Body fat distribution on computed tomography imaging and prostate cancer risk and mortality in the AGES-Reykjavik study

Barbra A. Dickerman*, Johanna E. Torfadottir, Unnur A. Valdimarsdottir, Edward Giovannucci, Kathryn M. Wilson, Thor Aspelund, Laufey Tryggvadottir, Lara G. Sigurdardottir, Tamara B. Harris, Lenore J. Launer, Vilmundur Gudnason, Sarah C. Markt, Lorelei A. Mucci

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Background: The World Cancer Research Fund classifies as “strong evidence” the link between obesity and the risk of advanced prostate cancer. In light of the different hormonal profiles associated with where adipose is stored, this study investigated the role of objectively measured body fat distribution and the risk of clinically relevant prostate cancer. Methods: This was a prospective study of 1832 men in the Age, Gene/Environment Susceptibility–Reykjavik study. From 2002 to 2006, participants underwent baseline computed tomography imaging of fat deposition, bioelectric impedance analysis, and measurement of body mass index (BMI) and waist circumference. Men were followed through linkage with nationwide cancer registries for the incidence of total (n = 172), high-grade (Gleason grade ≥8; n = 43), advanced (≥cT3b/N1/M1 at diagnosis or fatal prostate cancer over follow-up; n = 41), and fatal prostate cancer (n = 31) through 2015. Cox regression was used to evaluate the association between adiposity measures and prostate cancer outcomes. Results: Among all men, visceral fat (hazard ratio [HR], 1.31 per 1–standard deviation [SD] increase; 95% confidence interval [CI], 1.00-1.72) and thigh subcutaneous fat (HR, 1.37 per 1-SD increase; 95% CI, 1.00-1.88) were associated with risk of advanced and fatal disease, respectively. Among men who were leaner based on BMI, visceral fat was associated with both advanced and fatal disease. BMI and waist circumference were associated with a higher risk of advanced and fatal disease. No adiposity measures were associated with total or high-grade disease. Conclusions: Specific fat depots as well as BMI and waist circumference were associated with the risk of aggressive prostate cancer, which may help to elucidate underlying mechanisms and target intervention strategies.

Original languageEnglish
Pages (from-to)2877-2885
Number of pages9
Issue number16
Publication statusPublished - 15 Aug 2019

Bibliographical note

Funding Information:
This work was supported by funding from the National Cancer Institute of the National Institutes of Health (T32 CA 009001 to Barbra A. Dickerman and P50 CA 090381-15 to Sarah C. Markt and Lorelei A. Mucci), an ASISA Fellowship (to Barbra A. Dickerman), and the Prostate Cancer Foundation (to Lorelei A. Mucci and Kathryn M. Wilson). The AGES-Reykjavik study is supported by the Intramural Research Program of the National Institute on Aging (contract N01 AG 12100), the Hjartavernd (the Icelandic Heart Association), and the Althingi (the Icelandic Parliament). In addition, this study was supported by funding from the Harvard Catalyst Award and the Icelandic Cancer Society.

Publisher Copyright:
© 2019 American Cancer Society

Other keywords

  • adiposity
  • cohort
  • computed tomography
  • fat distribution
  • obesity
  • prostate cancer
  • visceral fat


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