Androgens, diabetes and prostate cancer

Grossmann, Mathis; Wittert, Gary

doi:10.1530/erc-12-0067

Cited by 72 publications

(81 citation statements)

References 101 publications

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“…Yet, multiple population-based studies have failed to show an association of circulating testosterone, dihydrotestosterone (DHT) or other sex steroids with PCa risk. 14,15 The Endogenous Hormones and Prostate Cancer Collaborative Group reviewed 18 prospective studies and failed to demonstrate an association between endogenous testosterone and PCa risk. Also, testosterone levels did not correlate to PCa aggressiveness.…”

Section: Discussionmentioning

confidence: 99%

Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer

Albuquerque

Guglielmetti

Barbosa³

et al. 2017

Rev. Assoc. Med. Bras.

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Objective: To evaluate the relation between serum total testosterone (TT) and prostate cancer (PCa) grade and the effect of race and demographic characteristics on such association. Method: We analyzed 695 patients undergoing radical prostatectomy (RP), of whom 423 had serum TT collected. Patients were classified as having hypogonadism or eugonadism based on two thresholds of testosterone: threshold 1 (300 ng/dL) and threshold 2 (250 ng/dL). We evaluated the relation between TT levels and a Gleason score (GS) ≥ 7 in RP specimens. Outcomes were evaluated using univariate and multivariate analyses, accounting for race and other demographic predictors. Results: Out of 423 patients, 37.8% had hypogonadism based on the threshold 1 and 23.9% based on the threshold 2. Patients with hypogonadism, in both thresholds, had a higher chance of GS ≥ 7 (OR 1.79, p=0.02 and OR 2.08, p=0.012, respectively). In the multivariate analysis, adjusted for age, TT, body mass index (BMI) and race, low TT (p=0.023) and age (p=0.002) were found to be independent risk factors for GS ≥ 7. Among Black individuals, low serum TT was a stronger predictor of high-grade disease compared to White men (p=0.02). Conclusion: Hypogonadism is independently associated to higher GS in localized PCa. The effect of this association is significantly more pronounced among Black men and could partly explain aggressive characteristics of PCa found in this race.

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Section: Discussionmentioning

confidence: 99%

Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer

Albuquerque

Guglielmetti

Barbosa³

et al. 2017

Rev. Assoc. Med. Bras.

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“…Current, albeit limited and preliminary data have not shown evidence that testosterone causes prostate cancer, or that it makes subclinical prostate cancer grow (Grossmann & Wittert 2012). However, it has been estimated that an RCT of 6000 men treated with testosterone or placebo for 3 years is necessary to detect a 30% increase in prostate cancer risk with testosterone therapy (Cunningham & Toma 2011).…”

Section: Testosterone Therapy: Potential Risksmentioning

confidence: 99%

Testosterone and glucose metabolism in men: current concepts and controversies

Grossmann¹

2013

Journal of Endocrinology

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A wealth of observational studies show that low testosterone is associated with insulin resistance and with an increased risk of diabetes and the metabolic syndrome. Experimental studies have identified potential mechanisms by which low testosterone may lead to insulin resistance. Visceral adipose tissue is an important intermediate in this relationship. Actions of testosterone or its metabolite oestradiol on other tissues such as muscle, liver, bone or the brain, and body composition-independent effects may also play a role. However, definitive evidence from randomised controlled trials (RCTs) to clarify whether the association of low testosterone with disordered glucose metabolism is causative is currently lacking. It therefore remains possible that this association is due to reverse causation, or simply originates by association with common health and lifestyle factors. RCTs of testosterone therapy in men with or without diabetes consistently show modest metabolically favourable changes in body composition. Despite this, testosterone effects on glucose metabolism have been inconsistent. Recent evidence suggests that the hypothalamic-pituitary-testicular axis suppression in the majority of obese men with metabolic disorders is functional, and may be, at least in part, reversible with weight loss. Until further evidence is available, lifestyle measures with emphasis on weight reduction, treatment of comorbidities and optimisation of diabetic control should remain the first-line treatment in these men. Such measures, if successful, may be sufficient to normalise testosterone levels in men with metabolic disorders, who typically have only modest reductions in circulating testosterone levels.

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“…It increases sensitivity of the insulin receptor [17], reduces insulin resistance and hyperinsulinemia, with favourably influence on the metabolic syndrome [18] and diabetes [19] in humans. Obesity promotes prostate cancer [20] which has been related to hyperinsulinemia and insulin resistance [2,[21][22][23]. Momordica extract exerts chemo-protective effect against prostate cancer cells in vitro [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Impaired insulin sensitivity is frequent during statin treatment [1]. Hyperinsulinemia has been associated with prostate- [2] and breast cancer [3,4], and with nonalcoholic fatty liver disease.…”

Section: Introductionmentioning

confidence: 99%

Treating Hyperinsulinemia with Momordica charantia

2015

J Metabolic Synd

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Objectives: To assess the efficacy of a novel nutraceutical mainly containing the extract of bitter gourd (Momordica charantia) and α-lipoic acid for the treatment of patients with hyperinsulinemia. Methods:Pilot prospective open-label cohort trial including 11 patients with hyperinsulinemia due to insulin resistance. The concentrations of insulin, C-peptide, glucose, haemoglobin A1c, total cholesterol, triglycerids, gamma-glutamyltransferase, and C-reactive protein were measured in blood take between 3 and 4 hours after dinner. Results:One and 4 months after initiation of treatment there was a significant decrease of the concentrations of Insulin (to average 25% of initial value), C-peptide (to average 44% of initial value), glucose, hemoglobin A1c and gamma-glutamyl transpeptidase.Clinical significance: Treatment of patients with hyperinsulinemia, with or without diabetes or metabolic syndrome, using a novel nutraceutical containing Momordica charantia and α-lipoic acid dramatically reduced insulin resistance and may have improved non-alcoholic fatty liver disease.

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Androgens, diabetes and prostate cancer

Cited by 72 publications

References 101 publications

Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer

Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer

Testosterone and glucose metabolism in men: current concepts and controversies

Treating Hyperinsulinemia with Momordica charantia

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