (i.e. obesity and others). Cross-sectional studies showed that obesity is associated with larger prostate volumes (PV). However, the effect of obesity on PV changes over time has been less studied, especially in men using 5α-reductase inhibitors. We tested if BMI is associated with changes in PV in a clinical trial of men at increased risk for prostate cancer. METHODS The Reduction by Dutasteride of Cancer Events (REDUCE) Trial was a 4-year randomized study of dutasteride vs. placebo for prevention of prostate cancer. Men were aged 50-75 years, had a pre-study PSA between 2.5-10 ng/mL, a prior negative biopsy for prostate cancer, and a pre-study PV <80cc. PV was obtained from TRUS during biopsies at 2 and 4 years and compared to baseline values for percent change. Of 8122 men in the efficacy population and after censoring any PV measurements after prostatic surgery, 4541 (55.9%) men had PV data at both baseline and 4-years. Of these, we excluded 112 men (2.5%) due to missing data or extreme changes in PV from baseline due to concerns about spurious values. BMI was tested continuously and in groups (<25, 25-29.9, 30-34.9, ≥35 kg/m2). We used multivariable linear regression to test if BMI was associated with PV changes at 4 years. Models were adjusted for confounders. RESULTS At baseline, men with higher BMI were younger (61.2 vs. 63.3 y for highest vs. lowest group, P-trend <0.001) and had larger PV (50.7 vs. 45.7 mL for highest vs. lowest group, P-trend<0.001). At 4-year, unadjusted analyses showed that higher baseline BMI was associated with increased PV growth in the placebo arm and attenuated PV reduction in the dutasteride arm (Fig). On multivariable analysis, relative to men with a BMI <25 kg/m2, men with a BMI >35 kg/m2 had 14.3% larger PV volume growth for men on the placebo arm (P=0.002) and 10.4% less PV reduction in men on dutasteride (P<0.001). There was no significant interaction between obesity and treatment arm (P=0.49). CONCLUSIONS In men with an elevated PSA and a negative biopsy, higher BMI was associated with increased PV growth and attenuation of PV reduction by dutasteride. Given obesity appears to be linked with PV growth, future studies are warranted to test if weight loss can slow prostate growth. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e700 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Roberto Muller Durham, NC More articles by this author Leah Gerber Durham, NC More articles by this author Daniel Moreira New Hyde Park, NY More articles by this author Gerald Andriole Saint Louis, MO More articles by this author J. Kellogg Parsons San Diego, CA More articles by this author Neil Fleshner Toronto, Canada More articles by this author Stephen Freedland Durham, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.035 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".