Abstract
BackgroundWe evaluated the association between serum levels of insulin‐like growth factor‐1 (IGF‐1), bioavailable testosterone, and surgical Gleason score (GS).MethodsWe analyzed 793 patients who underwent radical prostatectomy and 272 men with negative prostate biopsy. Serum levels of IGF‐1 and testosterone were measured before surgery or biopsy.ResultsThe mean IGF‐1 levels of prostate cancer patients and men with a negative biopsy were 143.8 and 118.9 ng/mL, respectively (P < 0.001). Men with high serum IGF‐1 were more likely to have prostate cancer (highest vs lowest quartile, odds ratio [OR] = 3.35; P trend < 0.001). However, among men with prostate cancer, the mean IGF‐1 levels of those with low (GS ≤ 6), intermediate (GS = 7), and high surgical GS (GS ≥8) were 151.7, 144.1, and 132.9 ng/mL, respectively (P < 0.001). Using quartile analysis, high serum IGF‐1 levels were shown to be associated with a low risk of high surgical GS (OR = 0.464; P trend = 0.006). Serum bioavailable testosterone concentration was positively correlated with serum IGF‐1 level (r = 0.157, P < 0.001). High bioavailable testosterone level was also associated with a low risk of high surgical GS in patients without diabetes mellitus (OR = 0.569; P trend = 0.040). Among men with biopsy GS ≤ 3 + 4 (n = 460), upgrading to high surgical GS was more frequent in patients with low IGF‐1 level (≤116.0 ng/mL; 9.9%) or low bioavailable testosterone level (≤0.85 ng/mL; 9.3%) than in patients with normal IGF‐1 and bioavailable testosterone levels (2.6%; P = 0.004).ConclusionsSerum levels of IGF‐1 and bioavailable testosterone show inverse associations with high surgical GS. This suggests that high‐grade prostate cancer develops independently of these two substances.
Highlights
Serum insulin-like growth factors (IGFs) have mitogenic and anti-apoptotic effects on normal and transformed prostatic epithelial cells.[1,2,3] Of these, ike growth factor-1 (IGF-1) mainly originates in the liver and shows low inter-individual variability in its circulating levels.[4]
The relationship between serum IGF-1 level and prostate cancer is of interest, because previous studies have suggested that aspects of energy metabolism and balance are associated with the incidence of prostate cancer,[6] and the effect of environmental factors on prostate cancer risk may be mediated by differences in the concentrations of substances including testosterone and prostate-specific antigen (PSA).[7]
We assessed the relationships among the serum levels of IGF-1, testosterone, and bioavailable testosterone, and the Gleason score (GS), in radical prostatectomy (RP) specimens, using samples collected from RP cohorts, in which the serum IGF-1 and other hormone levels were prospectively measured
Summary
Serum insulin-like growth factors (IGFs) have mitogenic and anti-apoptotic effects on normal and transformed prostatic epithelial cells.[1,2,3] Of these, IGF-1 mainly originates in the liver and shows low inter-individual variability in its circulating levels.[4]. We hypothesized that low IGF-1 levels might be associated with high-grade disease, because IGF-1 induces prostate cancer development via the androgen axis or has similar effects to testosterone. To test this hypothesis, we assessed the relationships among the serum levels of IGF-1, testosterone, and bioavailable testosterone, and the Gleason score (GS), in radical prostatectomy (RP) specimens, using samples collected from RP cohorts, in which the serum IGF-1 and other hormone levels were prospectively measured
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