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

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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.

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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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Authors and Affiliations

  1. Division of Urologic Surgery, Department of Surgery and the Duke Prostate Center, Duke University School of Medicine, Durham, NC, USA

    Daniel M. Moreira, Tiffany Anderson, Leah Gerber, Jean-Alfred Thomas, Lionel L. Bañez, Madeline G. McKeever, Jayakrishnan Jayachandran & Stephen J. Freedland

  2. Urology Section, Veterans Affairs Medical Center Durham, Durham, NC, USA

    Daniel M. Moreira, Leah Gerber, Jean-Alfred Thomas, Lionel L. Bañez, Madeline G. McKeever, Jayakrishnan Jayachandran & Stephen J. Freedland

  3. Department of Pathology, Duke University School of Medicine, Durham, NC, USA

    Stephen J. Freedland

  4. Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA

    Cathrine Hoyo

  5. JLC-Biomedical/Biotechnology Research Institute, Cancer Research Program, North Carolina Central University, Durham, NC, USA

    Delores Grant

  6. Division of Urology, DUMC, Duke University School of Medicine, Box 2626, Durham, NC, 27710, USA

    Daniel M. Moreira

Authors
  1. Daniel M. Moreira
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  2. Tiffany Anderson
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  3. Leah Gerber
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  4. Jean-Alfred Thomas
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  6. Madeline G. McKeever
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  7. Cathrine Hoyo
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  9. Jayakrishnan Jayachandran
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Corresponding author

Correspondence to Daniel M. Moreira.

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Views and opinions of, and endorsements by the author(s) do not reflect those of the US Army or the Department of Defense.

Jayakrishnan Jayachandran: Deceased.

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Moreira, D.M., Anderson, T., Gerber, L. et al. The association of diabetes mellitus and high-grade prostate cancer in a multiethnic biopsy series. Cancer Causes Control 22, 977–983 (2011). https://doi.org/10.1007/s10552-011-9770-3

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  • DOI: https://doi.org/10.1007/s10552-011-9770-3

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