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 $5.78{\mu}U/ml$ (p value: 0.0001*). The fasting insulin levels ${\mu}U/ml$ were categorized into the different ranges starting from ${\leq}2.75$, >2.75 to ${\leq}4.10$, >4.10 to ${\leq}6.10$, > $6.10{\mu}U/ml$. The maximum number of cases of prostatic carcinoma of fasting insulin levels falls in range of > $6.10{\mu}U/ml$. The highest insulin levels (> $6.10{\mu}U/ml$) were seen to be associated with an 2.55 fold risk of prostatic carcinoma when compared with fasting insulin levels of (< $2.75{\mu}U/ml$). Conclusions: Elevated fasting levels of serum insulin appear to be associated with a higher risk of prostate cancer.