In Prostate Cancer Journal it is
reported[1]:
Obesity and hypertension were each associated with an
increased risk for BCR of prostate cancer after RP, independent of age at
diagnosis and tumor pathological features. Given the increasing rates of
obesity, hypertension and prostate cancer, a better understanding of the
relationship between these entities is of significant public health importance.
Elucidation of the involved pathogenic mechanisms will be needed to establish
causality.
They conclude:
The pathogenic mechanisms potentially linking obesity and
other components of the MetS to prostate carcinogenesis are poorly understood.
The central derangement of MetS—a defect in insulinstimulated glucose uptake
with secondary hyperinsulinemia—may in fact be present in patients with
prostate cancer. Hyperinsulinemic men
have been shown to have higher circulating levels of insulin-like growth factor
1 (IGF-1), a putative prostate cancer mitogen.36 IGF-1 has a role in cellular proliferation and apoptosis reduction;
thus, increased bioavailability of IGF-1 may be relevant to prostate cancer
incidence and aggressiveness, though data demonstrating causality is lacking. …
Thus, obesity and MetS likely affect prostate
carcinogenesis via a complex interaction between altered androgen metabolism,
insulin resistance, and chronic inflammation. Further study is needed to
clarify these pathways.
Now at the same time in JAMA we have an article which states[2]:
Relative to normal weight, both
obesity (all grades) and grades 2 and 3 obesity were associated with
significantly higher all-cause mortality. Grade 1 obesity overall was not
associated with higher mortality, and overweight was associated with
significantly lower all-cause mortality. The use of predefined standard BMI
groupings can facilitate between-study comparisons.
Thus despite the objections related to personal attacks by
certain politicians, the facts are undeniable; they are put at risk by their
behavior. If they were using illicit substances, abusing alcohol, or even engaging
in highly risky sports, we would be concerned. They are public figures, namely
they have personally agreed to put themselves out to the public for
examination. Further they are on the public expense; we will pick up the tab
for their excesses. Thus they have an affirmative duty to respect the public
purse.
Perhaps the seven deadly sins are deadly because they lead
more swiftly to than end. Politicians have a duty to present a positive image,
albeit that all too often they fail. Yet on this point they generally do not
yell at those recognizing their failures, failures which are personally selected
and which continue.
References:
1. Asmar. R., et al, Hypertension, obesity and prostate cancer
biochemical recurrence after radical prostatectomy, Prostate Cancer and
Prostatic Disease (2013) 16, 61–65.
2. Flegal, K., et al, Association of All-Cause Mortality With
Overweight and Obesity Using Standard Body Mass Index Categories A Systematic
Review and Meta-analysis, January
2, 2013, Vol 309, No. 1
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