Associations between metabolic obesity phenotypes and prostate cancer in the U.S. population: a cross-sectional study.

Background: Metabolic obesity phenotypes have been identified as predictive factors for various cancers. This study aimed to investigate the association between metabolic obesity phenotypes and prostate cancer (PCa) among the U.S. population aged ≥50 years. Methods: This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey 1999-2018. Participants were categorized into four groups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). Weighted multivariable logistic regression was used to identify groups with a higher prevalence of PCa, and subgroup analyses were conducted based on age. Results: The median age of the participants was 64 years. No significant differences in PCa prevalence were found between the obese and non-obese groups (P=0.33). In the younger population (50 to 64 years old), metabolic abnormalities such as hyperglycemia (P=0.004) and hypertension (P<0.001) was strongly correlated with an increased PCa prevalence. Individuals with MUNO [odds ratio (OR) =3.179; 95% confidence interval (CI): 1.449-6.974] and those with MUO (OR =4.345; 95% CI: 2.076-9.093) were significantly associated with higher PCa prevalence. No significant differences in PCa prevalence were found between the MHNO and MHO groups, or between the MUNO and MUO groups. In the older population (age ≥65 years), no association was found between metabolic obesity phenotypes and PCa prevalence. Conclusions: Metabolic abnormalities play a more critical role than obesity alone in determining PCa prevalence, particularly among individuals aged 50 to 64 years old.