In contrast, several studies have shown that obesity is associated with an increased risk of PCa and poor prognosis, which can be explained by elevated levels of se-rum adipokines such as IL-6, leptin, TNF-α, CCL7, CXCL12, CXCL-1, VEGF, MCP-1, in-creased MMP-9 activity, and altered metabolism of sex hormones in obese individuals 13, 15, 73. This evidence concerns the gene MMP9 and posterior cortical atrophy.