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Bosco C, Garmo H, Hammar N, Walldius G, Jungner I, Malmström H, Holmberg L, Van Hemelrijck M. Glucose, lipids and gamma-glutamyl transferase measured before prostate cancer diagnosis and secondly diagnosed primary tumours: a prospective study in the Swedish AMORIS cohort. BMC Cancer 2018; 18:205. [PMID: 29463235 PMCID: PMC5819686 DOI: 10.1186/s12885-018-4111-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 02/08/2018] [Indexed: 01/28/2023] Open
Abstract
Background Improvements in detection and treatment of prostate cancer (PCa) translate into more men living with PCa, who are therefore potentially at risk of a secondly diagnosed primary tumour (SDPTs). Little is known about potential biochemical mechanisms linking PCa with the occurrence of SDPTs. The current study aims to investigate serum biomarkers of glucose and lipid metabolism and gamma-glutamyl transferase (GGT) measured prior to PCa diagnosis and their association with the occurrence of SDPTS. Methods From the Swedish AMORIS cohort, we selected all men diagnosed with PCa between 1996 and 2011, with at least one of the five biomarkers of interest (glucose, fructosamine, triglycerides, total cholesterol (TC), GGT) measured on average 16 years before PCa diagnosis (n = 10,791). Multivariate Cox proportional hazards models were used to determine hazard ratios (HR) for risk of SDPTs (overall and subtypes) by levels of the five biomarkers. Effect modification of treatment was assessed. Results 811 SDPTS were diagnosed during a median follow-up time of 5 years. Elevated levels of triglycerides (HR: 1.37, 95%CI: 1.17–1.60), TC (HR: 1.22, 95%CI: 1.04–1.42) and GGT (HR: 1.32, 95%CI: 1.02–1.71) were associated with an increased risk of SDPTs. Risk of SDPTs subtypes varied by biomarkers. Conclusion Elevated levels of biomarkers of lipid metabolism and GGT measured prior to PCa diagnosis were associated with an increased risk of SDPTs, suggesting a potential common biochemical background for development of PCa and SDPTs.
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Affiliation(s)
- Cecilia Bosco
- King's College London, Translational Oncology & Urology Research (TOUR) Division of Cancer Studies King's College London Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London, SE1 9RT, UK.
| | - Hans Garmo
- King's College London, Translational Oncology & Urology Research (TOUR) Division of Cancer Studies King's College London Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London, SE1 9RT, UK.,Regional Cancer Centre, Uppsala, Sweden
| | - Niklas Hammar
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Medical Evidence & Observational Research, Global Medical Affairs, AstraZeneca, Mölndal, Sweden
| | - Göran Walldius
- Department of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingmar Jungner
- Department of Clinical Epidemiology, Karolinska Institutet and CALAB Research, Stockholm, Sweden
| | - Håkan Malmström
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Swedish Orphan Biovitrum, AB, Stockholm, Sweden
| | - Lars Holmberg
- King's College London, Translational Oncology & Urology Research (TOUR) Division of Cancer Studies King's College London Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London, SE1 9RT, UK.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Mieke Van Hemelrijck
- King's College London, Translational Oncology & Urology Research (TOUR) Division of Cancer Studies King's College London Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London, SE1 9RT, UK.,Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Zhao Z, Reinstatler L, Klaassen Z, Xu Y, Yang X, Madi R, Terris MK, Qian SY, Kelavkar U, Moses KA. The Association of Fatty Acid Levels and Gleason Grade among Men Undergoing Radical Prostatectomy. PLoS One 2016; 11:e0166594. [PMID: 27880795 PMCID: PMC5120795 DOI: 10.1371/journal.pone.0166594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/01/2016] [Indexed: 12/31/2022] Open
Abstract
Background Epidemiological data suggest that omega-6 (ω-6) fatty acids (FAs) may be associated with cancer incidence and/or cancer mortality, whereas ω-3 FAs are potentially protective. We examined the association of the ratio of ω-6 to ω-3 FA (ω-6:ω-3) and individual FA components with pathological results among men with prostate cancer (PCa) undergoing radical prostatectomy. Methods Sixty-nine men were included in the study. Components of ω-6 (linoleic acid (LA), arachidonic acid (AA), and dihomo-γ-linolenic acid (DGLA)) and ω-3 (docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)) were analyzed by liquid chromatography/mass selective detector separation. Logistic regression analysis was performed to determine association of FA with pathological high grade (Gleason ≥4+3) disease. Results The were 35 men with low grade disease (Gleason ≤3+4) and 34 men with high grade disease. Men with low grade disease were significantly younger (58y vs 61y, p = 0.012) and had lower D’Amico clinical classification (p = 0.001) compared to men with high grade disease. There was no significant association of ω-6:ω-3 with high grade disease (OR 0.93, p = 0.78), however overall ω-6, ω-3, and individual components of ω-6 and ω-3 FAs except EPA were significantly associated with high grade disease (ω-6: OR 3.37, 95% CI: 1.27,8.98; LA: OR 3.33, 95% CI:1.24,8.94; AA: OR 2.93, 95% CI:1.24,6.94; DGLA: OR 3.21, 95% CI:1.28,8.04; ω-3: OR 3.47, 95% CI:1.22,9.83; DHA: OR 3.13, 95% CI:1.26,7.74). ω-6 and ω-3 FA components were highly correlated (Spearman ρ = 0.77). Conclusion Higher levels of individual components of ω-6 and ω-3FAs may be associated with higher-grade PCa. Impact Studies into the causative factors/pathways regarding FAs and prostate carcinogenesis may prove a potential association with PCa aggressiveness.
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Affiliation(s)
- Zhiguo Zhao
- Department of Biostatistics, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Lael Reinstatler
- Department of Surgery, Section of Urology, Medical College of Georgia–Augusta University, Augusta, Georgia, USA
| | - Zachary Klaassen
- Department of Surgery, Section of Urology, Medical College of Georgia–Augusta University, Augusta, Georgia, USA
| | - Yi Xu
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, ND, USA
| | - Xiaoyu Yang
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, ND, USA
| | - Rabii Madi
- Department of Surgery, Section of Urology, Medical College of Georgia–Augusta University, Augusta, Georgia, USA
| | - Martha K. Terris
- Department of Surgery, Section of Urology, Medical College of Georgia–Augusta University, Augusta, Georgia, USA
| | - Steven Y. Qian
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, ND, USA
| | | | - Kelvin A. Moses
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- * E-mail:
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