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Metabolic syndrome biomarkers and prostate cancer risk in the UK Biobank

Research output: Contribution to journalArticlepeer-review

Maria Monroy Iglesias, Beth Russell, Danielle Crawley, Naomi Allen, Ruth Travis, Aurora Perez-Cornago, Mieke Van Hemelrijck, Kerri Beckmann

Original languageEnglish
Pages (from-to)825-834
Number of pages10
JournalInternational Journal of Cancer
Issue number4
Accepted/In press1 Jan 2020
Published15 Feb 2021

Bibliographical note

Funding Information: Kerri Beckmann was supported by a National Health and Medical Research Council Early Career Researcher Fellowship (Australia) GNT1124210. Aurora Perez‐Cornago is supported by a Cancer Research UK Population Research Fellowship (C60192/A28516) and by the World Cancer Research Fund (WCRF UK), as part of the World Cancer Research Fund International grant programme (2019/1953). Ruth C. Travis was supported by Cancer Research UK (grant numbers C8221/A19170 and C8221/A29017). Funding Information: Cancer Research UK, Grant/Award Numbers: C8221/A29017, C8221/A19170; World Cancer Research Fund (WCRF UK), Grant/Award Number: 2019/1953; Cancer Research UK Population Research Fellowship, Grant/Award Number: C60192/A28516; National Health and Medical Research Council Early Career Researcher Fellowship (Australia), Grant/Award Number: GNT1124210 Funding information Publisher Copyright: © 2020 Union for International Cancer Control Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

King's Authors


We investigated the association between metabolic syndrome (MetS) and its components and risk of prostate cancer (PCa) in a cohort of men enrolled in the UK Biobank. Our study cohort included 220 622 PCa-free men with baseline measurements of triglycerides (TGs), HDL-cholesterol (HDL), glycated hemoglobin (HbA1c), blood pressure (BP), and waist circumference (WC). Multivariable Cox proportional hazards regression was used to analyze associations with PCa for: individual metabolic components (TG, HDL, HbA1c, BP, WC), combinations of two and three components, and MetS overall (three or more components). We conducted mediation analyses to examine potential hormonal and inflammatory pathways (total testosterone [TT], C-reactive protein [CRP], insulin-like growth factor 1 [IGF-1]) through which MetS components may influence PCa risk. A total of 5409 men in the study developed PCa during a median follow-up of 6.9 years. We found no significant association between MetS and PCa risk (hazard ratio [HR] = 0.99, 95% confidence interval [CI] = 0.92-1.06). No associations were found with PCa risk and individual measurements of TG, HDL, BP, or WC. However, an inverse association was observed with elevated HbA1c (≥42 mmol/mol) (HR = 0.89, 95% CI = 0.79-0.98). Consistent inverse associations were observed between HbA1c and risk of PCa. Mediation analysis revealed TT, CRP, and IGF-1 as potential mediating factors for this association contributing 10.2%, 7.1%, and 7.9% to the total effect, respectively. Overall MetS had no association with PCa risk. However, a consistent inverse association with PCa risk was found for HbA1c. This association may be explained in part through hormonal and inflammatory pathways.

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