Cardiometabolic risk and metabolic syndrome with prostate cancer-an inverse probability weighted study

Background: Presently, the conclusion of the association between cardiometabolic risk, metabolic syndrome and prostate cancer (PCa) is inconsistent. 

Methods: We analyzed the population of the Department of Urology of the First Affiliated Hospital of Xinjiang Medical University from 2020 to 2023. The case group included 390 PCa patients and the control group included 395 benign prostatic hyperplasia participants. Cardiometabolic risk factors were used to determine the cardiometabolic risk score (MetScore), cardiometabolic risk factors clusters, and suffering metabolic syndrome. Confounding factors between case group and control group were balanced by inverse probability weighting (IPTW), a four-point restricted cubic spline (RCS) was plotted to compare different stages of MetScore for PCa. Three models were developed, and weighted logistic regression analysis was used to explore factors affecting the prevalence of PCa. The robustness of the results was assessed by a stratified analysis and three sensitivity analyses. 

Results: After IPTW, in the case and control groups, the differences in basic information were not statistically significant (P > 0.05). RCS showed that there was a nonlinear relationship between the MetScore and the risk of developing PCa (P = 0.003). In Model 3, when MetScore was analyzed as a continuous variable, the risk of developing PCa increased by 2.3% for every 1 increase in MetScore. When MetScore was analyzed as a categorical variable, MetScore<-8.074 was considered as reference, the risk of developing PCa in individuals with MetScore − 8.074 ~ 19.240 was 1.600 times higher than in individuals with MetScore<-8.074, the risk of developing PCa in individuals with MetScore > 19.240 was 3.218 times higher than in individuals with MetScore <-8.074, and the difference among the groups was statistically significant (P for trend < 0.001). There was a 33.5% increased in the risk of developing PCa for every 1 increase in the number of cardiometabolic risk factors clusters. The risk of developing PCa in individuals with metabolic syndrome was 1.960 times higher than in those without metabolic syndrome. Stratification analysis and sensitivity analyses indicated that the robustness of the results. 

Conclusions: Elevated MetScore, cardiometabolic risk factors clusters, and metabolic syndrome were all risk factors for developing PCa, regardless of BF%.