Horm Metab Res 2003; 35(5): 296-300
DOI: 10.1055/s-2003-41305
Original Clinical
© Georg Thieme Verlag Stuttgart · New York

Metabolic Profile in Patients with Benign Prostate Hyperplasia or Prostate Cancer and Normal Glucose Tolerance

P.  F.  Zamboni1 , M.  Simone2 , A.  Passaro1 , E.  Doh  Dalla Nora1 , R.  Fellin1 , A.  Solini3
  • 1 Section of Internal Medicine II, University of Ferrara
  • 2 Division of Urology, Arcispedale S. Anna Ferrara
  • 3 Department of Internal Medicine, University of Pisa, Italy
Further Information

Publication History

Received 25 July 2002

Accepted after Revision 8 November 2002

Publication Date:
13 August 2003 (online)

Abstract

Familial predisposition together with several environmental factors may be involved in the pathogenesis of common prostate disease such as benign hypertrophy or prostate neoplasm. A higher incidence of both these conditions has been described in some insulin-resistant states such as obesity, but not much information is available on the effect of metabolic profile on gland morphology. The aim of this study was to evaluate the relation between glucose and lipid pattern and prostate diameters in two groups of non-diabetic individuals with benign prostate hypertrophy or cancer. 109 patients were recruited; plasma glucose, lipids and hormonal profile as well as an ultrasonographic evaluation of the gland volume and diameters were determined. Patients with prostate cancer had significantly higher levels of insulin and were more insulin resistant; in contrast, in subjects with prostate hypertrophy, fasting plasma glucose and - to a lesser extent - serum triglycerides emerged as the main determinants of gland volume. These observations may indicate that an improvement of insulin sensitivity and strategies to maintain a strict glucose and lipid control even in non-diabetic subjects are useful objectives in the prevention of prostate diseases.

