Cancer Causes & Control

, 22:977 | Cite as

The association of diabetes mellitus and high-grade prostate cancer in a multiethnic biopsy series

  • Daniel M. Moreira
  • Tiffany Anderson
  • Leah Gerber
  • Jean-Alfred Thomas
  • Lionel L. Bañez
  • Madeline G. McKeever
  • Cathrine Hoyo
  • Delores Grant
  • Jayakrishnan Jayachandran
  • Stephen J. Freedland
Original paper

Abstract

Objective

To analyze the association of diabetes mellitus (DM) with risk of prostate cancer and cancer grade among men undergoing prostate biopsy and to analyze how obesity and race modify these associations.

Materials and methods

Retrospective analysis of 998 men from the Durham VA undergoing first prostate biopsy between 2001 and 2009 with complete data available. History of DM was determined by chart review. Patients’ characteristics at biopsy were analyzed with chi-square and ranksum. Multivariable analyses of DM and risk of cancer and cancer grade were done using logistic regression adjusting for PSA, body mass index, race, age, year, and digital rectal exam.

Results

At biopsy, 284 (28%) men had DM. DM was associated with African American (AAM; p = 0.010) and higher BMI (p < 0.001). DM was not associated with prostate cancer risk on either bivariate (p = 0.600) or multivariate analysis (p = 0.485). Similar results were found after stratification by race and obesity. In multivariable analysis, DM was associated with greater risk of high-grade disease (RR = 2.13, p = 0.024). The association was stronger among obese men (RR = 3.84, p = 0.020) and null in non-obese subjects (RR = 1.39, p = 0.460). After further stratification by race, DM was associated with high-grade disease only in obese Caucasian men (CM; RR = 5.81, p = 0.025) but not in obese AAM. DM was not associated with risk of low-grade disease in all men together or after stratification by obesity or race.

Conclusion

History of DM was associated with greater risk of high-grade disease. The association was strongest among obese CM suggesting the effect of DM on high-grade prostate cancer is modified by race and obesity.

Keywords

Prostatic neoplasm Prostate-specific antigen Diabetes Mellitus Incidence Epidemiology Case–control studies Obesity Population groups Ethnic groups Continental population groups Male 

Notes

Acknowledgments

This study is supported by Department of Defense, Prostate Cancer Research Program (DMM, LLB, SJF), and the American Urological Association Foundation/Astellas Rising Star in Urology Award (SJF).

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Copyright information

© Springer Science+Business Media B.V. (outside the USA) 2011

Authors and Affiliations

  • Daniel M. Moreira
    • 1
    • 2
    • 6
  • Tiffany Anderson
    • 1
  • Leah Gerber
    • 1
    • 2
  • Jean-Alfred Thomas
    • 1
    • 2
  • Lionel L. Bañez
    • 1
    • 2
  • Madeline G. McKeever
    • 1
    • 2
  • Cathrine Hoyo
    • 4
  • Delores Grant
    • 5
  • Jayakrishnan Jayachandran
    • 1
    • 2
  • Stephen J. Freedland
    • 1
    • 2
    • 3
  1. 1.Division of Urologic Surgery, Department of Surgery and the Duke Prostate CenterDuke University School of MedicineDurhamUSA
  2. 2.Urology Section, Veterans Affairs Medical Center DurhamDurhamUSA
  3. 3.Department of PathologyDuke University School of MedicineDurhamUSA
  4. 4.Department of Community and Family MedicineDuke University Medical CenterDurhamUSA
  5. 5.JLC-Biomedical/Biotechnology Research Institute, Cancer Research ProgramNorth Carolina Central UniversityDurhamUSA
  6. 6.Division of UrologyDUMC, Duke University School of MedicineDurhamUSA

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