title: Elevated insulin and reduced insulin like growth factor binding protein-3/prostate specific antigen ratio with increase in prostate size in Benign Prostatic Hyperplasia.
abstract: BACKGROUND
  Insulin and insulin like growth factor-1 (IGF-1) have growth promoting effects, while insulin like growth factor binding protein-3 (IGFBP-3) has growth inhibitory effects. The present study was designed to assess the concentrations of insulin, IGF-1, IGFBP-3 and their association with prostate size in patients with BPH.
  
  
  METHODS
  Ninety 90 BPH cases and 90 controls were enrolled in the study. Insulin, IGF-1, IGFBP-3, PSA, testosterone and estradiol were estimated in both the groups.
  
  
  RESULTS
  Insulin, IGF-1 and estradiol were increased and IGFBP-3/PSA was decreased in BPH cases when compared with controls. Insulin (r=0.64, p=0.001) and IGF-1 (r=0.22, p=0.03) were positively correlated and IGFBP-3/PSA (r=-0.316, p=0.002) were negatively correlated with prostate size in BPH. Multivariate analysis showed that insulin (p=0.001) and IGFBP-3/PSA (p=0.004) predicts the prostate size in patients with BPH. Insulin was increased and IGFBP-3/PSA was reduced in BPH patients with increased prostate size. At a cutoff concentration of 527.52, IGFBP-3/PSA ratio was found to differentiate benign growth of prostate from normal prostate with 96% sensitivity and 96% specificity.
  
  
  CONCLUSIONS
  Insulin is elevated and IGFBP-3/PSA is reduced with increase prostate size in BPH cases.
authors.affiliation: Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Karli
authors.initials: K
authors.lastname: Sreenivasulu
authors.affiliation: Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. Electronic address: nandeesha.h@jipmer.edu.in.
authors.forename: Hanumanthappa
authors.initials: H
authors.lastname: Nandeesha
authors.affiliation: Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Lalgudi Narayanan
authors.initials: LN
authors.lastname: Dorairajan
authors.affiliation: Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Medha
authors.initials: M
authors.lastname: Rajappa
authors.affiliation: Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Vickneshwaran
authors.initials: V
authors.lastname: Vinayagam
mesh_terms: D006801:Humans; D007328:Insulin / Q000097:blood*; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000473:pathology*
chemical_list: C515497:IGFBP3 protein, human; D007328:Insulin; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I; D017430:Prostate-Specific Antigen
keywords: Benign Prostatic Hyperplasia; Estradiol; Insulin; Insulin like growth factor; Insulin like growth factor binding protein; Prostate specific antigen; Testosterone