References

  • 1 Borre M, Nerstrom B, Overgaard J. The natural history of prostate carcinoma based on a Danish population treated with no intent to cure.  Cancer. 1997;  80 917-928
  • 2 Parkin D M, Pisani P, Ferlay J. Global cancer statistics.  CA Cancr J Clin. 1999;  49 33-64
  • 3 Hekman P. Genetic and environmental factors in prostate cancer genesis: identifying high-risk cohorts.  Eur Urol. 1999;  35 362-369
  • 4 Gao J, Arnold J T, Isaacs J T. Conversion from a paracrine to an autocrine mechanism of androgen-stimulated growth during malignant transformation of prostatic epithelial cells.  Cancer Res. 2001;  61 5038-5044
  • 5 Asamoto M, Hokaiwado N, Cho Y M, Takahashi S, Ikeda Y, Imaida K, Shirai T. Prostate carcinomas developing in transgenic rats with SV40 T antigen expression under probasin promoter control are strictly androgen dependent.  Cancer Res. 2001;  61 4693-4700
  • 6 Nomura A M, Kolonel L N. Prostate cancer: a current perspective.  Epidemiol Rev. 1991;  13 200-207
  • 7 Sciarra F, Toscano V. Role of estrogens in human benign prostatic hyperplasia.  Arch Androl. 2000;  44 213-222
  • 8 Muir C S, Nectoux J, Staszewski J. The epidemiology of prostatic cancer: geographical distribution and time trends.  Acta Oncol. 1991;  30 133-140
  • 9 Chan J M, Stampfer M J, Giovannucci E, Gann P H, Ma J, Wilkinson P, Hennekens C H, Pollak M. Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study.  Science. 1998;  279 563-566
  • 10 Pollak M. Insulin-like growth factors and prostate cancer.  Epidemiol Rev. 2001;  23 59-66
  • 11 Putnam S D, Cerhan J R, Parker A S, Bianchi G D, Wallace R B, Cantor K P, Lynch C F. In white men obesity is a risk factor for more clinically significant prostate cancer.  Ann Epidemiol. 2000;  10 361-369
  • 12 Hsing A W, Deng J, Sesterhenn I A, Mostofi F K, Stanczyk F Z, Benichou J, Xie T, Gao Y T. Body size and prostate cancer: a population-based case-control study in China.  Cancer Epidemiol Biomarkers Prev. 2000;  9 1335-1341
  • 13 Will J C, Vinicor F, Calle E E. Is diabetes mellitus associated with prostate cancer incidence and survival?.  Epidemiology. 1999;  10 313-318
  • 14 Gapstur S M, Gann P H, Colangelo L A, Barron-Simpson R, Kopp P, Dyer A, Liu K. Postload plasma glucose concentration and 27-year prostate cancer mortality (United States).  Cancer Causes Control. 2001;  12 763-772
  • 15 Meigs J B, Mohr B, Barry M J, Collins M M, Mc Kinlay J B. Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men.  J Clin Epidemiol. 2001;  54 935-944
  • 16 Lee E, Park M S, Shin C, Lee H, Yoo K, Kim Y, Shin Y, Paik H Y, Lee C. A high-risk group for prostatism: a population-based epidemiological study in Korea.  Br J Urol. 1997;  79 736-741
  • 17 Matthews D R, Hosker J P, Rudenski A S, Naylor B A, Treacher D F, Turner R C. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.  Diabetologia. 1985;  28 412-419
  • 18 Collins G N, Raab G M, Hehir M, King B, Garraway W M. Reproducibility and observer variability of transrectal ultrasound measurements of prostatic volume.  Ultrasound Med Biol. 1995;  21 1101-1105
  • 19 Bourke J B, Chir B, Griffin J P. Hypertension, diabetes and blood groups in benign prostatic hypertrophy.  Br J Urol. 1966;  38 18-23
  • 20 Hammarsten J, Hogstedt B. Hyperinsulinemia as a risk factor for developing benign prostatic hyperplasia.  Eur Urol. 2001;  39 151-158
  • 21 Giovannucci E, Rimm E B, Stampfer M J, Colditz G A, Willett W C. Diabetes mellitus and risk of prostate cancer.  Cancer Causes Control. 1998;  9 3-9
  • 22 Moore M A, Park C B, Tsuda H. Implications of the hyperinsulinaemia-diabetes-cancer link for preventive efforts.  Eur J Cancer Prev. 1998;  7 89-107
  • 23 Nakamura J, Kasuya Y, Hamada Y, Nakashima E, Naruse K, Yasuda Y, Kato K, Hotta N. Glucose-induced hyperproliferation of cultured rat aortic smooth muscle cells through polyol pathway hyperactivity.  Diabetologia. 2001;  44 480-487
  • 24 Singh G, Lakkis C L, Laucirica R, Epner D E. Regulation of prostate cancer cell division by glucose.  J Cell Physiol. 1999;  180 431-438
  • 25 Tymchuk C N, Barnard R J, Hebr D, Aronson W J. Evidence of an inhibitory effect of diet and exercise on prostate cancer cell growth.  J Urol. 2001;  166 1185-1189
  • 26 Cohen P. Serum insulin-like growth factor-I levels and prostate cancer risk: interpreting the evidence.  J Natl Cancer Inst. 1998;  90 876-879
  • 27 Iwamura M, Sluss P M, Casamento J B, Cockett A T. Insulin like growth factor I: action and receptor characterization in human prostate cancer cell lines.  Prostate. 1993;  22 243-252
  • 28 Leherer S, Diamond E J, Stagger S, Stone N N, Stock R G. Increased serum insulin associated with increased risk of prostate cancer recurrence.  Prostate. 2002;  50 1-3
  • 29 Shaneyfelt T, Husein R, Bubley G, Mantzoros C S. Hormonal predictor of prostate cancer: a meta-analysis.  J Clin Oncol. 2000;  18 847-853
  • 30 Haffner S M. Sex hormone-binding protein, hyperinsulinemia, insulin resistance and non insulin dependent diabetes.  Horm Res. 1996;  45 233-237
  • 31 Pasquali R, Casimirri F, De Iasio R, Mesini P, Boschi S, Chierici R, Flamia R, Biscotti M, Vicennati V. Insulin regulates testosterone and sex-hormone-binding globulin concentrations in adult normal-weight and obese men.  J Clin Endocrinol Metab. 1995;  80 654-658
  • 32 Loukovaara M, Carson M, Adlercreutz H. Regulation of production and secretion of sex hormone-binding globulin in HepG2 cell cultures by hormones and growth factors.  J Clin Endocrinol Metab. 1995;  80 160-164
  • 33 Hammarsten J, Hogstedt B. Clinical, anthropometric, metabolic and insulin profile of men with fast annual growth rates of benign prostatic hyperplasia.  Blood Press. 1999;  8 29-36
  • 34 Kirby R S. Clinical pharmacology of alpha1-adrenoceptor antagonists.  Eur Urol. 1999;  36 48-53
  • 35 Dickerman R D, McConathy W J, Zachariah N Y. Testosterone, sex-hormone-binding globulin, lipoproteins, and vascular disease risk.  J Cardiovasc Risk. 1997;  4 363-366
  • 36 Hislop M S, StClair Gibson A, Lambert M I, Noakes T D, Marais A D. Effect of androgen manipulation on postprandial triglyceridemia, low-density lipoprotein particle size and lipoprotein(a) in men.  Atherosclerosis. 2001;  59 425-432
  • 37 Bhasin S, Woodhouse L, Casaburi R, Singh A B, Bhasin D, Berman N, Chen X, Yarasheski K E, Magliano L, Dzekov C, Dzekov J, Bross R, Phillips J, Sinha-Hikim I, Shen R, Storer T W. Testosterone dose-response relationships in healthy young men.  Am J Physiol. 2001;  28 E1172-E1181
  • 38 Pugeat M, Moulin P, Cousin P, Fimbel S, Nicolas M H, Crave J C, Lejeune H. Interrelations between sex hormone-binding globulin (SHBG), plasma lipoproteins and cardiovascular risk.  J Steroid Biochem Mol Biol. 1995;  53 567-572
  • 39 Goodman-Gruen D, Barrett-Connor E. Sex differences in the association of endogenous sex hormone levels and glucose tolerance status in older men and women.  Diabetes Care. 2000;  23 912-918
  • 40 Oh J Y, Barrett-Connor E, Wedick N M, Wingard D L. Endogenous sex hormones and the development of type 2 diabetes in older men and women: the Rancho Bernardo study.  Diabetes Care. 2002;  25 55-60
  • 41 Satariano W A, Ragland K E, van den Eeen S K. Causes of death in men diagnosed with prostate carcinoma.  Cancer. 1998;  83 1180-1188

A. Solini, M.D. 

Department of Internal Medicine University of Pisa · Section of Internal Medicine III ·

Via Roma 67 · 56100 Pisa

Phone: +39(050)993482

Fax: +39(050)553235

Email: a.solini@int.med.unipi.it

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