title: Diabetes mellitus and prostate cancer risk of different grade or stage: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Prior studies have reported that diabetes mellitus might reduce the overall prostate cancer risk. We examined this association by conducting a detailed meta-analysis of the studies published in peer-reviewed literature on the association between diabetes mellitus and prostate cancer risk of different stage or grade.
  
  
  METHODS
  A comprehensive search for articles of MEDLINE and EMBASE databases and bibliographies of retrieved articles published up to October 23, 2012 was performed. Methodological quality assessment of the trials was based on the Newcastle-Ottawa Scale. Meta-analysis was performed using STATA 12.0.
  
  
  RESULTS
  We included 9 studies in the meta-analysis (5 studies examining the relation of different stage only, 2 studies for grade only, and 2 studies for both grade and stage), and found an inverse association between diabetes mellitus and prostate cancer of different stage or grade. The relative risk (RRs) was moderately stronger for low grade (RR 0.74, 95% confidence interval (CI), 0.64-0.86) and localized disease (RR 0.72, 95% CI 0.67-0.76) compared with high grade (RR 0.78, 95% CI 0.67-0.90) and advanced disease (RR 0.85, 95% CI 0.75-0.97).
  
  
  CONCLUSIONS
  This study suggests an inverse relationship between diabetes mellitus and prostate cancer of different stage or grade. Possible biases underlying this association are discussed.
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, Shanghai, PR China.
authors.forename: Hua
authors.initials: H
authors.lastname: Xu
authors.forename: Hao-wen
authors.initials: HW
authors.lastname: Jiang
authors.forename: Guan-xiong
authors.initials: GX
authors.lastname: Ding
authors.forename: Hu
authors.initials: H
authors.lastname: Zhang
authors.forename: Li-min
authors.initials: LM
authors.lastname: Zhang
authors.forename: Shan-hua
authors.initials: SH
authors.lastname: Mao
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
mesh_terms: D048909:Diabetes Complications / Q000209:etiology*; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000209:etiology* / Q000473:pathology*; D012306:Risk