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Lin CC, Wu MF, Chang YL, Sheu WHH, Liou WS. Glycemic control was associated with nonprostate cancer and overall mortalities in diabetic patients with prostate cancer. J Chin Med Assoc 2022; 85:331-340. [PMID: 34561410 DOI: 10.1097/jcma.0000000000000623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) can worsen the prognosis or survival in prostate cancer (PC) patients. We investigated whether glycemic control impacts mortality in PC patients with existing diabetes. METHODS All PC patients with or without preexisting DM were enrolled from 2006 to 2017. Mean hemoglobin A1c (HbA1c) values (<7%, 7%-9%, ≥9%) were used to represent glycemic control. Major outcomes included all-cause, PC-specific, and non-PC mortalities. Statistical analyses were performed using Cox regression models with adjusted mean HbA1c and other related confounders. RESULTS A total of 831 PC patients were enrolled (non-DM group, n = 690; DM group with a record of mean HbA1c values, n = 141). Results showed that the DM group with mean HbA1c level ≥ 9% (n = 14) had significantly increased risk for all-cause and non-PC mortality (hazard ratio [HR], 3.09; 95% CIs, 1.15-8.32; p=0.025 and HR, 5.49; 95% CIs, 1.66-18.16; p = 0.005, respectively), but not for PC-specific mortality (HR, 1.03; 95% CIs, 0.13-8.44; p = 0.975), compared with the non-DM group. CONCLUSION Our findings indicate that PC patients with DM who had a mean HbA1c level ≥ 9% had higher risks of all-cause and non-PC mortality compared with non-DM subjects. Further large and long-term studies are needed to verify the effect of glycemic control in PC patients with DM.
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Affiliation(s)
- Chih-Chung Lin
- Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Ming-Fen Wu
- Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Yen-Lin Chang
- Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Wayne Huey-Herng Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- College of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
- Institute of Medical Technology, National Chung Hsing University, Taichung, Taiwan, ROC
- College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Wen-Shyong Liou
- Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- School of Pharmacy, China Medical University, Taichung, Taiwan, ROC
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High aldehyde dehydrogenase 1 activity is related to radiation resistance due to activation of AKT signaling after insulin stimulation in prostate cancer. Biochem Biophys Res Commun 2022; 590:117-124. [PMID: 34974299 DOI: 10.1016/j.bbrc.2021.12.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/20/2021] [Accepted: 12/25/2021] [Indexed: 12/24/2022]
Abstract
The association between type 2 diabetes mellitus and prostate cancer is still under investigation, and the relationship between hyperinsulinemia and prostate cancer stem-like cells (CSCs) is elusive. Here, we investigated the function of insulin/AKT signaling in prostate CSCs. We isolated prostate CSCs as aldehyde dehydrogenase 1-high (ALDH1high) cells from the human prostate cancer 22Rv1 cell line using an ALDEFLUOR assay and established several ALDH1high and ALDH1low clones. ALDH1high clones showed high ALDH1 expression which is a putative CSC marker; however, they showed heterogeneity regarding tumorigenicity and resistance to radiation and chemotherapy. Interestingly, all ALDH1high clones showed lower phosphorylated AKT (Ser473) (pAKT) levels than the ALDH1low clones. PI3K/AKT signaling is a key cell survival pathway and we analyzed radiation resistance under AKT signaling activation by insulin. Insulin increased pAKT levels in ALDH1high and ALDH1low cells; the fold increase rate of pAKT was higher in ALDH1high cells than in ALDH1low cells. Insulin induced resistance to radiation and chemotherapy in ALDH1high cells, and the increased levels of pAKT induced by insulin were significantly related to radiation resistance. These results suggest that ALDH1 suppresses baseline pAKT levels, but AKT can be activated by insulin, leading to treatment resistance.
