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Int. J. Mol. Sci. 2014, 15(8), 13615-13623; doi:10.3390/ijms150813615

Role of Serum Cholesterol and Statin Use in the Risk of Prostate Cancer Detection and Tumor Aggressiveness

1
Department of Urology, Vall d'Hebron University Hospital and Autonomous University of Barcelona, Barcelona 08035, Spain
2
Department of Pathology, Vall d'Hebron University Hospital and Autonomous University of Barcelona, Barcelona 08035, Spain
3
Department of Medical Oncology, Vall d'Hebron University and Hospital Autonomous University of Barcelona, Barcelona 08035, Spain
4
Research Unit in Biomedicine and Translational Oncology, Vall d'Hebron Research Institute and Hospital and Autonomous University of Barcelona, Barcelona 08035, Spain
5
Department of Basic Sciences, International University of Catalonia, Barcelona 08017, Spain
6
IDIBELL-Bellvitge Biomedical Research Institute, Hospitalet de Llobregat, Barcelona 08908, Spain
*
Author to whom correspondence should be addressed.
Received: 6 May 2014 / Revised: 11 July 2014 / Accepted: 11 July 2014 / Published: 6 August 2014
(This article belongs to the Special Issue Molecular Research in Urology 2014)
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Abstract

The aim of this study was to analyze the relationship between statin use along with serum cholesterol levels and prostate cancer (PCa) detection and aggressiveness. Statin users of three years or more and serum cholesterol levels (SC) were assessed in 2408 men scheduled for prostate biopsy. SC was classified as normal (NSC: <200 mg/dL) or high (HSC: >200 mg/dL). High-grade PCa (HGPCa) was considered if the Gleason score was greater than 7. Statin users comprised 30.9% of those studied. The PCa detection rate was 31.2% of men on statins and 37% of non-statin users (p < 0.006). The PCa detection rate was 26.3% in men with NSC and 40.6% in those with HSC (p < 0.001). In the subset of NSC men, the PCa rate was 26.5% for statin users and 26.2% for non-users (p = 0.939), while in men with HSC, the PCa rate was 36.4% for statin users and 42.0% for non-statin users (p = 0.063). The HGPCa rate was 41.8% for statin users and 32.5% for non-users (p = 0.012). NSC men had a 53.8% rate of HGPCa, while the rate was only 27.6% in HSC men (p < 0.001). NSC men on statins had an HGPCa rate of 70.2%, while non-statin users had a rate of 41.2% (p < 0.001). The HGPCa rate for HSC men on statins was 18.8%, while the rate was 30.0% (p = 0.011) for non-users. Logistic regression analysis suggested that serum cholesterol levels could serve as an independent predictor of PCa risk, OR 1.87 (95% CI 1.56–2.24) and HGPCa risk, OR 0.31 (95% CI 0.23–0.44), while statin usage could not. Statin treatment may prevent PCa detection through serum cholesterol-mediated mechanisms. A disturbing increase in the HGPCa rate was observed in statin users who normalized their serum cholesterol. View Full-Text
Keywords: statins; cholesterol; prostate cancer risk; prostate cancer aggressiveness statins; cholesterol; prostate cancer risk; prostate cancer aggressiveness
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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MDPI and ACS Style

Morote, J.; Celma, A.; Planas, J.; Placer, J.; de Torres, I.; Olivan, M.; Carles, J.; Reventós, J.; Doll, A. Role of Serum Cholesterol and Statin Use in the Risk of Prostate Cancer Detection and Tumor Aggressiveness. Int. J. Mol. Sci. 2014, 15, 13615-13623.

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