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Systematic Review

Could Reducing Body Fatness Reduce the Risk of Aggressive Prostate Cancer via the Insulin Signalling Pathway? A Systematic Review of the Mechanistic Pathway

1
Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
2
Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, UK
3
IGF & Metabolic Endocrinology Group, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS10 5NB, UK
*
Author to whom correspondence should be addressed.
These authors contributed equally.
These authors contributed equally.
Academic Editor: Anna Floegel
Metabolites 2021, 11(11), 726; https://doi.org/10.3390/metabo11110726
Received: 24 September 2021 / Revised: 18 October 2021 / Accepted: 19 October 2021 / Published: 23 October 2021
(This article belongs to the Special Issue Metabolomics Meets Epidemiology)
Excess body weight is thought to increase the risk of aggressive prostate cancer (PCa), although the biological mechanism is currently unclear. Body fatness is positively associated with a diminished cellular response to insulin and biomarkers of insulin signalling have been positively associated with PCa risk. We carried out a two-pronged systematic review of (a) the effect of reducing body fatness on insulin biomarker levels and (b) the effect of insulin biomarkers on PCa risk, to determine whether a reduction in body fatness could reduce PCa risk via effects on the insulin signalling pathway. We identified seven eligible randomised controlled trials of interventions designed to reduce body fatness which measured insulin biomarkers as an outcome, and six eligible prospective observational studies of insulin biomarkers and PCa risk. We found some evidence that a reduction in body fatness improved insulin sensitivity although our confidence in this evidence was low based on GRADE (Grading of Recommendations, Assessment, Development and Evaluations). We were unable to reach any conclusions on the effect of insulin sensitivity on PCa risk from the few studies included in our systematic review. A reduction in body fatness may reduce PCa risk via insulin signalling, but more high-quality evidence is needed before any conclusions can be reached regarding PCa. View Full-Text
Keywords: body fatness; prostate cancer; biomarker; insulin; insulin signalling; mechanisms; systematic review body fatness; prostate cancer; biomarker; insulin; insulin signalling; mechanisms; systematic review
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MDPI and ACS Style

James, R.; Dimopoulou, O.; Martin, R.M.; Perks, C.M.; Kelly, C.; Mathias, L.; Brugger, S.; Higgins, J.P.T.; Lewis, S.J. Could Reducing Body Fatness Reduce the Risk of Aggressive Prostate Cancer via the Insulin Signalling Pathway? A Systematic Review of the Mechanistic Pathway. Metabolites 2021, 11, 726. https://doi.org/10.3390/metabo11110726

AMA Style

James R, Dimopoulou O, Martin RM, Perks CM, Kelly C, Mathias L, Brugger S, Higgins JPT, Lewis SJ. Could Reducing Body Fatness Reduce the Risk of Aggressive Prostate Cancer via the Insulin Signalling Pathway? A Systematic Review of the Mechanistic Pathway. Metabolites. 2021; 11(11):726. https://doi.org/10.3390/metabo11110726

Chicago/Turabian Style

James, Rachel, Olympia Dimopoulou, Richard M. Martin, Claire M. Perks, Claire Kelly, Louise Mathias, Stefan Brugger, Julian P.T. Higgins, and Sarah J. Lewis 2021. "Could Reducing Body Fatness Reduce the Risk of Aggressive Prostate Cancer via the Insulin Signalling Pathway? A Systematic Review of the Mechanistic Pathway" Metabolites 11, no. 11: 726. https://doi.org/10.3390/metabo11110726

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