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Post-diagnosis serum insulin-like growth factors in relation to dietary and lifestyle changes in the Prostate testing for cancer and Treatment (ProtecT) trial.
Cancer Causes Control 2017; 28(8):877-888CC

Abstract

PURPOSE

The insulin-like growth factor (IGF) system is modifiable by diet and lifestyle, and has been linked to prostate cancer development and progression.

METHODS

We conducted a prospective cohort study of 621 men diagnosed with localized prostate cancer to investigate the associations of dietary and lifestyle changes with post-diagnosis circulating levels of IGF-I and IGFBP-3. We used analysis of covariance to estimate the associations, controlling for baseline IGF-I or IGFBP-3, respectively.

RESULTS

Mean IGF-I levels were 6.5% (95% CI -12.8, -0.3%, p = 0.04) lower in men who decreased their protein intake after diagnosis compared to men who did not change. Men who changed their fruit and vegetable intake had lower IGF-I levels compared to non-changers [Decreased intake: -10.1%, 95% CI -18.4, -1.8%, p = 0.02; Increased intake: -12.0%, 95% CI -18.4, -1.8%, p = 0.002]. IGFBP-3 was 14.6% (95% CI -24.5, -4.8%, p = 0.004) lower in men who achieved a healthy body mass index after diagnosis. Men who became inactive had 9.5% higher average IGF-I levels (95% CI 0.1, 18.9%, p = 0.05).

CONCLUSIONS

Decreased protein intake and body mass index, and increased physical activity and fruit and vegetable intake, following a prostate cancer diagnosis were associated with reduced post-diagnosis serum IGF-I and IGFBP-3. Counterintuitively, reduced fruit and vegetable intake was also associated with reduced IGF-I, but with weak statistical support, possibly implicating chance. If confirmed in other studies, our findings may inform potential lifestyle interventions in prostate cancer. ProtecT was registered at International Standard Randomised Controlled Trial Registry, http://isrctn.org as ISRCTN20141297.

Authors+Show Affiliations

School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK. Vanessa.Er@bristol.ac.uk. National Institute for Health Research (NIHR) Bristol Nutrition Biomedical Research Unit, Level 3, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK. Vanessa.Er@bristol.ac.uk.National Institute for Health Research (NIHR) Bristol Nutrition Biomedical Research Unit, Level 3, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK. IGFs and Metabolic Endocrinology Group, School of Clinical Sciences, University of Bristol, Learning and Research Building, Southmead Hospital, Bristol, BS10 5NB, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK. Medical Research Council Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK. National Institute for Health Research (NIHR) Bristol Nutrition Biomedical Research Unit, Level 3, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK. Medical Research Council Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK.Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK.Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK.National Institute for Health Research (NIHR) Bristol Nutrition Biomedical Research Unit, Level 3, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK. IGFs and Metabolic Endocrinology Group, School of Clinical Sciences, University of Bristol, Learning and Research Building, Southmead Hospital, Bristol, BS10 5NB, UK.School of Social and Community Medicine, University of Bristol, Canynge Hall, 39,Whatley Road, Bristol, BS8 2PS, UK. National Institute for Health Research (NIHR) Bristol Nutrition Biomedical Research Unit, Level 3, University Hospitals Bristol Education & Research Centre, Upper Maudlin Street, Bristol, BS2 8AE, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28646365

