Influence of Diabetes Mellitus on Metabolic and Hormonal Interactions Promoting Aggressive Prostate Cancer

Background and objectives Diabetes mellitus might play a vital role in promoting prostate cancer development, progression, and aggressiveness. The influence of diabetes on prostate cancer outcomes has long been debated. However, the mechanism through which diabetes mediates its effect on prostate cancer development and progression has not been established. This study aimed to study the influence of diabetes mellitus on prostate cancer outcome and aggressiveness. Material and methods This study includes 100 patients newly diagnosed with benign prostatic hyperplasia (BPH) and 200 patients with histologically confirmed prostate adenocarcinoma, of which 100 were diabetic. Descriptive statistics were performed to analyse and summarize the results as mean±standard deviation (SD). Statistically significant differences between two or more groups were determined using ANOVA and the post hoc Tukey test. Chi-square test was performed to compare the distribution of tumor grades and risk categories between patients with prostate cancer with diabetes and without diabetes. Correlation analyses were performed to analyse the association of metabolic and hormonal parameters among themselves and cancer grade. Multiple linear regression analysis was done to analyse the relationship of hormone profile with the risk of prostate cancer in men with and without diabetes. Results Data showed that serum insulin and IGF-1 were significantly elevated in prostate cancer, highest being in prostate cancer with diabetes, and they had a positive association with prostate cancer Gleason score, grade, and high risk. Lipid profile and HbA1c also had a significant association with prostate cancer Gleason score and grade. Men with diabetes and prostate cancer were diagnosed with higher-grade and high-risk cancer than men with prostate cancer but without diabetes. Conclusion This study confirms the influence of diabetes on metabolic and hormonal parameters, particularly serum HbA1c, insulin, IGF1, and prostate-specific antigen, which are positively associated with higher grade and high risk, thus leading to the development and promotion of aggressive cancer in patients with coincidental diabetes.