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Bernal-Soriano MC, Lumbreras B, Hernández-Aguado I, Pastor-Valero M, López-Garrigos M, Parker LA. Untangling the association between prostate-specific antigen and diabetes: a systematic review and meta-analysis. Clin Chem Lab Med 2020; 59:11-26. [PMID: 32681769 DOI: 10.1515/cclm-2020-0145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/23/2020] [Indexed: 12/13/2022]
Abstract
Objectives Several studies have shown an inverse association between diabetes mellitus and prostate cancer (PCa). Some researchers suggest that this relationship is due to reduced PCa detection in diabetics due to lower prostate-specific antigen (PSA) levels compared to non-diabetics. Our objective is to analyze the impact of diabetes on PSA in asymptomatic men without known prostate pathology and without prior prostate intervention. Methods We searched Medline (via PubMed), Embase and Scopus. We included studies that reported the relationship between serum PSA levels and diabetes or diabetes treatment in asymptomatic adult men without known prostate pathology, and without prior prostate intervention. Pooled mean differences were compared between diabetics and non-diabetics. Results Of 2,392 screened abstracts, thirteen studies met the inclusion criteria and 8 (62%) reported appropriate measures that could be included in a meta-analysis. Eleven (85%) examined the influence of diabetes on PSA levels and 8 (62%) evaluated the influence of diabetes treatments on PSA levels. Overall diabetics had a significantly lower PSA level compared to non-diabetics (mean difference: -0.07 ng/mL; 95% CI -0.10, -0.04). Conclusions Diabetes and related factors (such as disease duration, severity and treatment) were significantly associated with lower PSA levels among asymptomatic men, yet differences were small and are unlikely to influence PCa detection in a screening setting.
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Affiliation(s)
- Mari Carmen Bernal-Soriano
- Department of Public Health, University Miguel Hernández, Crta. Nacional, N-332, s/n, Sant Joan, Alicante, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Blanca Lumbreras
- Department of Public Health, University Miguel Hernández, Crta. Nacional, N-332, s/n, Sant Joan, Alicante, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ildefonso Hernández-Aguado
- Department of Public Health, University Miguel Hernández, Crta. Nacional, N-332, s/n, Sant Joan, Alicante, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María Pastor-Valero
- Department of Public Health, University Miguel Hernández, Crta. Nacional, N-332, s/n, Sant Joan, Alicante, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maite López-Garrigos
- Clinical Laboratory Department, University Hospital of San Juan de Alicante, Alicante, Spain
| | - Lucy A Parker
- Department of Public Health, University Miguel Hernández, Crta. Nacional, N-332, s/n, Sant Joan, Alicante, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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