Impact of diabetes mellitus on the detection of prostate cancer via contemporary multi (≥12)-core prostate biopsy

BACKGROUND Currently, controversy continues regarding the association between diabetes mellitus (DM) and prostate cancer (PCa). We investigated the impact of DM in PCa detection among men who underwent contemporary multi-core prostate biopsy. METHODS. In this retrospective study, we reviewed records of 3,925 men who underwent multi (>= 12)-core prostate biopsy at our institution. Biopsy outcomes were analyzed with respect to various variables, including DM, patient age, body mass index (BMI), prostate-specific antigen (PSA), digital rectal exam (DRE) finding, ultrasound finding, and prostate volume. RESULTS. Among 3,925 subjects, 607 (15.5%) reported having DM at biopsy. Overall PCa was detected from biopsy in 1,387 (35.3%) patients, and high grade (biopsy Gleason score >= 7) PCa in 781 (19.9%). In multivariate analysis incorporating variables of patient age, BMI, PSA, DRE finding, ultrasound finding, and prostate volume, DM was observed to be significantly associated with higher odds of overall PCa detection via contemporary prostate biopsy (OR 1.46, P = 0.019). When analyzed by tumor grade, DM was significantly associated with higher rate of high grade PCa detection from biopsy in multivariate analysis (OR 1.54, P = 0.036) whereas DM and detection of low grade (biopsy Gleason score <= 6) PCa demonstrated no significant association (OR 1.11, P = 0.558). CONCLUSIONS. Our results showed DM was independently associated with the detection of high grade PCa via contemporary multi-core prostate biopsy. Further investigations would be needed to elucidate exact biologic basis of relationship between the two diseases. Prostate 72: 51-57, 2012. (C) 2011 Wiley Periodicals, Inc.