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Bleach R, Sherlock M, O'Reilly MW, McIlroy M. Growth Hormone/Insulin Growth Factor Axis in Sex Steroid Associated Disorders and Related Cancers. Front Cell Dev Biol 2021; 9:630503. [PMID: 33816477 PMCID: PMC8012538 DOI: 10.3389/fcell.2021.630503] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/11/2021] [Indexed: 12/13/2022] Open
Abstract
To date, almost all solid malignancies have implicated insulin-like growth factor (IGF) signalling as a driver of tumour growth. However, the remarkable level of crosstalk between sex hormones, the IGF-1 receptor (IGF-1R) and its ligands IGF-1 and 2 in endocrine driven cancers is incompletely understood. Similar to the sex steroids, IGF signalling is essential in normal development as well as growth and tissue homoeostasis, and undergoes a steady decline with advancing age and increasing visceral adiposity. Interestingly, IGF-1 has been found to play a compensatory role for both estrogen receptor (ER) and androgen receptor (AR) by augmenting hormonal responses in the absence of, or where low levels of ligand are present. Furthermore, experimental, and epidemiological evidence supports a role for dysregulated IGF signalling in breast and prostate cancers. Insulin-like growth factor binding protein (IGFBP) molecules can regulate the bioavailability of IGF-1 and are frequently expressed in these hormonally regulated tissues. The link between age-related disease and the role of IGF-1 in the process of ageing and longevity has gained much attention over the last few decades, spurring the development of numerous IGF targeted therapies that have, to date, failed to deliver on their therapeutic potential. This review will provide an overview of the sexually dimorphic nature of IGF signalling in humans and how this is impacted by the reduction in sex steroids in mid-life. It will also explore the latest links with metabolic syndromes, hormonal imbalances associated with ageing and targeting of IGF signalling in endocrine-related tumour growth with an emphasis on post-menopausal breast cancer and the impact of the steroidal milieu.
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Affiliation(s)
- Rachel Bleach
- Endocrine Oncology Research Group, Department of Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Mark Sherlock
- Academic Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Dublin, Ireland
| | - Michael W O'Reilly
- Academic Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Dublin, Ireland
| | - Marie McIlroy
- Endocrine Oncology Research Group, Department of Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Harraz AM, Atia N, Ismail A, Abol-Enein H, Abdel-Aziz AF. Serum lipids might improve prostate-specific antigen sensitivity in patients undergoing transrectal ultrasonography-guided biopsy for suspected prostate cancer: A pilot study. Arab J Urol 2019; 17:195-199. [PMID: 31489234 PMCID: PMC6711128 DOI: 10.1080/2090598x.2019.1626126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/17/2019] [Indexed: 11/05/2022] Open
Abstract
Objectives: To investigate the potential use of body mass index (BMI) and serum lipids in improving prostate-specific antigen (PSA) sensitivity in patients undergoing biopsy for suspicion of prostate cancer, as there is an established relationship between metabolic syndrome, obesity and serum lipids with prostate cancer. Patients and methods: A pilot study was conducted in a tertiary referral centre between June 2016 and August 2017 of patients undergoing transrectal ultrasonography (TRUS)-guided biopsy. After the result of TRUS-biopsy, the first 50 patients diagnosed with prostate cancer (study group) and those with no prostate cancer (control group) were enrolled. BMI, serum PSA level, fasting blood sugar and lipid profile (e.g. cholesterol, triglycerides, low-density lipoprotein [LDL] and high-density lipoprotein [HDL]), were compared between the groups. Results: Higher