Untangling the association between prostate-specific antigen and diabetes: a systematic review and meta-analysis

Bernal-Soriano, Mari Carmen; Lumbreras, Blanca; Hernández-Aguado, Ildefonso; Pastor-Valero, María; López-Garrigós, Maite; Parker, Lucy

doi:10.1515/cclm-2020-0145

Cited by 10 publications

(6 citation statements)

References 43 publications

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“…9 There is also a lower PCa detection rate among individuals with DM2, which could be due to the association between DM2 and increased body fat mass with reduced androgen levels, which could lead to lower PSA levels in serum because the testosterone level controls the production of PSA. 6,14,15 This inverse association between DM and PCa is apparently not related to the age of the DM patient or the time elapsed since its diagnosis. 2…”

Section: Pathophysiology and Relationship Between Prostate Cancer And...mentioning

confidence: 88%

Diabetes and prostate cancer, an ambiguous relationship between two pathologies of high worldwide prevalence

Maraschio,

De Bonis,

Buso

et al. 2023

UNOAJ

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Patients with diabetes mellitus (DM) have a lower risk of developing Prostate Cancer (PCa). This apparent "protection" is mainly due to a deficit in the insulin signal and a state of hypogonadism associated with insulin resistance (IR), which would bring about a decrease in available testosterone levels. On the other hand, the concomitance of DM in patients with PCa leads to higher morbidity and mortality, even in tumor stages with a good prognosis, in the context of a lower response rate to cancer treatments and a higher frequency of tumor recurrence. Glycemic control directly affects these prognostic factors, since an adequate clinical-nutritional approach is mandatory in this dual relationship pathology.

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Section: Pathophysiology and Relationship Between Prostate Cancer And...mentioning

confidence: 88%

Diabetes and prostate cancer, an ambiguous relationship between two pathologies of high worldwide prevalence

Maraschio,

De Bonis,

Buso

et al. 2023

UNOAJ

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“…Fukui et al [ 20 ] found that serum PSA levels were 10-16% lower in diabetic men than in healthy Japanese men, excluding the age group of 40-49 years. Bernal-Soriano et al [ 21 ] also concluded in a meta-analysis that diabetic men showed lower PSA levels than non-diabetics.…”

Section: Discussionmentioning

confidence: 99%

Poor Glycemic Control Affecting Screening of Prostate Carcinoma

Bharti,

Shekhar,

Prakash

et al. 2024

Cureus

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Introduction Diabetes and cancer are commonly linked together. The possible links include insulin resistance, hyperinsulinemia, hyperglycemia, oxidative stress, and chronic inflammation. These are factors that have potential promoting effects on the progression of cancer in many ways. Measurement of prostate-specific antigen (PSA) is widely applied for early detection of prostate cancer. However, several factors influence serum PSA levels in men including age, benign prostatic hyperplasia, prostatitis, and body mass index (BMI). The risk of several malignancies is increased in diabetes but the risk of prostate carcinoma in diabetic patients is reduced secondary to lowering of testosterone levels during the state of hyperinsulinemia. A negative association between serum PSA levels and metformin use is also an explanation of low cancer prostate incidence with diabetes. Objective The study aims to evaluate the PSA levels in diabetic patients with poor glycemic control i.e., glycated hemoglobin (HbA1c) ≥ 7%) vs good glycemic control (HbA1c < 7%). Materials and methods Samples of PSA in diabetic patients collected in the Department of Biochemistry at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, were included. The observational study was carried out on clinically diagnosed 318 cases of diabetes attending both the outpatient and inpatient Department, IGIMS, Patna. Six ml venous blood samples were collected from patients after obtaining informed consent and ethical clearance. Patient details regarding age, complete clinical details, and general physical examinations were recorded. Serum levels of PSA, fasting plasma glucose (FPG) and HbA1c were analyzed and values were compared. The serum level of PSA was estimated by the chemiluminescent immunoassay (CLIA) method on an automated immunoassay analyzer in the Department of Biochemistry, maintaining all the quality control precautions using a control, calibrator, and reagent kit. HbA1c estimation was by chromatography technique. Fasting plasma glucose was estimated using the hexokinase method on an automated chemistry analyzer. Statistical analyses were performed using SPSS software, version 16.0 (SPSS Inc., Chicago). The median and interquartile range were calculated for numerical variables. Covariance analysis was used in the comparisons among groups. The Mann-Whitney U test was applied to detect the comparison between the two groups. Significance was determined by the P value. P value<0.05 was considered significant. Result Serum PSA value was found to be higher in (the good glycemic control group) with a median of 0.99 with an interquartile range of 3.14, than in (the bad glycemic control group) with a median of 0.49 with an interquartile range of 3.9, and the difference is statistically significant. The difference is also statistically significant in the subgroup (i) with PSA value <4 ng/ml. In subgroups (ii) and (iii), PSA values 4 ng/ml-8 ng/ml and PSA values ...

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“…Inci et al [205] reported decreased levels of PSA in patients with liver cirrhosis in relation to reduced prostate volume in these patients and also lower testosterone and protein levels. Patients with diabetes presented lower PSA levels than healthy subjects [206], while an inverse correlation was observed with body mass index, with lower PSA concentrations in obese patients [207]. Patients with heart disease or those undergoing cardiac surgery may present increased PSA levels [208].…”

Section: Prostate-specific Antigen (Psa)mentioning

confidence: 95%

Factors influencing blood tumor marker concentrations in the absence of neoplasia

Trapé,

Fernández-Galán,

Auge

et al. 2024

TUB

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BACKGROUND: Tumor markers (TMs) are a heterogeneous group of molecules used in the diagnosis, prognosis and follow-up of cancer patients. During neoplastic differentiation, cells can either directly synthesize or induce the synthesis of TMs, and the release of these molecules into the bloodstream allows their quantification in biological fluids. Although very small concentrations of TMs are usually present in the serum or plasma of healthy subjects, increased concentrations may also be found in the presence of benign diseases or due to technical interference, producing false positive results. MATERIAL AND METHODS AND RESULTS: Our review analyses the causes of false positives described between January 1970 to February 2023 for the TMs most frequently used in clinical practice: α-fetoprotein (AFP), β2-microglobulin (β2-M), cancer antigen 15-3 (CA 15-3), cancer antigen CA 19-9 (CA 19-9), cancer antigen CA 72-4 (CA 72-4), cancer antigen 125 (CA 125), carcinoembryonic antigen (CEA), chromogranin A (CgA), choriogonadotropin (hCG), cytokeratin 19 fragment (CYFRA 21-1), neuron-specific enolase (NSE), human epididymis protein 4 (HE4), serum HER2 (sHER2), squamous cell carcinoma antigen (SCCA), protein induced by vitamin K absence-II (PIVKA-II), Pro-gastrin-releasing peptide (Pro-GRP), prostate-specific antigen (PSA), Protein S-100 (S-100) and thyroglobulin (Tg). A total of 247 references were included. CONCLUSIONS: A better understanding of pathophysiological processes and other conditions that affect the concentration of TMs might improve the interpretation of results and their clinical application.

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Untangling the association between prostate-specific antigen and diabetes: a systematic review and meta-analysis

Cited by 10 publications

References 43 publications

Diabetes and prostate cancer, an ambiguous relationship between two pathologies of high worldwide prevalence

Diabetes and prostate cancer, an ambiguous relationship between two pathologies of high worldwide prevalence

Poor Glycemic Control Affecting Screening of Prostate Carcinoma

Factors influencing blood tumor marker concentrations in the absence of neoplasia

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