title: Poor glycemic control of diabetes mellitus is associated with higher risk of prostate cancer detection in a biopsy population.
abstract: OBJECTIVE
  To evaluate the impact of glycemic control of diabetes mellitus (DM) on prostate cancer detection in a biopsy population.
  
  
  METHODS
  We retrospectively reviewed the records of 1,368 men who underwent prostate biopsy at our institution. We divided our biopsy population into three groups according to their history of DM, and their Hemoglobin A1c (HbA1c) level: a no-DM (DM-) group; a good glycemic control (DM+GC) group (HbA1c <6.5%); and a poor glycemic control (DM+PC) group (HbA1c ≥6.5%). For sub-analyses, the DM+PC group was divided into a moderately poor glycemic control (DM+mPC) group (6.5≤ HbA1c <7.5%) and a severely poor glycemic control (DM+sPC) group (HbA1c ≥7.5%).
  
  
  RESULTS
  Among 1,368 men, 338 (24.7%) had a history of DM, and 393 (28.7%) had a positive biopsy. There was a significant difference in prostatic specific antigen density (PSAD) (P = 0.037) and the frequency of abnormal DRE findings (P = 0.031) among three groups. The occurrence rate of overall prostate cancer (P<0.001) and high-grade prostate cancer (P = 0.016) also presented with a significantly difference. In the multivariate analysis, the DM+PC group was significantly associated with a higher rate of overall prostate cancer detection in biopsy subjects compared to the DM- group (OR = 2.313, P = 0.001) but the DM+PC group was not associated with a higher rate of high-grade (Gleason score ≥7) diseases detected during the biopsy (OR = 1.297, P = 0.376). However, in subgroup analysis, DM+sPC group was significantly related to a higher risk of high-grade diseases compared to the DM- group (OR = 2.446, P = 0.048).
  
  
  CONCLUSIONS
  Poor glycemic control of DM was associated with a higher risk of prostate cancer detection, including high-grade disease, in the biopsy population.
authors.affiliation: Department of Urology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, Korea.
authors.forename: Juhyun
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Urology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, Korea.
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Urology, Seoul National University Hospital 101, Daehak-Ro Jongno-gu, Seoul, Korea.
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Urology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, Korea.
authors.forename: Seung Bae
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Urology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, Korea.
authors.forename: Hwancheol
authors.initials: H
authors.lastname: Son
authors.affiliation: Department of Urology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, Korea.
authors.forename: Hyeon
authors.initials: H
authors.lastname: Jeong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D048909:Diabetes Complications / Q000378:metabolism / Q000473:pathology; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000096:biosynthesis*; D012307:Risk Factors
chemical_list: D017430:Prostate-Specific Antigen