BMI, cholesterol, LDL and lower HDL together with PSA were significantly associated with a positive biopsy. On multivariate analysis, LDL (odds ratio [OR] 5.3, 95% confidence interval [CI] 1.2–24.9; P = 0.03) and total PSA level (OR 12.9, 95% CI 4.7–35; P < 0.001) were independent predictors of a positive biopsy. A combination of LDL <80 mg/dL and PSA level <26 ng/mL threshold values determined by receiver operating characteristic curve analysis, had a sensitivity and specificity of 94% and 28%, respectively; whilst, the negative (NPV) and positive predictive values were 82.4% and 56.6%, respectively. The sensitivity and NPV of the combination was significantly higher than that of PSA level alone (94% vs 72% and 82.4% vs 75%, respectively; P < 0.001). Conclusions: Serum lipids might have a role in the diagnosis of prostate cancer and could be used as an adjunct to PSA measurement to improve sensitivity and avoid unnecessary biopsies. Abbreviations: AUC: area under the curve; BMI: body mass index; FBS: fasting blood sugar; HDL: high-density lipoprotein; LDL: low-density lipoprotein; LOX-1: lectin-like oxidised LDL receptor-1; OR: odds ratio; ROC: receiver operating characteristic; RP: radical prostatectomy; TG: triglyceride
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Affiliation(s)
- Ahmed M Harraz
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Nora Atia
- Department Biochemistry, Mansoura University, Mansoura, Egypt
| | - Amani Ismail
- Department of Clinical Pathology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Hassan Abol-Enein
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - A F Abdel-Aziz
- Department Biochemistry, Mansoura University, Mansoura, Egypt
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Hoang DV, Shivappa N, Pham NM, Hebert JR, Binns CW, Lee AH. Dietary inflammatory index is associated with increased risk for prostate cancer among Vietnamese men. Nutrition 2019; 62:140-145. [PMID: 30889455 DOI: 10.1016/j.nut.2018.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/26/2018] [Accepted: 12/29/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Inflammatory potential of diet, as measured by the dietary inflammatory index (DII), has consistently been associated with an increased risk for prostate cancer (PCa). However, data has largely been reported in populations with more proinflammatory dietary patterns, whereas there is high diversity in dietary pattern worldwide. The aim of this study was to assess the association between DII scores and the risk for PCa in Vietnam. METHODS A case-control study of 652 participants (244 incident PCa patients, 64-75 y of age, and 408 controls, frequency matched for age) was conducted in Ho Chi Minh City, Vietnam, from 2013 to 2015. Habitual diet was ascertained using a validated food frequency questionnaire (FFQ), whereas other factors, including demographic and lifestyle characteristics, were assessed via face-to-face interviews. The daily intake of pro- and anti-inflammatory nutrients for each participant was calculated from the FFQ and used to estimate individuals' energy-adjusted DII (E-DII) scores. Multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models. RESULTS Comparing the middle and highest versus lowest tertile of DII scores, there was an increased risk for overall PCa. The OR and associated 95% CI was 2.63 (1.61-4.37) and 3.35 (2.06-5.53), respectively (Ptrend < 0.01). Similar results were found for low-moderate and high-grade PCa. The respective ORs (95% CI) were 3.34 (1.66-7.13) and 5.29 (2.69-11.18), Ptrend < 0.001, and 2.51 (1.40-4.63) and 2.57 (1.43-4.73), Ptrend 0.006. CONCLUSION A proinflammatory diet was associated with increased risk for PCa among Vietnamese men.
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Affiliation(s)
- Dong Van Hoang
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Vietnam National Cancer Institute, Vietnam National Cancer Hospital, 30 Cau Buou, Hanoi, Vietnam.
