title: Linking pre-diabetes with benign prostate hyperplasia. IGFBP-3: a conductor of benign prostate hyperplasia development orchestra?
abstract: Benign prostatic hyperplasia (BPH) represents a pattern of non-malignant growth of prostatic fibromuscular stroma. Metabolic disturbances such us pre-diabetes and metabolic syndrome may have a role in BPH pathophysiology. A potential explanation for the above relationship involves the insulin-like growth factor (IGF) axis as well as IGF binding proteins, (IGFBPs) of which the most abundant form is IGFBP-3. Therefore, the aim of the present study was to investigate the association between intra-prostatic levels of IGF-1, IGF-2 as well as to evaluate the role of locally expressed IGFBP-3 in BPH development in pre-diabetes. A total of 49 patients admitted to the Urology department of a tertiary urban Greek hospital, for transurethral prostate resection, or prostatectomy and with pre-diabetes [impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) or both] were finally included. The majority of the sample consisted of subjects with IGT (51.0%), followed by IFG and IGT (32.7%) and isolated IFG (16.3%). For all participants a clinical examination was performed and blood samples were collected. In addition, total prostate (TP) volume or transitional zone (TZ) volume were estimated by transrectal ultrasonography. The results of the multivariate analysis regarding TP volume showed that higher PSA (p<0.001), larger waist circumference (p=0.007) and higher IGFBP-3 expression levels (p<0.001) independently predicted higher TP volume. The results regarding the volume of the TZ showed that higher PSA (p<0.001), larger waist circumference (p<0.001) and higher IGFBP-3 expression levels (p=0.024) were independently associated with higher TZ volume. Our findings show that intra-prostatic levels of IGFBP-3, PSA and waist circumference, but not overall obesity, are positively associated with prostate volume. IGFBP-3 seems to be a multifunctional protein, which can potentiate or inhibit IGF activity.
authors.affiliation: Diabetes Center, Tzanio General Hospital of Piraeus, Piraeus, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Protopsaltis
authors.affiliation: Department of Urology, Asklipieio General Hospital, Voula, Greece.
authors.forename: Achilles
authors.initials: A
authors.lastname: Ploumidis
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National University of Athens, Athens, Greece.
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Sergentanis
authors.affiliation: Department of Molecular Pathology and Genetics, Locus Medicus Laboratory, Athens, Greece.
authors.forename: Padelis
authors.initials: P
authors.lastname: Constantoulakis
authors.affiliation: Diabetes Center, Tzanio General Hospital of Piraeus, Piraeus, Greece.
authors.forename: Kostantinos
authors.initials: K
authors.lastname: Tzirogiannis
authors.affiliation: Department of Molecular Pathology and Genetics, Locus Medicus Laboratory, Athens, Greece.
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Kyprianidou
authors.affiliation: 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Ag. Panteleimon", Piraeus, Greece.
authors.forename: Athanasia K
authors.initials: AK
authors.lastname: Papazafiropoulou
authors.affiliation: Diabetes Center, Tzanio General Hospital of Piraeus, Piraeus, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Melidonis
authors.affiliation: Department of Urology, Asklipieio General Hospital, Voula, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Delakas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011236:Prediabetic State / Q000378:metabolism*; D011470:Prostatic Hyperplasia / Q000378:metabolism* / Q000503:physiopathology; D060888:Real-Time Polymerase Chain Reaction; D055105:Waist Circumference / Q000502:physiology
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3