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Prediagnostic markers of insulin resistance and prostate cancer risk and death: a pooled study
Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Department of Translational Medicine, Lund University, Malmö, Sweden; Institute of Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, Austria.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0001-6808-4405
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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2023 (English)In: Cancer Medicine, E-ISSN 2045-7634, Vol. 12, no 12, p. 13732-13744Article in journal (Refereed) Published
Abstract [en]

Background: Insulin resistance has been shown to be related to a higher risk of several cancers, but the association with prostate cancer (PCa) has been inconsistent.

Methods: We investigated prediagnostic markers of insulin resistance in men in four cohorts in Sweden, in relation to PCa risk (total, non-aggressive and aggressive) and PCa death using multivariable-adjusted Cox regression. The number of men, PCa cases and PCa deaths was up to 66,668, 3940 and 473 for plasma glucose and the triglyceride-glucose (TyG) index, and up to 3898, 586 and 102 for plasma insulin, glycated haemoglobin (HbA1c) and leptin.

Results: Higher HbA1c was related to a lower risk of non-aggressive PCa but no significant associations were found for insulin resistance markers with the risk of aggressive or total PCa. In PCa cases, higher glucose and TyG index were related to a higher risk of PCa death (hazard ratio [HR] per higher standard deviation, 1.22, 95% CI 1.00–1.49 and 1.24, 95% CI 1.00–1.55), which further increased when restricting the analyses to glucose and TyG index measures taken <10 years before the PCa diagnosis (HR, 1.70, 95% CI 1.09–2.70 and 1.66, 95% CI 1.12–2.51). No associations were observed for other markers in relation to PCa death.

Conclusions: The results of this study showed no associations of insulin resistance markers with the risk of clinically relevant PCa, but higher glucose and TyG index were associated with poorer survival from PCa. The lack of association for other insulin resistance markers may be due to their smaller sample size.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 12, no 12, p. 13732-13744
Keywords [en]
insulin resistance, prospective studies, prostatic neoplasms
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-208261DOI: 10.1002/cam4.6004ISI: 000979235300001PubMedID: 37102250Scopus ID: 2-s2.0-85156191845OAI: oai:DiVA.org:umu-208261DiVA, id: diva2:1758251
Funder
Swedish Cancer Society, 2017/475Swedish Cancer Society, 2017/1019Swedish Cancer Society, 201,033 PjFSwedish Research Council, 2018-02825Swedish Research Council, 2017‐00650The Crafoord Foundation, 20200546ProstatacancerförbundetAvailable from: 2023-05-22 Created: 2023-05-22 Last updated: 2024-01-17Bibliographically approved

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Häggström, Christel

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