Halina Grosman

Prostate cancer (PCa) is one of the most common diseases in men. It is important to assess prognostic factors and whether high cortisol levels and complex hormonal interactions could be responsible for PCa development. We evaluated the relationship between cortisol, leptin and estrogens in 141 men, 71 with PCa and the remaining 70 constituting a low risk group (LRG). They were recruited for this study from a total of 2906 middleaged men (ages 4570 years) who completed an evaluation for prostatic diseases at the Urology Division, Hospital de Clinicas "Jose de San Martin", University of Buenos Aires, in May 2009. In this cross sectional study, cortisol, PSA, totaltestosterone, freetestosterone, bioavailable testosterone, LH and estradiol were measured in serum. We observed increased cortisol levels in PCa patients as compared to LRG cases (p=0.004,). Leptin and estradiol levels were also higher in PCa patients (p=0.048; p<0.0001, respectively). Logistic regression analysi...

Introduccion: No obstante el gran valor del Antigeno Prostatico Especifico total (PSAt), su utilidad en ocasiones es discutible, particularmente en pacientes con PSAt elevado, biopsia prostatica negativa para Adenocarcinoma de Prostata (CaP) y sintomas obstructivos que requieren resolucion quirurgica. Material y metodos: Se evaluo en forma retrospectiva 171 pacientes adenomectomizados con PSAt elevado y biopsia preoperatoria negativa para CaP. Se analizo el PSAt pre y postoperatorio, la incidencia de CaP y sus posibles predictores. Resultados: Hubo 2 casos de CaP Incidental (CaPI) (1,2%), 2 pacientes con PSAt elevado y diagnostico de CaP en el seguimiento. No se encontro significancia ni tendencia estadistica del PSAt ni de la densidad del PSA (PSAd) con el CaPI. Observamos una reduccion del PSAt del 83,2%. Conclusiones: La adenomectomia fue una conducta segura, destacando el bajo valor predictivo del marcador y la baja prevalencia de CaPI en esta poblacion.

Introduccion: La hiperplasia prostatica benigna (HPB) constituye una patologia con alta prevalencia en hombres mayores, y en su patogenia es posible la influencia de la inflamacion prostatica. La resistencia a la insulina, que se presenta con hiperinsulinemia (que forma parte del sindrome metabolico [SM]) y el factor de crecimiento simil insulina tipo 1 (insulin-like growth factor-1, IGF-1) (relacionado con la obesidad) se asocian al aumento de sintomas urinarios por inflamacion prostatica y crecimiento prostatico debido a que influyen sobre vias de senalizacion que generan proliferacion celular. A su vez, la leptina (tambien elevada en la obesidad) poseeria efectos sobre el crecimiento celular. Objetivo: Evaluar la relacion entre estas tres moleculas (resistencia a la insulina, IGF-1 y leptina) con la hiperplasia prostatica benigna. Material y metodo: Poblacion seleccionada de una convocatoria realizada bajo la denominacion “Campana de deteccion temprana del cancer de prostata”. Se...

Previous studies have tested the relationship between chronic stress and sex hormones, but inconsistent results have been found. One possibility is that this association may depend on other biological factors. This study examined the relationship between stressful life events (LE) and sex hormones in men, and whether cortisol is involved in this relationship. From a total number of 2906 men who completed a screening for the early detection of prostate cancer, 139 healthy men (mean ± SD age, 57.8 ± 5.7 years) were included in this study. Participants were assessed with the Holmes and Rahe questionnaire in relation to their experience of LE during the previous 1-5 years. Salivary and serum cortisol was measured at 08:00-09:00 h, as well as luteinizing hormone (LH), total testosterone, epinephrine (E) and norepinephrine (NE). LE weight sum and LE number positively correlated with LH (r = 0.293, p = 0.004; r = 0.220, p = 0.031, respectively). In a multiple regression analysis, LE-sum ex...

Psychological factors and stressful life events (LE) are considered to play a role in the onset of the metabolic syndrome (MS). We tested the association between LE and cortisol, a marker of chronic stress, with the risk of developing MS and their interaction. From a total number of 2906 men who completed a screening for the early detection of prostate cancer, 149 healthy men (mean ± SD age, 58.6 ± 7.7 years) were included in this study. Participants were assessed by the Holmes and Rahe questionnaire about their experience of LE during the previous 1-5 years. MS was diagnosed according to National Cholesterol Education Program-Adult Treatment Panel III (ATP-III) and International Diabetes Federation (IDF) criteria. Serum cortisol was measured at 08:00-09:00 h. Participants with MS (IDF criteria) reported significantly more past LE (p = 0.009) and greater summed weight of LE (p = 0.049) than those without MS. Furthermore, LE interacted with cortisol in relation to MS: in men with increased serum cortisol levels ( ≥ 13.7 μg/dl), number of LE significantly predicted MS-status (relative risk (RR) = 1.16, p = 0.03), whereas in men with low cortisol, LE were unrelated to MS (p = 0.52). We conclude that LE were significantly more prevalent in men with the MS than without the MS, according to IDF criteria, independent of the effects of age and body mass index, especially in men with increased serum cortisol levels.

To evaluate lipoprotein profile and sex hormones in patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) and their possible associations with some inflammatory markers linked to PCa. A total of 150 men (50-65 years), matched by age and body mass index (BMI), included in this study and divided into three groups according to total prostate specific antigen (PSA), digital rectal examination and prostate biopsy: 50 PCa, 50 BPH and 50 controls. Total cholesterol (Chol), HDL-chol, LDL-chol, triglycerides (TG), total testosterone (T), free T (FT), bioavailable T (BioT), estradiol and SHBG were measured. The free androgen index (FAI) and TG/HDL-chol were calculated. In 25 PCa and 25 controls, C-reactive protein (hs-CRP), adiponectin and insulin were determined. Patients with PCa showed higher TG/HDL-chol and diminished HDL-chol than Controls and BPH. PSA correlated inversely with HDL-chol and directly with TG/HDL-chol. FAI, FT, BioT and estradiol levels were higher, and SHBG and adiponectin were lower in PCa than in Controls. No differences were found in androgens between BPH and PCa. Our most novel findings are that the patients with PCa presented lower total Chol and HDL-chol and higher TG/HDL-chol than BPH and Controls. Patients with PCa showed higher androgens and lower adiponectin than Controls.