Diabetes, Glycated Hemoglobin and Risk of PCa in the UK Biobank Study

[pjoshea13]

New UK study [1] looked at any cancer association with diabetes & independently, with HbA1c (glycated hemoglobin [2]), although the two are closely associated.

"Diabetes was associated with increased risk of cancers of the stomach, liver, bladder, endometrium, and lung among smokers, and with decreased risk of prostate cancer."

"Compared to the normal HbA1c category, the increased risk category was positively associated with risk of cancers of the colon, liver, bladder and lung among smokers, and the high risk category was associated with increased risk of cancers of the esophagus, liver, pancreas and bladder, and with decreased risk of prostate cancer."

In a sense this is old news, but a recent paper suggested that the associations are not real. i.e. not real for PCa but real for every other cancer type. LOL

The Otto Warburg "sugar feeds cancer" hoards probably don't know that PCa does not preferentially use glucose, at least in the early stages, and that the inversre association with high HbA1c is really an association with the burnout of pancreatic beta cells that produce insulin. Diabetics are protected from PCa because they no longer overproduce the insulin that caused the burnout. IMO

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/321...

Cancer Epidemiol Biomarkers Prev

2020 Mar 16[Online ahead of print]

Diabetes, Glycated Hemoglobin and Risk of Cancer in the UK Biobank Study

Rita Peila 1 , Thomas E Rohan 2

Affiliations expand

PMID: 32179703 DOI: 10.1158/1055-9965.EPI-19-1623

Abstract

Background: Evidence suggest that diabetes and glycated hemoglobin (HbA1c) levels are associated with cancer risk. However, previous studies have been limited variably by failure to adjust for cancer-specific risk factors (e.g., body mass index), inattention to diabetes duration and use of anti-diabetic medications, and failure to stratify by obesity.

Methods: We examined the association between diabetes, HbA1c, and cancer risk in the UK Biobank, using data from 476,517 participants (54% women), followed for an average period of 7.1 years. Diabetes was defined based on baseline self-reported diagnosis of diabetes and/or use of diabetes medication, while HbA1c measured at baseline was categorized as low (<31mmol/mol), normal (31-<39mmol/mol), increased risk (39-<48mmol/mol), and high risk for diabetes (>=48mmol/mol). Multivariable Cox proportional hazards models were used to estimate the association of diabetes and cancer at different anatomical sites, with adjustment for cancer-specific risk factors.

Results: Diabetes was associated with increased risk of cancers of the stomach, liver, bladder, endometrium, and lung among smokers, and with decreased risk of prostate cancer. Compared to the normal HbA1c category, the increased risk category was positively associated with risk of cancers of the colon, liver, bladder and lung among smokers, and the high risk category was associated with increased risk of cancers of the esophagus, liver, pancreas and bladder, and with decreased risk of prostate cancer.

Conclusions: These results suggest that both diabetes and/or elevated HbA1c are associated with risk of cancer at several anatomical sites.

Impact: The associations of diabetes and HbA1c levels with cancer suggest their importance in cancer prevention.

Copyright ©2020, American Association for Cancer Research.

[2] en.wikipedia.org/wiki/Glyca...

[PhilipSZacarias]

I agree with respect to PCa metabolism becoming more glucose based but I am still puzzled. For a long period of time prior to diagnosis with PCa, people who are trending to become diabetics, have elevated insulin levels. Diets rich in both sugar and carbohydrates lead to large infusions of insulin, and over time liver and muscle cells become resistant. Insulin is reported to have growth promoting properties effects on cancer cells, so I would expect this to be a factor. Cheers, Phil

[pjoshea13 in reply to PhilipSZacarias]

Phil,

My contention is that established diabetics have risk similar to that for those with a healthy diet. Actual rates for U.S. men are inflated because of the large number of pre-diabetics - those who might never become diabetic, but have high insulin production due to carbs. Insulin is a known growth factor for PCa. So instead of diabetics being 'protected', it's the other way around. Non-diabetics in our age group are in a demographic where symptoms of the metabolic syndrome are common (to the point where increased heart disease risk is a known comorbidity for men with PCa), T levels are lower, the HDL-C:Triglycerides is lower. & so on.

A related problem is that elevated triglycerides result in increased visceral fat, which secretes estradiol [E2]. The male body does not want elevated E2, so it cuts down on T production, the putative source of E2. This leads to a poor E2:T ratio & men continue to lose muscle & gain fat, producing more E2. Men start to shop for training bras. The only way out of the downward spiral is to raise T levels to high-normal. This will quickly alter the fat:muscle ratio. Instead they are advised to cut calories & to study the food pyramid & reduce fat intake. LOL

-Patrick