Role of hyperinsulinemia in increased risk of prostate cancer: A case control study from Kathmandu valley

Aim: To investigate the effect of hyperglycemia and hyperinsulinemia on prostate cancer risk. Materials and Methods: This hospital based study was carried out using data retrieved from the register maintained in the Department of Biochemistry of a tertiary care hospital of Kathmandu, Nepal between 31^st December, 2011 and 31^st October, 2013. The variables collected were age, serum cholesterol, serum calcium, PSA, fasting blood glucose, serum insulin. Analysis was performed by descriptive statistics and testing of hypothesis using Excel 2003, R 2.8.0, Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version. Results: Of the total 125 subjects enrolled in our present study, 25 cases were of PCa and 100 were healthy controls. The mean value of fasting plasma glucose was 95.5 mg/dl in cases of prostatic carcinoma and the mean value of fasting plasma insulin was 5.78 μU/ml (p value: 0.0001*). The fasting insulin levels μU/ml were categorized into the different ranges starting from ≤2.75, >2.75 to ≤4.10, >4.10 to ≤6.10, >6.10μU/ml. The maximum number of cases of prostatic carcinoma of fasting insulin levels falls in range of >6.10μU/ml. The highest insulin levels (>6.10μU/ml) were seen to be associated with an 2.55 fold risk of prostatic carcinoma when compared with fasting insulin levels of <2.75 μU/ml). Conclusions: Elevated fasting levels of serum insulin appear to be associated with a higher risk of prostate cancer.