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The Relationship Between Metformin and Serum Prostate‐Specific Antigen Levels
- Source :
- The Prostate
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- BACKGROUND Metformin is the first-line oral antihyperglycemic of choice for individuals with type 2 diabetes. Recent evidence supports a role for metformin in prostate cancer chemoprotection. However, whether metformin indeed influences prostate biology is unknown. We aimed to study the association between metformin and serum prostate-specific antigen (PSA) levels—the primary prostate cancer biomarker. METHODS We conducted a cross-sectional study of 326 prostate cancer-free men with type 2 diabetes were recruited between 2004 and 2013 at St. Michael's Hospital. Men were excluded if they had a PSA ≥10-ng/ml, or used >2,550-mg/d metformin or supplemental androgens. Multivariate linear regressions quantified the association between metformin dose and log-PSA. Secondary analyses quantified the association between other antihyperglycemics (sulfonylureas, thiazolidinediones) and PSA; sensitivity analyses tested covariate interactions. RESULTS Median PSA was 0.9-ng/ml (IQR: 0.5–1.6-ng/ml). Metformin dose associated positively with BMI, HbA1c, diabetes duration, and number of statin, acetylsalicylic acid, diuretic users, and number of antihyperglycemics used, and negatively with LDL-C. In multivariate models, PSA changed by −8% (95%CI: −13 to −2%, P = 0.011) per 500-mg/d increase in metformin. Men with diabetes for ≥6 years (n = 163) saw a greater difference in PSA per 500-mg/d metformin (−12% [95% CI: −19 to −4%, P = 0.002], P-interaction = 0.018). Serum PSA did not relate with sulfonylureas, thiazolidinediones, or total number of antihyperglycemic agents used. Our findings are limited by the cross-sectional design of this study. CONCLUSIONS Metformin dose-dependently inversely associated with serum PSA, independent of other antihyperglycemic medications. Whether metformin confers a dose-dependent benefit on prostate tumorigenesis and progression warrants investigation. Prostate 76:1445–1453, 2016. © 2016 The Authors. The Prostate published by Wiley Periodicals, Inc.
- Subjects :
- Male
Oncology
medicine.medical_specialty
Statin
endocrine system diseases
medicine.drug_class
Urology
medicine.medical_treatment
Antineoplastic Agents
Type 2 diabetes
Chemoprevention
PSA
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Prostate
Internal medicine
Diabetes mellitus
Biomarkers, Tumor
Humans
Hypoglycemic Agents
Medicine
030212 general & internal medicine
Dose-Response Relationship, Drug
business.industry
nutritional and metabolic diseases
Original Articles
Middle Aged
Prostate-Specific Antigen
prostate cancer
dose‐response
medicine.disease
Metformin
3. Good health
Cross-Sectional Studies
medicine.anatomical_structure
Endocrinology
Diabetes Mellitus, Type 2
antihyperglycemic
030220 oncology & carcinogenesis
Biomarker (medicine)
Original Article
cross‐sectional
Diuretic
business
medicine.drug
Subjects
Details
- ISSN :
- 10970045 and 02704137
- Volume :
- 76
- Database :
- OpenAIRE
- Journal :
- The Prostate
- Accession number :
- edsair.doi.dedup.....df54489a47355848fb7376de576243ba
- Full Text :
- https://doi.org/10.1002/pros.23228