The Influences of Metformin on Prostate in Terms of PSA Level and Prostate Volume
5 January 2019
Objectives: The effects of metformin on prostate volume and prostate-specific antigen (PSA) were investigated.
Materials and Methods:: We enrolled 384 newly diagnosed diabetes mellitus (DM) patients and 152 controls all of whom were >50 years into our prospective cross-sectional observational study. The first group contained patients receiving metformin only, the second group were taking a mixture of medications, including metformin plus other oral anti-diabetics, and the third was the control group. Before beginning treatment, body mass indices (BMI) of all cases were obtained. Prostate volumes evaluated using transabdominal ultrasonography at the sixth and twelfth month. Insulin, glycosylated hemoglobin (HbA1C), insulin sensitivity index (ISI), insulin-rich growth factor (IGF-1), PSA, free PSA, and total testosterone levels were measured.
Results: The differences in BMI between the first and third group were statistically significant (p <0.05). There were no statistical differences among the groups in terms of prostate volumes (> 0.05). The differences between the groups for insulin, HbA1C, ISI, IGF-1 (somatomedin), PSA, free PSA and total testosterone levels were insignificant (p >0.05).
Free PSA and total testosterone levels in groups 1 and 2 were not statistically different at the beginning of treatment and the sixth month (p >0.05), but within groups 1 and 2, only PSA levels were different at the start of the study until completion. No differences were seen in the third group.
Conclusion: Metformin appears to cause a decrease in PSA levels. The mechanism and any effects on prostate tissue will be studied in future randomized, prospective studies.
- Metformin effect
- PSA level
- prostate biopsy
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Demir A, Karadag MA, Turkeri L. Is there a relationship between the number of lymph nodes and disease parameters in patients who underwent retropubic prostatectomy. Int Urol and Nephrol. 2014;46(8):1537-41
Niraula S, Pond G, de Wit R, Eisenberger M, Tannock IF, Joshua AM. Influence of concurrent medications on outcomes of men with prostate cancer included in the TAX 327 study. Can Urol Assoc J. 2013; 7:E74-E81
Murtola TJ, Tammela TL, Lahtela J, Auvinen A. Antidiabetic medication and prostate cancer risk: A population-based case control study. Am J Epidemiol. 2008; 168:925-31
Sadeghi N, Abbruzzese JL, Yeung SC, Hassan M, Li D. Metformin use is associated with better survival of diabetic patients with pancreatic cancer. Clin Cacer Res. 2012; 18:2905-12.
Clements A Gao B, Yeap SH, Wong MK, Ali SS, Gurney H. Metformin in prostate cancer: Two for the price of one. Ann Oncol. 2011; 22:2556-60
Gormley GJ, Stoner E, Bruskewitz RC, et al: The effect of finasteride in men with benign prostatic hyperplasia. N Engl J Med 1992;327:1185-1191
Noto H, Goto A, Tsujimoto T, Noda M. Cancer risk in diabetic patients treated with metformin: A systematic review and meta-analysis. Plos One 2012; 7:3
Van Staa TP, Patel D, Gallagher AM, de Bruin ML. Glucose-lowering agents and the patterns of risk for cancer: a study with the General Practice Research Database and secondary care data. Diabetologia 2011;55(3):654-65
Wotton CJ, Yeates DG, Goldacre MJ. Cancer in patients admitted to hospital with diabetes mellitus aged 30 years and over: record linkage studies. Diabetologia 2011;54:527-534
Berstein Lev M. Metformin in obesity, cancer and aging: Addressing controversies. Aging 2012; 4:5
Patel T, Hruby G, Badani K, Abate-Shen C, McKiernan JM. Clinical outcomes after radical prostatectomy in diabetic patients treated with metformin. Urology 2010; 76(5):1240-4
Nordström T, Clements M, Karlsson R, Adolfsson J, Grönberg H. The risk of prostate cancer for men on aspirin, statin or antidiabetic medications. Eur J Cancer 2015; 51(6):725-33
Merrick GS, Bennett A, Couture T, Butler WM, Galbreath RW, Adamovich E. Metformin does not predict for prostate cancer diagnosis, grade, or volume of disease after transperineal template-guided mapping biopsy. Am J Clin Oncol 2015; Jan 8
Randazzo M, Beatrice J, Huber A, et al. Influence of metformin use on PSA values, free-to-total PSA, prostate cancer incidence and grade and overall survival in a prospective screening trial (ERSPC Aarau). World J Urol 2014; Oct 31 [Epub ahead of print]
Lee SY, Song CH, Xie YB, Jung C, Choi HS, Lee K. SMILE upregulated by metformin inhibits the function of androgen receptor in prostate cancer cells. Cancer Lett 2014; 28:354(2):390-7
Preston MA, Riis AH, Ehrenstein V, Breau RH, et al. Metformin use and prostate cancer risk. Eur Urol 2014; 66(6):1012-20
Goodwin PJ, and Stambolic V. Obesity and insulin resistance in breast cancer—chemoprevention strategies with a focus on metformin. Breast; Suppl 2011; 3:S31-35
Becker S, Dossus L, and Kaaks R. Obesity related hyperinsulinaemia and hyperglycaemia and cancer development. Arch Physiol Biochem 2009; 115:86-96
Morss AS, Edelman ER. Glucose modulates basement membrane fibroblast growth factor-2 via alterations in endothelial cell permeability. J Biol Chem 2007; 282:14635-14644
Barclay AW, Petocz P, McMillan-Price J, Flood VM, Prvan T, et al. Glycemic index, glycemic load, and chronic disease risk—a metanalysis of observational studies. Am J Clin Nutr 2008; 87:627-637
Ranasinghe WKB, Sengupta S, Williams S, et al. The effects of nonspecific HIF1alpha inhibitors on development of castrate resistance and metastases in prostate cancer. Cancer Medicine 2014; 3(2):245-251
Mottet N, Bellmunt J, Briers E, et al. Guidelines on prostate cancer, European Association of Urology 2015; p. 17
Han YY, Song JY, Talbott EO. Serum folate and prostate-specific antigen in the United States. Cancer Causes Control 2013; 24(8):1595-604
Demir A, Karadag MA, Cecen K, Uslu M, Arslan OE. Monopolar versus Plasmakinetic Energy Effect on prostatic tissue damage in terms of PSA levels: a prospective randomized trial. Urol Int 2015; 95(3):265-8
Mutlu N, Turkeri LN, Yencilek F, Demir A, Emerk K Complexed prostate specific antigen: A better test in the diagnosis of prostate cancer for the clinically relevant 2.5-4 ng/ml total PSA range. Canadian J Urology 2009;16(2):4558-4567
Bonn SE, Sjölander A, Tillander A, Wiklund F, Grönberg H, Balter K. Body Mass Index in relation to serum prostate-specific antigen levels and prostate cancer risk. Int J Cancer 2016;1;139(1):50-7
Kyler KE, Kadakia RB, Palac HL, Kwon S, Ariza AJ, Binns HJ. Use of metformin for weight management in children and adolescents with obesity in the clinical setting. Clin Pediatr (Phila) 2018;57(14):1677-1685
Ellul P, Delorme R, Cortese S. Metformin for weight gain associated with second-generation antipsychotics in children and adolescents: A systematic review and meta-analysis. CNS Drugs 2018; doi: 10.1007/s40263-018-0571-z ( Epub ahead of print)
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