Can I give you some background to what motivated our research is that we see an inconsistent pattern in association between different biomarkers of glycemia and prostate cancer incidence and mortality. So what we wanted to do was incorporate several different biomarkers of glycemia to better define normal glycemia as well as hyperglycemia and see what these patterns look like for prostate cancer mortality.

We started by looking in a prospective epidemiological cohort called the Atherosclerosis Risk in Communities Study which started in 1987. The investigators had followed participants for close to thirty years and had collected health data on participants during this time. In our analysis we limited to roughly 5,000 men and what we found was that in men that had high glycemia on three different biomarkers had close to a fivefold increased risk of dying from prostate cancer compared to men that were normal on the same three biomarkers. This pattern of elevated risk with higher glycemia was consistent in both African-American men as well as Caucasian men.

So we looked at traditional biomarkers of fasting glucose as well as haemoglobin A1c and then we had access to an additional marker called glycated albumin which is currently under investigation in the US as a marker to measure glycemic control and to monitor diabetes.

What did you find?

As I mentioned earlier, across levels of elevated glycemia defined by these categories based on these three markers we saw a consistent pattern of elevated risk with if you’re high on all three markers, as I said, it was close to a fivefold increased risk, that was statistically significant, whereas if you were high on two markers that was close to about 2½ times increased risk, although that one was not statistically significant. Then if you were high on just one marker that was above a threefold increased risk which I believe was statistically significant.

We also saw an elevated risk, close to a threefold increased risk, among people who were low on at least one of these markers compared to the normal group but in this low group that was not statistically significant. Then for people with diagnosed diabetes who were classified separately we saw an elevated risk as well that was not statistically significant.

What is your take home message?

The take home here really is the importance of good glycemic control because we know that glycemia is an important risk factor for many diseases besides cancer – cardiovascular disease, diabetes – and so this really drives home the point of having good glycemic control.