title: Hyperglycemia and prostate cancer recurrence in men treated for localized prostate cancer.
abstract: BACKGROUND
  Obesity is consistently linked with prostate cancer (PCa) recurrence and mortality, though the mechanism is unknown. Impaired glucose regulation, which is common among obese individuals, has been hypothesized as a potential mechanism for PCa tumor growth. In this study, we explore the relationship between serum glucose at time of treatment and risk of PCa recurrence following initial therapy.
  
  
  METHODS
  The study group comprised 1734 men treated with radical prostatectomy (RP) or radiation therapy (RT) for localized PCa between 2001-2010. Serum glucose levels closest to date of diagnosis were determined. PCa recurrence was determined based on PSA progression (nadir PSA+2 for RT; PSA≥0.2 for RP) or secondary therapy. Multivariate Cox regression was performed to determine whether glucose level was associated with biochemical recurrence after adjusting for age, race, body mass index, comorbidity, diagnosis of diabetes, Gleason Sum, PSA, treatment and treatment year.
  
  
  RESULTS
  Recurrence was identified in 16% of men over a mean follow-up period of 41 months (range 1-121 months). Those with elevated glucose (≥100 mg/dl) had a 50% increased risk of recurrence (HR 1.5, 95% CI: 1.1-2.0) compared with those with a normal glucose level (<100 mg/dl). This effect was seen in both those undergoing RP (HR 1.9, 95% CI: 1.0-3.6) and those treated with RT (HR 1.4, 95% CI: 1.0-2.0).
  
  
  CONCLUSIONS
  Glucose levels at the time of PCa diagnosis are an independent predictor of PCa recurrence for men undergoing treatment for localized disease.
authors: Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA. jlwright@uw.edu
authors: J L
authors: JL
authors: Wright
authors: S R
authors: SR
authors: Plymate
authors: M P
authors: MP
authors: Porter
authors: J L
authors: JL
authors: Gore
authors: D W
authors: DW
authors: Lin
authors: E
authors: E
authors: Hu
authors: S B
authors: SB
authors: Zeliadt
mesh_terms: D000368:Aged; D001786:Blood Glucose; D001918:Brachytherapy; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000209:etiology / Q000517:prevention & control; D009765:Obesity / Q000097:blood / Q000150:complications; D016016:Proportional Hazards Models; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000209:etiology / Q000628:therapy; D012306:Risk
chemical_list: D001786:Blood Glucose