title: Polymorphisms of Genes Involved in Glucose and Energy Metabolic Pathways and Prostate Cancer: Interplay with Metformin.
abstract: BACKGROUND
  Energy metabolism is important in cancer proliferation and progression, but its role in prostate cancer (PCa) remains unclear.
  
  
  OBJECTIVE
  We explored whether single-nucleotide polymorphisms (SNPs) of genes involved in energy metabolic pathways are associated with PCa risk and prognosis, and whether antidiabetic treatment modifies any such association.
  
  
  METHODS
  The PRACTICAL Consortium genotyped 397 SNPs among 3241 screened participants (including 801 PCa cases) in the Finnish Prostate Cancer Screening Trial and 1983 hospital-based PCa cases. Information on medication use was obtained from a national prescription database.
  
  
  METHODS
  Genetic risk scores were calculated in terms of SNPs associated with PCa incidence or survival at a significance level of p < 5×10(-3). Hazard ratios for PCa and disease-specific death were calculated via Cox regression modelling. The predictive value of the genetic risk score was evaluated using receiver operating characteristic and Harrell's c-index analyses.
  
  
  CONCLUSIONS
  A total of 30 SNPs were associated with PCa risk and ten SNPs with survival. The genetic risk score was consistently associated with PCa survival. The risk association was non-significantly weaker in metformin users. The genetic risk score did not improve prediction of PCa risk, but slightly improved the ability to predict PCa survival when added to conventional predictors (c-index improved from 87.4 to 87.9; p<0.001). A limitation is that information on diabetes apart from medication use was unavailable for the study population.
  
  
  CONCLUSIONS
  SNPs of genes involved in energy metabolic pathways are associated with PCa survival. This suggests an important role of glucose metabolism in PCa progression, which could point to new avenues for prevention of PCa death.
  
  
  RESULTS
  Genetic changes in glucose and energy metabolic pathways are associated with a higher risk of high-risk prostate cancer and adverse outcomes.
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland; Department of Urology, Tampere University Hospital, Tampere, Finland. Electronic address: teemu.murtola@uta.fi.
authors.forename: Teemu J
authors.initials: TJ
authors.lastname: Murtola
authors.affiliation: Institute of Biosciences and Medical Technology / BioMediTech and Fimlab Laboratories, University of Tampere, Tampere, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Wahlfors
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Haring
authors.affiliation: Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Kimmo
authors.initials: K
authors.lastname: Taari
authors.affiliation: Department of Clinical Chemistry, University of Helsinki, Helsinki, Finland.
authors.forename: Ulf-Håkan
authors.initials: UH
authors.lastname: Stenman
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland; Department of Urology, Tampere University Hospital, Tampere, Finland.
authors.forename: Teuvo L J
authors.initials: TL
authors.lastname: Tammela
authors.affiliation: Institute of Biosciences and Medical Technology / BioMediTech and Fimlab Laboratories, University of Tampere, Tampere, Finland; Institute of Biomedicine, Medical Biochemistry and Genetics, University of Turku, Turku, Finland.
authors.forename: Johanna
authors.initials: J
authors.lastname: Schleutker
authors.affiliation: School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Anssi
authors.initials: A
authors.lastname: Auvinen
mesh_terms: D004734:Energy Metabolism / Q000187:drug effects* / Q000235:genetics*; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D008297:Male; D008687:Metformin / Q000494:pharmacology*; D020641:Polymorphism, Single Nucleotide / Q000187:drug effects*; D011471:Prostatic Neoplasms / Q000235:genetics* / Q000378:metabolism*; D012189:Retrospective Studies; D012306:Risk
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin; D005947:Glucose
keywords: Glucose metabolism; Prostate cancer; Risk; Survival