Citation

Er, Vanessa, et al. "Post-diagnosis Serum Insulin-like Growth Factors in Relation to Dietary and Lifestyle Changes in the Prostate Testing for Cancer and Treatment (ProtecT) Trial." Cancer Causes & Control : CCC, vol. 28, no. 8, 2017, pp. 877-888.
Er V, Biernacka K, Simpkin AJ, et al. Post-diagnosis serum insulin-like growth factors in relation to dietary and lifestyle changes in the Prostate testing for cancer and Treatment (ProtecT) trial. Cancer Causes Control. 2017;28(8):877-888.
Er, V., Biernacka, K., Simpkin, A. J., Martin, R. M., Jeffreys, M., Emmett, P., ... Lane, J. A. (2017). Post-diagnosis serum insulin-like growth factors in relation to dietary and lifestyle changes in the Prostate testing for cancer and Treatment (ProtecT) trial. Cancer Causes & Control : CCC, 28(8), pp. 877-888. doi:10.1007/s10552-017-0910-2.
Er V, et al. Post-diagnosis Serum Insulin-like Growth Factors in Relation to Dietary and Lifestyle Changes in the Prostate Testing for Cancer and Treatment (ProtecT) Trial. Cancer Causes Control. 2017;28(8):877-888. PubMed PMID: 28646365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-diagnosis serum insulin-like growth factors in relation to dietary and lifestyle changes in the Prostate testing for cancer and Treatment (ProtecT) trial. AU - Er,Vanessa, AU - Biernacka,Kalina, AU - Simpkin,Andrew J, AU - Martin,Richard M, AU - Jeffreys,Mona, AU - Emmett,Pauline, AU - Gilbert,Rebecca, AU - Avery,Kerry N L, AU - Walsh,Eleanor, AU - Davis,Michael, AU - Donovan,Jenny L, AU - Neal,David E, AU - Hamdy,Freddie C, AU - Holly,Jeff M P, AU - Lane,J Athene, Y1 - 2017/06/23/ PY - 2016/10/07/received PY - 2017/06/17/accepted PY - 2017/6/25/pubmed PY - 2017/12/13/medline PY - 2017/6/25/entrez KW - Diet KW - Insulin-like growth factors KW - Lifestyle KW - Post-diagnosis KW - Prostatic neoplasms SP - 877 EP - 888 JF - Cancer causes & control : CCC JO - Cancer Causes Control VL - 28 IS - 8 N2 - PURPOSE: The insulin-like growth factor (IGF) system is modifiable by diet and lifestyle, and has been linked to prostate cancer development and progression. METHODS: We conducted a prospective cohort study of 621 men diagnosed with localized prostate cancer to investigate the associations of dietary and lifestyle changes with post-diagnosis circulating levels of IGF-I and IGFBP-3. We used analysis of covariance to estimate the associations, controlling for baseline IGF-I or IGFBP-3, respectively. RESULTS: Mean IGF-I levels were 6.5% (95% CI -12.8, -0.3%, p = 0.04) lower in men who decreased their protein intake after diagnosis compared to men who did not change. Men who changed their fruit and vegetable intake had lower IGF-I levels compared to non-changers [Decreased intake: -10.1%, 95% CI -18.4, -1.8%, p = 0.02; Increased intake: -12.0%, 95% CI -18.4, -1.8%, p = 0.002]. IGFBP-3 was 14.6% (95% CI -24.5, -4.8%, p = 0.004) lower in men who achieved a healthy body mass index after diagnosis. Men who became inactive had 9.5% higher average IGF-I levels (95% CI 0.1, 18.9%, p = 0.05). CONCLUSIONS: Decreased protein intake and body mass index, and increased physical activity and fruit and vegetable intake, following a prostate cancer diagnosis were associated with reduced post-diagnosis serum IGF-I and IGFBP-3. Counterintuitively, reduced fruit and vegetable intake was also associated with reduced IGF-I, but with weak statistical support, possibly implicating chance. If confirmed in other studies, our findings may inform potential lifestyle interventions in prostate cancer. ProtecT was registered at International Standard Randomised Controlled Trial Registry, http://isrctn.org as ISRCTN20141297. SN - 1573-7225 UR - https://www.unboundmedicine.com/medline/citation/28646365/Post_diagnosis_serum_insulin_like_growth_factors_in_relation_to_dietary_and_lifestyle_changes_in_the_Prostate_testing_for_cancer_and_Treatment__ProtecT__trial_ L2 - https://doi.org/10.1007/s10552-017-0910-2 DB - PRIME DP - Unbound Medicine ER -