Plasma prostasin levels tied to diabetes risk and cancer mortality: Study

Sweden: A new study data suggest that plasma prostasin levels may help predict the risk of diabetes and cancer mortality. This analysis study elucidating the association between diabetes and cancer was published in Diabetologia. 

The study found a positive correlation between plasma prostasin levels and diabetes risk and cancer mortality risk, especially in individuals with high blood glucose levels. The findings may shed new light on the relationship between diabetes and cancer.

Several epidemiological studies have presented considerable evidence of diabetes being associated with an increased risk of cancer. Prostasin, a trypsin-like serine protease is an epithelial sodium channel stimulator. It has been linked with the suppression of tumors, glucose metabolism, and hyperglycemia-associated tumor pathology. However, the association between prostasin, diabetes, and cancer mortality has not been well investigated in humans.

Xue Bao, Lund University, Sweden, and colleagues analyzed data from more than 20 years of follow-up of patients in the Malmö Diet and Cancer Study to investigate the associations between plasma prostasin and diabetes, and to explore whether prostasin affects cancer mortality risk in individuals with hyperglycemia.

Researchers used samples from the study to measure the plasma prostasin and statistical analysis was performed with both sex-specific quartiles and per 1 SD. The cross-sectional association between plasma prostasin and diabetes was first studied in 4658 participants (age 57.5 ± 5.9 years, 39.9% men). After excluding 361 with prevalent diabetes, the associations of prostasin with incident diabetes and cancer mortality risk were assessed using Cox regression analysis. The interactions between prostasin and blood glucose levels as well as other covariates were tested.

Key findings of the analysis,

• The adjusted OR for prevalent diabetes in the 4th vs 1st quartile of prostasin concentrations was 1.95.

• During mean follow-up periods of 21.9 ± 7.0 and 23.5 ± 6.1 years, respectively, 702 participants developed diabetes and 651 died from cancer.

• The adjusted HR for diabetes in the 4th vs 1st quartile of prostasin concentrations was 1.76.

• There was a significant association between prostasin and fasting blood glucose for cancer mortality risk, with a stronger association observed in individuals with impaired fasting blood glucose levels at baseline (HR per 1 SD change 1.52).

The researchers conclude that individuals with elevated prostasin levels are at increased risk of diabetes and among them, those having both the elevated levels of prostasin and blood glucose are at higher cancer mortality risk. Health care professionals should pay special attention to these individuals.

Reference:

Bao, X., Xu, B., Muhammad, I.F. et al. Plasma prostasin: a novel risk marker for incidence of diabetes and cancer mortality. Diabetologia (2022). https://doi.org/10.1007/s00125-022-05771-w