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Hyperglycemia, Classified with Multiple Biomarkers Simultaneously in Men without Diabetes, and Risk of Fatal Prostate Cancer.

TitleHyperglycemia, Classified with Multiple Biomarkers Simultaneously in Men without Diabetes, and Risk of Fatal Prostate Cancer.
Publication TypeJournal Article
Year of Publication2019
AuthorsMarrone MT, Selvin E, Barber JR, Platz EA
Secondary AuthorsJoshu CE
JournalCancer Prev Res (Phila)
Volume12
Issue2
Pagination103-112
Date Published2019 02
ISSN1940-6215
KeywordsBiomarkers, Blood Glucose, Case-Control Studies, Diabetes Mellitus, Follow-Up Studies, Humans, Hyperglycemia, Incidence, Male, Maryland, Middle Aged, Prognosis, Prospective Studies, Prostatic Neoplasms, Survival Rate
Abstract

The association between hyperglycemia and prostate cancer risk is inconsistent, and its association with prostate cancer mortality is understudied. Thus, we investigated the association between hyperglycemia and prostate cancer risk and mortality using multiple biomarkers simultaneously to classify hyper- and normoglycemia. We conducted a prospective analysis of 5,162 cancer-free men attending visit 2 (1990-1992) of the Atherosclerosis Risk in Communities (ARIC) study followed for total ( = 671) and lethal ( = 69) prostate cancer incidence and prostate cancer mortality ( = 64) through 2012. Men without diagnosed diabetes were classified as normo- or hyperglycemic using joint categories of fasting glucose, glycated hemoglobin, and glycated albumin (or fructosamine) defined by clinical or research cutpoints. We evaluated the multivariable-adjusted association of hyperglycemia with prostate cancer incidence and mortality using Cox proportional hazards regression; men with diagnosed diabetes were included as a separate exposure category. Among 4,753 men without diagnosed diabetes, 61.5% were classified as having hyperglycemia (high on ≥1 biomarker). HbA1c and glycated albumin together classified 61.9% of 1,736 men with normal fasting glucose as normoglycemic. Compared with men who were normal on all three biomarkers, men who were high on ≥1 biomarker had an increased risk of lethal [HR, 2.50; 95% confidence interval (CI), 1.12-5.58] and fatal (HR, 3.20; 95% CI, 1.26-8.48) disease, but not total prostate cancer incidence (HR, 0.98; 95% CI, 0.81-1.20); associations were similar including fructosamine instead of glycated albumin. Our findings indicate hyperglycemia is associated with an increased risk of lethal and fatal prostate cancer, but not total prostate cancer incidence.

DOI10.1158/1940-6207.CAPR-18-0216
Alternate JournalCancer Prev Res (Phila)
PubMed ID30538098
PubMed Central IDPMC6365210
Grant ListP30 CA006973 / CA / NCI NIH HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
K24 DK106414 / DK / NIDDK NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
U01 CA164975 / CA / NCI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
T32 CA009314 / CA / NCI NIH HHS / United States