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Clinical Chemistry 56: 1-3, 2010. First published November 5, 2009; 10.1373/clinchem.2009.137406
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(Clinical Chemistry. 2010;56:1-3.)
© 2010 American Association for Clinical Chemistry, Inc.

Editorials

Adiponectin and Prostate Cancer Mortality: To Be or Not to Be Skinny?

Stephen J. Freedland1,2,a, Christina D. Williams1,2 and Elizabeth M. Masko1

1 Duke Prostate Center, Duke University, and 2 Durham VA Medical Center, Durham, NC.

aAddress correspondence to this author at: Duke University, DUMC Box 2626, Durham, NC. Fax 919-668-7093; e-mail steve.freedland@duke.edu.

The first 20% of the full text of this article appears below.

Obesity is one of the biggest public health crises of our day. In the United States, 1 in 3 adult men is obese. This rate is staggeringly high compared with obesity rates in other countries—notably those in Asia, where obesity rates are <5%. Obesity is well known to increase the risk for numerous medical problems, such as diabetes, heart disease, and hypertension, and has been linked with the incidence of and the mortality from multiple cancers.

In terms of prostate cancer, the relationship with obesity is complex (1). In the 20 000-foot view, obesity appears to be associated with a slightly decreased risk in the incidence of prostate cancer, but it is also associated with a clear and consistent, albeit modest, increased risk of prostate cancer mortality. Multiple molecular mechanisms have been proposed to explain these observations (2). Ultimately, the contributions from each of these mechanisms remain unclear. Therefore, it is important to continue to investigate the pathways that link obesity with aggressive prostate cancer.

With that goal in mind, Li and coworkers (3) describe in this issue of Clinical Chemistry their investigation of whether prediagnostic concentrations of adipocytokines (leptin or adiponectin) correlated with prostate cancer incidence or disease aggressiveness/mortality. This study used frozen serum samples from nearly 1300 adult male participants nested within the Physicians’ Health Study. The strength of this analysis was the fact that samples were collected before the diagnosis of prostate cancer. The design of this prospective cohort study thus avoids the limitations of case–control studies, in which biomarkers are measured in men already known to have the disease. The problem with the case–control approach is that increased . . . [Full Text of this Article]