The association of diabetes and positive prostate biopsy in a US veteran population

Abstract

BACKGROUND:Several studies have shown a protective effect of diabetes mellitus (DM) on incidence of prostate cancer; however, the data are not consistent. Moreover, whether or not DM is associated with a positive result among patients referred for prostate biopsy due to abnormal PSA and/or abnormal digital rectal examination is not clear. METHODS:A retrospective review of 3162 consecutive men who underwent prostate biopsy between January 2000 and July 2009 at the Atlanta Veterans Affairs Medical Center was performed. Men with positive and negative biopsies were compared for various demographic and clinical factors. The data were analyzed using logistic regression models with results expressed as adjusted odds ratios (ORs) with corresponding 95% confidence intervals (CI).RESULTS: DM was associated with increased odds of positive biopsy in the overall cohort (OR 1.26, 95% CI: 1.01-1.55; P ¼ 0.04). Subjects with DM had higher odds of more aggressive disease (Gleason X7) than those without the condition (OR 1.31, 95% CI: 0.98-1.74; P ¼ 0.07). Race had no significant impact on these results. CONCLUSIONS:In this large series of prostate biopsies, diabetes is associated with higher odds of positive biopsy and higher Gleason grade. More studies investigating the role of DM and its associated comorbidities in prostate carcinogenesis are needed.

Exendin-4, a GLP-1 Receptor Agonist, Attenuates Prostate Cancer Growth

“…Although numerous types of cancer have been recognized to be associated with diabetes and metabolic syndrome (14), the association of diabetes and metabolic syndrome with prostate cancer remains controversial (15)(16)(17)(18)(19). Indeed, diabetes has been associated with both advanced prostate cancer and prostate cancer mortality, but not with the total phenomena caused by prostate cancer.…”

“…After 0, 24, 48, 72, and 96 h, the cells were harvested, and cell proliferation was analyzed by cell counting using a hemocytometer. Control (nontreated), black circles with solid line; Ex-4 (10 nmol/L), black squares with dotted line; PKI [14][15][16][17][18][19][20][21][22] (10 mmol/L), white circles with solid line; Ex-4 (10 nmol/L) + PKI [14][15][16][17][18][19][20][21][22] (10 mmol/L), white squares with dotted line. One-way ANOVA was performed to calculate statistical significance: **P < 0.01 vs. control.…”

“…3), suggesting that GLP-1R is functionally intact and responsive to Ex-4 in LNCap cells. Furthermore, the antiproliferative effect of Ex-4 was canceled by the PKA inhibitor PKI [14][15][16][17][18][19][20][21][22] (Fig. 4D) and forskolin-inhibited LNCap cell proliferation (Supplementary Fig.…”

“…Unpaired t tests were performed to calculate statistical significance: *P < 0.05 vs. 0 min, **P < 0.01 vs. 0 min. D: LNCap cells were maintained in media supplemented with 10% FBS with or without 10 nmol/L Ex-4 or 10 mmol/L PKI [14][15][16][17][18][19][20][21][22] . After 0, 24, 48, 72, and 96 h, the cells were harvested, and cell proliferation was analyzed by cell counting using a hemocytometer.…”

GLP-1 receptor agonist as treatment for cancer as well as diabetes: beyond blood glucose control

“…Among the cancers on which the effects of GLP-1 activity have not been examined, we focused on prostate cancer and examined the anti-prostate cancer effect of GLP-1 action using the GLP-1 receptor agonist exendin-4 [55]. While numerous types of cancer are associated with diabetes and metabolic syndrome [57], the association between diabetes, metabolic syndrome, and prostate cancer remains controversial [58][59][60][61][62]. Given that the incidence of prostate cancer seems to be reduced in patients with diabetes owing to reduced testosterone caused by insulin deficiency [63], patients with obesity, insulin resistance, and hyperinsulinemia may have a higher risk of prostate cancer.…”