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Mineral metabolism abnormalities in patients with prostate cancer: a systematic case controlled study

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Abstract

Purpose

Prostate cancer is the most common tumor in men. To the best of our knowledge a systematic assessment of bone and mineral abnormalities has not been performed in prostatic cancer patients consecutively enrolled.

Methods

This study was therefore carried out to investigate changes of skeletal and mineral metabolism in patients with prostate cancer (n  = 69). A population of patients with cancer of various origin was also investigated as a control group (n  = 53), since a comparison with non-prostate cancer patients has not been previously reported.

Results

In the prostatic cancer group, one patient had extremely high values of C-terminal Fibroblast Growth Factor 23, low values of tubular reabsorption of phosphate and very high values of bone alkaline phosphatase, suggesting the diagnosis of oncogenic osteomalacia. We found nine patients with primary hyperparathyroidism in the group of prostate cancer vs. only one in cancer patients group (p  <  0.026). We stratified the population on the basis of Gleason score, prostate specific antigen and hormonal therapy. Using a generalized linear model with a logit link to predict the probability of developing primary hyperparathyroidism, only Gleason score, C-terminal fibroblast growth factor 23 and hormonal therapy had a significant effect (p  < 0.05). Controlling for other covariates, a rise in fibroblast growth factor 23 increases the odds of developing primary hyperparathyroidism by 2% (p  = 0.017), while patients with higher values of Gleason score have a much greater probability of developing primary hyperparathyroidism (log-odds  =  3.6, p  <  0.01). The probability decreases with higher values of Gleason score while on hormonal therapy; a further decrease was observed in patients on hormonal treatment and lower values of GS. Finally, lower grade of Gleason score without hormonal therapy have a significant protective factor (p  <  0.01) decreasing the odds of developing primary hyperparathyroidism by 8%.

Conclusion

We showed a remarkable prevalence of primary hyperparathyroidism in men with prostate cancer; the multivariate analysis demonstrates that higher aggressiveness of prostate cancer, as determined by Gleason score, is a significant predictor of increased risk of developing primary hyperparathyroidism.

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Funding

This work was supported by public fund (“Sapienza” Rome University, Bando Ricerca Scientifica, 2015).

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Author notes

    Authors and Affiliations

    1. Department of Gynecology-Obstetrics & Urology, Sapienza University of Rome, Rome, Italy

      Francesco Minisola, Alessandro Sciarra & Magnus Von Heland

    2. Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy

      Cristiana Cipriani, Luciano Colangelo, Mirella Cilli, Salvatore Minisola & Jessica Pepe

    3. Faculty of Economics, UNINT University, Via delle Sette Chiese 139, 00147, Rome, Italy

      Luciano Nieddu

    4. Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy

      Emanuela Anastasi

    5. Department of Pediatrics and Infantile Neuropsychiatry, Sapienza University of Rome, Rome, Italy

      Roberto Pascone

    6. Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Rome, Italy

      Daniele Diacinti & Flavia Longo

    Authors
    1. Francesco Minisola
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    2. Cristiana Cipriani
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    13. Salvatore Minisola
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    Corresponding author

    Correspondence to Salvatore Minisola.

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    Conflict of interest

    The authors declare that they have no competing interests.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all individual participants included in this study.

    Additional information

    Francesco Minisola and Cristiana Cipriani contributed equally to this work.

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    Minisola, F., Cipriani, C., Colangelo, L. et al. Mineral metabolism abnormalities in patients with prostate cancer: a systematic case controlled study. Endocrine 59, 338–343 (2018). https://doi.org/10.1007/s12020-017-1351-0

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    • DOI: https://doi.org/10.1007/s12020-017-1351-0

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