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High LDL level linked to positive prostate biopsy in blacks

Last Updated: 2009-11-26 11:00:04 -0400 (Reuters Health)

November 30, 2009

Last Updated: 2009-11-26 11:00:04 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Black men with elevated low density lipoprotein (LDL) levels face an increased risk of positive prostate biopsy, according to a report in the November issue of The Journal of Urology.

Some studies have suggested an association between reduced cholesterol levels and a decreased incidence of prostate cancer, the authors explain, but which lipid components contribute to the risk of prostate cancer has not been determined.

Dr. Kelvin A. Moses and colleagues from Atlanta Veterans Affairs Medical Center and Emory University, Atlanta, analyzed their prostate biopsy database containing complete data on 1775 men to determine whether measured lipid profile components are associated with a diagnosis of prostate cancer at biopsy.

After adjustment for a number of factors associated with prostate cancer risk, increased serum LDL was associated with positive prostate biopsy in African Americans, but not in non-African Americans, the authors report.

Compared with LDL levels below 100 mg/dL, positive prostate biopsy rates in African American men were 49% higher for LDL levels between 100 and 130 mg/dL, 53% higher for LDL levels between 130 and 160 mg/dL, and 224% higher for LDL levels above 160 mg/dL.

Non-HDL cholesterol showed a similar interaction with race and prostate cancer, the researchers note, but there was no association between statin intake and prostate cancer diagnosis in the total study population or in the groups stratified by race.

Patients with positive prostate biopsy had higher triglyceride levels than did those with negative prostate biopsy, but the association was only significant for triglyceride levels above 250 mg/dL. HDL levels were not associated with prostate biopsy results.

Increasing age, high prostate specific antigen levels, and abnormal digital rectal examination were also associated with increasing odds of prostate cancer, the investigators say.

"The results combined with those of other studies of cholesterol, dietary fat intake, and androgen regulation of lipid metabolism provide justification for further research into the mechanisms that may explain racial disparity in prostate cancer incidence and prognosis," the authors conclude.

J Urol 2009;182:2219-2225.

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