A141: Hyperglycaemia is associated with intermediate and high grade prostate cancer among Swedish men

Rhonda Arthur1,Henrik Møller1,Hans Garmo1,Lars Holmberg1,Niklas Hammar2,Göran Walldius2,Ingmar Jungner2,Håkan Malmström2,Mats Lambe3,Mieke Van Hemelrijck1

1King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, UK,2Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden,3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Presenting date: Monday 2 November
Presenting time: 12.20-13.10

Background

Patients with diabetes mellitus have a lower incidence of prostate cancer. It has been hypothesised that this reduction is due to hypoinsulinemia which may play a role in counteracting the potential carcinogenic effects of hyperglycaemia, androgens and Insulin Growth Factor-1 bioactivity. In this prospective study, we aimed to investigate the association between pre-diagnostic serum glucose and prostate cancer grade among Swedish men with prostate cancer.

Method

The study comprised 14768 Swedish men who were diagnosed with prostate cancer between 1996 and 2011. We extracted information on age at diagnosis, educational level, fasting status, serum lipids and serum glucose from the Swedish AMORIS database. Information on Gleason score was retrieved through linkage with the National Prostate Cancer Registry. Our primary outcome was prostate cancer severity which was characterised by low grade (N=7275), intermediate (N=5045) or high grade (N=2448) prostate cancer. Univariate and multivariate logistic regression was used to investigate the association between serum glucose levels (clinical cut-off points) and prostate cancer severity. We also conducted further stratified analyses to assess the differences in association among men <60, 60-69 and ?60 years.

Results

Mean age was 67 years. Hyperglycaemia was positively associated with intermediate (Gleason 7) and high grade (Gleason 8+) prostate cancer (adjusted odds ratio (OR) for ? 5.6mmol/l versus < 5.6mmol/l: 1.17; 95 %CI: 1.04-1.30 and 1.25; 1.09-1.44 respectively). In men aged 60-69 years, hyperglycaemia was positively associated with risk of intermediate and high grade prostate cancer (adjusted odds ratio (OR) for ? 5.6mmol/l vs < 5.6mmol/l: 1.25; 1.07-1.47 and 1.53; 1.23-1.89, respectively), compared to low or normal serum glucose levels.

Conclusion

Our findings suggest that higher serum glucose may influence prostate cancer aggressiveness.