| | - Nitin Shivappa
- The Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
| | - Ngoc Minh Pham
- Curtin University, Kent Street, Bentley, Perth, Western Australia 6102, Western Australia; Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - James R Hebert
- The Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
| | - Colin W Binns
- Curtin University, Kent Street, Bentley, Perth, Western Australia 6102, Western Australia
| | - Andy H Lee
- Curtin University, Kent Street, Bentley, Perth, Western Australia 6102, Western Australia
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Abstract
Frailty is a state of vulnerability and a consequence of cumulative decline in multiple physiological systems over a lifespan. The occurrence of frailty depends on deterioration in muscle and nerve function, declining cardiopulmonary reserve and loss of executive function. Diabetes mellitus (DM) often causes functional impairment in each of the above systems, thus leading to a loss of whole body homeostasis and deterioration in physical function. Inability of self-management in DM patients may also have considerable impact on the development of sarcopenia/frailty. Thus, there may be positive feedback between the progression of diabetic complications and frailty/sarcopenia. While various factors are involved in this process, insulin resistance or insulin depletion may be an important factor in the progression of frailty in diabetes patients since insulin is well known to be an anabolic hormone in muscle. Interestingly, in our study targeting elderly DM patients, low HbA1c was a significant and independent risk factor for frailty, as assessed using a broad sense frailty scale, the Clinical Frailty Scale (CSF), suggesting that reverse metabolism due to malnutrition in elderly type 2 DM patients might be involved. Therefore, an intervention that includes proper nutrition and exercise training may be essential for the prevention of frailty. The pathogenesis of frailty in DM patients is extensively discussed in this review.
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Affiliation(s)
- Toshihiko Yanase
- Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
| | - Ikumi Yanagita
- Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
- Department of Diabetes and Metabolism, Muta Hospital, Fukuoka 814-0163, Japan
| | - Kazuo Muta
- Department of Diabetes and Metabolism, Muta Hospital, Fukuoka 814-0163, Japan
| | - Hajime Nawata
- Department of Diabetes and Metabolism, Muta Hospital, Fukuoka 814-0163, Japan
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Yanase T, Kawanami T, Tanaka T, Tanabe M, Nomiyama T. Impact of metabolic disorders on prostate cancer growth: Androgen and insulin resistance perspectives. Reprod Med Biol 2017; 16:252-257. [PMID: 29259475 PMCID: PMC5715889 DOI: 10.1002/rmb2.12039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 05/06/2017] [Indexed: 12/24/2022] Open
Abstract
Background A high prevalence of cancers in metabolic disorders, like metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM), recently has been noted, including prostate cancer (PC), which is androgen-sensitive. However, the pathological relationship among testosterone and insulin and insulin-like growth factor (IGF)-1 signaling in relation to MetS and T2DM with PC remains unclear. Methods Papers were reviewed, including those by the authors. Results In MetS or the initial stage of T2DM accompanying insulin resistance, insulin and IGF-1 signaling could be essential for PC growth. In the advanced stage of T2DM, the decrease in insulin secretion might work against PC growth. A decrease in testosterone concentration with T2DM also might suppress PC proliferation. Androgen deprivation therapy in patients with PC might increase the risk of MetS and/or T2DM and consequently cardiovascular events. Certain drugs for T2DM treatment, such as metformin and glucagon-like peptide-1 analog, potentially might be useful for the treatment of PC. Conclusion The improvement of insulin resistance appears to be essential for the prevention of PC growth. Further studies are needed to clarify the complicated pathophysiology of metabolic disorders in PC growth.
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Affiliation(s)
- Tashihiko Yanase
- Department of Endocrinology and Diabetes MellitusSchool of MedicineFukuoka UniversityFukuokaJapan
- Department of Bioregulatory Science of Life‐related DiseasesFukuoka UniversityFukuokaJapan
| | - Takako Kawanami
- Department of Endocrinology and Diabetes MellitusSchool of MedicineFukuoka UniversityFukuokaJapan
| | - Tomoko Tanaka
- Department of Endocrinology and Diabetes MellitusSchool of MedicineFukuoka UniversityFukuokaJapan
- Department of Bioregulatory Science of Life‐related DiseasesFukuoka UniversityFukuokaJapan
| | - Makito Tanabe
- Department of Endocrinology and Diabetes MellitusSchool of MedicineFukuoka UniversityFukuokaJapan
| | - Takashi Nomiyama
- Department of Endocrinology and Diabetes MellitusSchool of MedicineFukuoka UniversityFukuokaJapan
- Department of Bioregulatory Science of Life‐related DiseasesFukuoka UniversityFukuokaJapan
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