title: Association between metabolic syndrome, diabetes mellitus and prostate cancer risk.
abstract: BACKGROUND
  The worldwide incidence of diabetes mellitus is rapidly increasing. There is recent interest in the influence of glucose metabolism on oncogenesis. We investigated the role of diabetes mellitus and the metabolic syndrome (MS) on prostate cancer development.
  
  
  METHODS
  This study consisted of 11 541 men with coronary heart disease screened to participate in a secondary cardiac prevention trial. MS was defined according to modified NCEP/ATP III criteria. Multivariable regression analysis accounting for competing risks was performed using a modified Cox proportional hazard model in order to assess the association between diabetes, the MS and the subsequent development of prostate cancer.
  
  
  RESULTS
  At baseline, subjects were classified into one of the four groups: (1) 6119 (53%) with neither diabetic mellitus nor MS, (2) 3376 (29%) with the MS but without diabetes, (3) 560 (5%) with diabetes mellitus but without MS and (4) 1486 (13%) with both conditions. Median follow-up was 12.7 years (range 0-15.7 years). During follow-up, 459 new cases of prostate cancer were recorded. The age-adjusted hazard ratio (HR) for prostate cancer was reduced in diabetic patients compared with those without diabetes, 0.54 and 95% confidence interval of 0.40-0.73. No significant association was noted between the presence of MS and prostate cancer development. On multivariate analysis, diabetes mellitus continued to protect against the development of prostate cancer, this was more pronounced in the absence of MS (HR=0.43, P=0.01 for diabetes in the absence of MS; HR=0.64, P=0.08 in the presence of MS).
  
  
  CONCLUSIONS
  The results of this study indicate an inverse association between type 2 diabetes mellitus and prostate cancer risk.
authors: Department of Oncology, Institute of Oncology, Sheba Medical Center, Ramat Gan, Israel. yaacovla@gmail.com
authors: Y R
authors: YR
authors: Lawrence
authors: O
authors: O
authors: Morag
authors: M
authors: M
authors: Benderly
authors: V
authors: V
authors: Boyko
authors: I
authors: I
authors: Novikov
authors: A P
authors: AP
authors: Dicker
authors: U
authors: U
authors: Goldbourt
authors: S
authors: S
authors: Behar
authors: M
authors: M
authors: Barchana
authors: I
authors: I
authors: Wolf
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000150:complications* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D016032:Randomized Controlled Trials as Topic; D012306:Risk