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Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/74450

Type: Journal article
Title: Androgens, diabetes and prostate cancer
Author: Grossmann, Mathis
Wittert, Gary Allen
Citation: Endocrine-Related Cancer, 2012; 19(5):F47-F62
Publisher: Society for Endocrinology and European Society of Endocrinology
Issue Date: 2012
ISSN: 1351-0088
School/Discipline: Medicine
Statement of
Responsibility: 
Mathis Grossmann and Gary Wittert
Abstract: Metabolic disorders such as diabetes, obesity and the metabolic syndrome have been shown to modulate prostate cancer (PCa) risk and aggressiveness in population-based and experimental studies. While associations between these conditions are modest and complex, two consistent findings have emerged. First, there is observational evidence that obesity and associated insulin excess are linked to increased PCa aggressiveness and worse outcomes. Secondly and somewhat paradoxically, long-standing diabetes may be protective against PCa development. This apparent paradox may be due to the fact that long-standing diabetes is associated with insulin depletion and decreased IGF1 signalling. Men with obesity or diabetes have moderate reductions in their androgen levels. The interconnectedness of metabolic and androgen status complicates the dissection of the individual roles of these factors in PCa development and progression. Metabolic factors and androgens may promote prostate carcinogenesis via multiple mechanisms including inflammation, adipokine action, fatty acid metabolism and IGF signalling. Moreover, androgen deprivation, given to men with PCa, has adverse metabolic consequences that need to be taken into account when estimating the risk benefit ratio of this therapy. In this review, we will discuss the current epidemiological and mechanistic evidence regarding the interactions between metabolic conditions, sex steroids and PCa risk and management.
Rights: © 2012 Society for Endocrinology
RMID: 0020122564
DOI: 10.1530/ERC-12-0067
Appears in Collections:Medicine publications
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