Blood protein levels can signal risk of diabetes and cancer death, study shows

Doctors have identified a protein in their blood that they believe could serve as an early warning sign for patients at risk of developing diabetes and dying from cancer.

Researchers from Sweden and China analyzed two decades of health records from more than 4,500 middle-aged adults in the Malmö Diet and Cancer Study. They found that those with the highest levels of prostasin, a protein that circulates in the blood, were almost twice as likely to have diabetes as those with the lowest levels.

Some of those enrolled in the study already had diabetes, so the scientists looked at who among those without the disease went on to be diagnosed later. People in the first trimester of prostasin levels were found to be 76% more likely to develop diabetes than those in the bottom trimester.

Dr. Xue Bao, the study’s first author at the Affiliated Hospital of Nanjing University School of Medicine in China, said prostasin was a potential new “risk marker” for diabetes, but also death from cancer, especially in people with high blood sugar.

Prostasin has several roles in the body, including regulating blood pressure and blood volume, and it also suppresses the growth of tumors that are fueled by high blood sugar. Although type 2 diabetes is known to increase the risk of certain cancers, including tumors of the pancreas, liver, bowel, and endometrium, the biological mechanisms are far from clear.

After investigating the link between prostasin and diabetes, the researchers looked at whether people with high levels of the protein had a higher risk of cancer.

Writing in Diabetologia, they describe how those in the top quartile of prostasin levels were 43% more likely to die from cancer than those in the bottom quartile.

According to the study, participants with elevated prostasin and blood sugar levels had a significantly higher risk of dying from cancer. For every doubling of prostasin concentration, the risk of death from cancer increased by 24% in those without high blood sugar and by 139% in those with high blood sugar. “Special attention should be paid to these individuals,” the authors write.

It is not clear whether an elevated level of prostasin plays a role in the disease or is simply a biological marker that increases as the disease develops. One possibility, the authors suggest, is that prostasin levels rise in an attempt to suppress high blood sugar levels, but are unable to stop or reverse the damage caused.

“The relationship between diabetes and cancer is poorly understood and this protein could provide a possible shared link between the two conditions,” said Professor Gunnar Engström, lead author of the study at Lund University.

“We now need to examine to what extent prostasin is causally related to these diseases or whether it is a valuable marker of increased disease risk,” Engström added.

“It might also be possible to identify people at higher risk of diabetes and cancer and offer preventive measures.”

Because the findings are drawn from people in one city, they may not apply to larger populations. The researchers also note that prostasin was measured from frozen blood taken at a single time point and that the study could not distinguish between different types of diabetes.

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Jessica Brown, from Diabetes UK, said: “We know there is a connection between diabetes and some types of cancer, and this study suggests that levels of a particular protein, called prostasin, are linked to both conditions.

“Gaining a better understanding of the changes inside the body that can put people at risk of diabetes and cancer will help scientists find ways to protect people from these serious conditions, but there is still much to discover.

“We need more research to find out whether prostasin plays a direct role in the development of type 2 diabetes and poorer cancer outcomes in people with high blood sugar levels.”

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