2157 THE ASSOCIATION OF DIABETES MELLITUS AND HIGH-GRADE PROSTATE CANCER IN A MULTIETHNIC BIOPSY SERIES

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening V1 Apr 20102157 THE ASSOCIATION OF DIABETES MELLITUS AND HIGH-GRADE PROSTATE CANCER IN A MULTIETHNIC BIOPSY SERIES Daniel Moreira, Tiffany Anderson, Leah Gerber, Jean-Alfred Thomas, Madeline McKeever, Lionel Banez, Jayakrishnan Jayachandran, and Stephen Freedland Daniel MoreiraDaniel Moreira More articles by this author , Tiffany AndersonTiffany Anderson More articles by this author , Leah GerberLeah Gerber More articles by this author , Jean-Alfred ThomasJean-Alfred Thomas More articles by this author , Madeline McKeeverMadeline McKeever More articles by this author , Lionel BanezLionel Banez More articles by this author , Jayakrishnan JayachandranJayakrishnan Jayachandran More articles by this author , and Stephen FreedlandStephen Freedland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2259AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Diabetes mellitus (DM) and prostate cancer are major public health problems. The association between these two common entities has been the subject of much investigation. Previously, we found diabetes at the time of radical prostatectomy was associated with worse outcomes for white-obese men, but better outcomes among black men and non-obese white men. The association of DM with prostate cancer grade has only been evaluated in a limited number of studies that showed mixed results. We analyzed the association between history of DM with risk of prostate cancer and cancer grade among men undergoing prostate biopsy and analyzed how obesity and race modify these associations. METHODS Retrospective analysis of 1,031 subjects from the Durham VA undergoing first prostate biopsy between 1994 and 2008 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 prostate cancer and cancer grade (<7 vs. >7) were done with logistic regression adjusting for preoperative PSA, body mass index (BMI), race, age, year of biopsy and digital rectal exam. RESULTS At the time of biopsy, 290 (28%) men had DM. History of DM was associated with black race (P=0.006) and higher BMI (P<0.001). Diabetes was not associated with prostate cancer risk on either univariate (P=0.682) or multivariate analysis (P=0.596). Similar results were found after stratification by race and obesity. In multivariable analysis, DM was significantly associated with greater risk of high-grade disease (RR=2.15, 95%CI=1.14-4.07, P=0.018). The association was stronger among obese men (RR=3.76, 95%CI=1.30-10.92, P=0.015) and null in non-obese subjects (RR=1.34, 95%CI=0.57-3.17, P=0.498). After further stratification by race, DM was associated with high-grade disease only in obese white men (RR=4.82, 95%CI=1.17-19.9, P=0.029) but not in obese black men (RR=2.83, 95%CI=0.54-14.9, P=0.218). DM was not associated with risk of low-grade disease in all men (RR=1.01, 95%CI=0.75-1.38, P=0.902) or after stratification by obesity or race. CONCLUSIONS Among men undergoing prostate biopsy, history of DM was significantly associated with greater risk of high-grade disease. The association was strongest among obese white subjects suggesting the effect of DM on high-grade prostate cancer is modified by race and obesity, which is in agreement with our previous study of DM and biochemical recurrence after radical prostatectomy. Durham, NC© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e839 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Moreira More articles by this author Tiffany Anderson More articles by this author Leah Gerber More articles by this author Jean-Alfred Thomas More articles by this author Madeline McKeever More articles by this author Lionel Banez More articles by this author Jayakrishnan Jayachandran More articles by this author Stephen Freedland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...