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Latest Update on Metformin
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<blockquote data-quote="Nelson Vergel" data-source="post: 79199" data-attributes="member: 3"><p><span style="font-size: 12px"><strong>The Relationship Between Metformin and Serum Prostate-Specific Antigen Levels.</strong></span></p><p><span style="font-size: 12px"><strong></strong></span></p><p>Jayalath VH, et al. Prostate. 2016.</p><p>Authors</p><p>Jayalath VH1,2,3, Ireland C1,2, Fleshner NE3,4, Hamilton RJ3,4, Jenkins DJ5,6,7,8.</p><p>Author information</p><p>1Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada.</p><p>2Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.</p><p>3Department of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada.</p><p>4Department of Surgery-Urology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.</p><p>5Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada.</p><p>6Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. </p><p>7Department of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada.</p><p>8Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.</p><p></p><p>Prostate. 2016 Nov;76(15):1445-53. doi: 10.1002/pros.23228. Epub 2016 Jul 12.</p><p></p><p>Abstract</p><p>BACKGROUND: Metformin is the first-line oral antihyperglycemic of choice for individuals with type 2 diabetes. Recent evidence supports a role for metformin in prostate cancer chemoprotection. However, whether metformin indeed influences prostate biology is unknown. We aimed to study the association between metformin and serum prostate-specific antigen (PSA) levels-the primary prostate cancer biomarker.</p><p></p><p>METHODS: We conducted a cross-sectional study of 326 prostate cancer-free men with type 2 diabetes were recruited between 2004 and 2013 at St. Michael's Hospital. Men were excluded if they had a PSA&#8201;&#8805;10-ng/ml, or used >2,550-mg/d metformin or supplemental androgens. Multivariate linear regressions quantified the association between metformin dose and log-PSA. Secondary analyses quantified the association between other antihyperglycemics (sulfonylureas, thiazolidinediones) and PSA; sensitivity analyses tested covariate interactions.</p><p></p><p>RESULTS: Median PSA was 0.9-ng/ml (IQR: 0.5-1.6-ng/ml). Metformin dose associated positively with BMI, HbA1c, diabetes duration, and number of statin, acetylsalicylic acid, diuretic users, and number of antihyperglycemics used, and negatively with LDL-C. In multivariate models, PSA changed by -8% (95%CI: -13 to -2%, P&#8201;=&#8201;0.011) per 500-mg/d increase in metformin. Men with diabetes for &#8805;6 years (n&#8201;=&#8201;163) saw a greater difference in PSA per 500-mg/d metformin (-12% [95% CI: -19 to -4%, P&#8201;=&#8201;0.002], P-interaction&#8201;=&#8201;0.018). Serum PSA did not relate with sulfonylureas, thiazolidinediones, or total number of antihyperglycemic agents used. Our findings are limited by the cross-sectional design of this study.</p><p></p><p>CONCLUSIONS: <strong>Metformin dose-dependently inversely associated with serum PSA, independent of other antihyperglycemic medications. Whether metformin confers a dose-dependent benefit on prostate tumorigenesis and progression warrants investigation. </strong>Prostate 76:1445-1453, 2016.</p></blockquote><p></p>
[QUOTE="Nelson Vergel, post: 79199, member: 3"] [SIZE=3][B]The Relationship Between Metformin and Serum Prostate-Specific Antigen Levels. [/B][/SIZE] Jayalath VH, et al. Prostate. 2016. Authors Jayalath VH1,2,3, Ireland C1,2, Fleshner NE3,4, Hamilton RJ3,4, Jenkins DJ5,6,7,8. Author information 1Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada. 2Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 3Department of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada. 4Department of Surgery-Urology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 5Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada. 6Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 7Department of Surgical Oncology-Urology, Princess Margaret Cancer Center, Toronto, Ontario, Canada. 8Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada. Prostate. 2016 Nov;76(15):1445-53. doi: 10.1002/pros.23228. Epub 2016 Jul 12. Abstract BACKGROUND: Metformin is the first-line oral antihyperglycemic of choice for individuals with type 2 diabetes. Recent evidence supports a role for metformin in prostate cancer chemoprotection. However, whether metformin indeed influences prostate biology is unknown. We aimed to study the association between metformin and serum prostate-specific antigen (PSA) levels-the primary prostate cancer biomarker. METHODS: We conducted a cross-sectional study of 326 prostate cancer-free men with type 2 diabetes were recruited between 2004 and 2013 at St. Michael's Hospital. Men were excluded if they had a PSA ≥10-ng/ml, or used >2,550-mg/d metformin or supplemental androgens. Multivariate linear regressions quantified the association between metformin dose and log-PSA. Secondary analyses quantified the association between other antihyperglycemics (sulfonylureas, thiazolidinediones) and PSA; sensitivity analyses tested covariate interactions. RESULTS: Median PSA was 0.9-ng/ml (IQR: 0.5-1.6-ng/ml). Metformin dose associated positively with BMI, HbA1c, diabetes duration, and number of statin, acetylsalicylic acid, diuretic users, and number of antihyperglycemics used, and negatively with LDL-C. In multivariate models, PSA changed by -8% (95%CI: -13 to -2%, P = 0.011) per 500-mg/d increase in metformin. Men with diabetes for ≥6 years (n = 163) saw a greater difference in PSA per 500-mg/d metformin (-12% [95% CI: -19 to -4%, P = 0.002], P-interaction = 0.018). Serum PSA did not relate with sulfonylureas, thiazolidinediones, or total number of antihyperglycemic agents used. Our findings are limited by the cross-sectional design of this study. CONCLUSIONS: [B]Metformin dose-dependently inversely associated with serum PSA, independent of other antihyperglycemic medications. Whether metformin confers a dose-dependent benefit on prostate tumorigenesis and progression warrants investigation. [/B]Prostate 76:1445-1453, 2016. [/QUOTE]
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