Drawing data from 25 cohort studies involving over 974,000 men, the researchers systematically evaluated the relationship between major cardiometabolic conditions—including diabetes, dyslipidemia, obesity, and hypertension—and the development of aggressive prostate cancer, defined as locally advanced (T3–T4, Grade Group 4–5), node-positive, or metastatic disease. The team used a random-effects model following PRISMA guidelines to estimate hazard ratios (HRs) and confidence intervals across multiple studies.
Key Findings:
- The analysis identified clear associations between metabolic disorders and the risk of aggressive prostate cancer.
- Men with diabetes had an 18% higher risk of developing aggressive prostate cancer (HR 1.18).
- Those with obesity showed a 15% increased risk (HR 1.15).
- Participants with hypertension had a 7% higher risk of aggressive disease (HR 1.07).
- Dyslipidemia did not demonstrate any significant association with prostate cancer aggressiveness (HR 1.03).
These findings suggest that metabolic imbalances—particularly related to glucose regulation, weight, and blood pressure—may play a role in tumor progression and biological behavior.
The researchers noted that diabetes, obesity, and hypertension are modifiable conditions, meaning tighter metabolic control and preventive measures could help reduce prostate cancer burden. “Our findings reinforce the importance of lifestyle modification, weight management, and optimal cardiometabolic care as part of prostate cancer prevention strategies,” the authors explained.
While the meta-analysis provides compelling evidence, the study also had limitations. Considerable heterogeneity among included studies and variations in defining or measuring metabolic conditions may have influenced the outcomes. Furthermore, since the study design was observational, causality cannot be established. Future prospective and mechanistic studies are needed to confirm whether these metabolic disorders directly contribute to cancer progression or serve as markers of overall poor health.
The researchers emphasized that if these associations are indeed causal, they could open new avenues for collaborative management between oncologists and primary care physicians. Integrating metabolic screening and control into prostate cancer care could help identify high-risk men earlier and potentially reduce aggressive disease incidence through lifestyle interventions, metabolic optimization, and vigilant surveillance for disease progression.
"Overall, the large-scale analysis highlights that cardiometabolic health is intricately tied to cancer outcomes. Addressing obesity, diabetes, and hypertension may not only improve cardiovascular well-being but could also serve as a preventive measure against aggressive prostate cancer," the authors concluded.
Reference:
Amirmokri, A.J., Loffredo, C.A., Makambi, K.H. et al. Assessing the relationship between cardiometabolic diseases and the risk of developing aggressive prostate cancer: a systematic review and meta-analysis. BMC Cancer 25, 1645 (2025). https://doi.org/10.1186/s12885-025-14809-2
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