Elevated insulin and reduced insulin like growth factor binding protein-3/prostate specific antigen ratio with increase in prostate size in Benign Prostatic Hyperplasia

Insulin and insulin like growth factor-1 (IGF-1) have growth promoting effects, while insulin like growth factor binding protein-3 (IGFBP-3) has growth inhibitory effects. The present study was designed to assess the concentrations of insulin, IGF-1, IGFBP-3 and their association with prostate size in patients with BPH.

Ninety 90 BPH cases and 90 controls were enrolled in the study. Insulin, IGF-1, IGFBP-3, PSA, testosterone and estradiol were estimated in both the groups.

Insulin, IGF-1 and estradiol were increased and IGFBP-3/PSA was decreased in BPH cases when compared with controls. Insulin (r=0.64, p=0.001) and IGF-1 (r=0.22, p=0.03) were positively correlated and IGFBP-3/PSA (r=-0.316, p=0.002) were negatively correlated with prostate size in BPH. Multivariate analysis showed that insulin (p=0.001) and IGFBP-3/PSA (p=0.004) predicts the prostate size in patients with BPH. Insulin was increased and IGFBP-3/PSA was reduced in BPH patients with increased prostate size. At a cutoff concentration of 527.52, IGFBP-3/PSA ratio was found to differentiate benign growth of prostate from normal prostate with 96% sensitivity and 96% specificity.

Insulin is elevated and IGFBP-3/PSA is reduced with increase prostate size in BPH cases.

Clinica chimica acta; international journal of clinical chemistry. 2017 Mar 11 [Epub ahead of print]

Karli Sreenivasulu, Hanumanthappa Nandeesha, Lalgudi Narayanan Dorairajan, Medha Rajappa, Vickneshwar Vinayagam

Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India., Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. Electronic address: ., Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.