Published 2017-03-16
exsa hadibrata H R Danarto


Objective: This study aims to determine the effect of diabetes mellitus (DM) and body mass index (BMI) on the risk of prostate cancer and high grade prostate cancer. Materials & method: This study is a retrospective observational study with cross-sectional design, using secondary data to determine the relationship of diabetes mellitus, body mass index and HbA1c levels with the degree of differentiation histopathologic prostate cancer. Data were analyzed using Chi-Square test, T-test and Man Whitney test with a confidence level of p<0.05 and a=0.05. Results: There are 78 samples diagnosed with prostate cancer. A total of 12 (15.4%) samples are diabetes mellitus, 18 (22.9%) samples classified as body mass index more than 23.4 (5.1%) samples have elevated levels of HbA1c levels >6.5. On histopathologic examination, it was found as many as 45 (57.7%) samples with high grade prostate cancer, as much as 9 (11.5%) samples with moderate grade prostate cancer, and as many as 24 (30.8%) samples with low grade prostate cancer. In bivariate analysis diabetes mellitus, BMI>23, and HbA1c level relationship with high grade prostate cancer is not statistically significant with p>0.05. Conclusion: There were no statistically significant relationship between diabetes, BMI and increased levels of HbA1c with high grade prostate cancer.



Diabetes, body mass index, HbA1c, prostate cancer


Klein EA, Platz EA, Thompson IM. Epidemiology, etiology, and prevention of prostate cancer. In: Wein AJ, Kovoussi LR, Novick AC, Part in AW, Peters CA, 10th Ed. Campbell-Walsh Urology. Philadelphia: Saunders; 2012. p. 2854-73.

Mottet N, Schalken JA, Heidenreich A, Bastian PJ, Irani J, Salomon L, et al. Highlights on prostate cancer from urological and oncological congresses in 2007. Eur Urol. 2008; Suppl 7: 460-73.

Long XJ. Diabetes mellitus and prostate cancer risk in Asian countries: A meta-analysis. Asian Pacific J Cancer Prev. 2012; 13: 4097-100.

Demir U, Koehler A, Schneider R. Metformin anti-tumor effect via disruption of the MID1 translational regulator complex and AR down regulation in prostate cancer cells. BMC Cancer. 2014; 31: 14-52.

Fall K, Garmo H, Gudbjornsdottir S. Diabetes mellitus and prostate cancer risk; A nationwide case-control study within PCBaSe Sweden. Cancer Epidemiol Biomarkers Prev. 2013; 22: 1102-9.

Kasper JS, Giovannucci E. A meta-analysis of diabetes mellitus and the risk of prostate cancer. Cancer Epidemiol Biomarkers Prev. 2006; 15: 2056-62.

Ozbek E. Diabetes mellitus and HbA1c levels associated with high grade prostate cancer. Asian Pacific J Cancer Prev. 2014; 15(6): 2555-8.

Ikatan Ahli Urologi Indonesia. Panduan Penatalaksanaan Kanker Prostat; 2011.

Bonovas S, Filioussi K, Tsantes A. Diabetes mellitus and risk of prostate cancer: A Meta-Analysis. Diabetologia. 2004; 47(6): 1071–8. [PubMed: 15164171].

Kasper JS, Liu Y, Pollak MN, Rifai N, Giovannucci E. Hormonal profile of diabetic men and the potential link to prostate cancer. Cancer Causes Control. 2008; 19(7): 703-10. [PubMed: 18340542].

Moreira DM, Anderson T, Gerber L. The association of diabetes mellitus and high-grade prostate cancer in a multiethnic biopsy series. Cancer Causes Control. 2011; 22: 977-83.

Xylinas E, Ploussard G, Durand X. Low pretreatment total testosterone (3ng/mL) predicts extra prostatic disease in prostatectomy specimens from patients with preoperative localized prostate cancer. BJU Int. 2011; 107: 1400-3.

Giovannucci E, Michaud D. The role of obesity and related metabolic disturbances in cancers of the colon, prostate, and pancreas. Gastroenterology. 2007; 132: 2208-25.

Abdollah F. Does diabetes mellitus increase the risk of high-grade prostate cancer in patients undergoing radical prostatectomy. Prostate Cancer and Prostatic Diseases. 2011; 14: 74-78.

Hua Xu. Diabetes mellitus reduces prostate cancer risk − no function of age at diagnosis or duration of disease. Asian Pacific J Cancer Prev. 2013; 14(1): 441-7.

Wright JL, Stanford JL. Metformin use and prostate cancer in Caucasian men: Results from a population-based case-control study. Cancer Causes Control. 2009; 20: 1617-22.

Brandon Pierce. Why are diabetics at reduced risk for prostate cancer? A review of the epidemiologic evidence. Urologic Oncology: Seminars and Original Investigations. 2012; 30: 735-43.

Di Francesco Simona, Tenaglia RL. Obesity, diabetes and aggressive prostate cancer. Cent Eur J Urol. 2013; 66: 423-7.

Hammarsten J, Hogstedt B. Hyperinsulinaemia: A prospective risk factor for lethal clinical prostate cancer. Eur J Cancer. 2005; 41: 2887-95.

Hong Sung Kyu. Significance of preoperative HbA1c level in patients with diabetes mellitus and clinically localized prostate cancer. The Prostate. 2009; 69: 820-82.

Copyright Information
Department of Urology, Faculty of Medicine/Airlangga University