A protein could predict a person’s risk of getting diabetes or dying from cancer. It is called prostasin and according to a study published in ‘Diabetologia’, the journal of the European Association for the Study of Diabetes (Eadv), when it is present in the blood in large quantities it can increase the chances of developing the ‘blood disease by 76%. sweet ‘and 43% those of death from cancer, with a particularly marked association in the case in which high prostasin is also associated with hyperglycemia. The researchers analyzed blood samples of 4,658 adults (average age 58 years, 40% men), taken as part of the Malmö Diet and Cancer Study, a large prospective research underway since the early 1990s in the city of Malmo in southern Sweden. The published analysis is “the most comprehensive of its kind ever conducted so far and sheds new light on the biological link between diabetes and cancer,” says Gunnar Engström of Lund University in Malmö, co-lead author of the work indicating prostasin – mainly present in epithelial cells lining the internal and external surfaces of the body – as “a new potential risk marker for the development of diabetes and cancer mortality, especially in people with high blood sugar levels,” emphasizes first research author Xue Bao, from the affiliated hospital of the University Medical School in Nanjing, China. An “easily accessible”, accurate ‘spy’ indicator, because it can be measured through a simple sampling. The results correlating prostasin levels to the risk of diabetes and cancer death remained valid even after correcting them for various confounding factors including age, gender, waistline, bad cholesterol levels, blood pressure, medication intake, habit to smoking and alcohol. However, the authors highlight that the study is observational and describe several limitations: for example, the blood samples used had been stored for at least a decade, and the data obtained on participants from a Swedish city may not be generalizable on a large scale to other populations. Although it is known that people with type 2 diabetes are about twice as likely to get pancreatic, endometrial and liver cancer, and a 30% higher risk of bowel cancer and a 20% higher risk of cancer breast, the mechanisms behind this link remain poorly understood. Researchers have focused on prostasin for its effects in regulating sodium levels, blood volume and blood pressure, and because the substance has been observed to affect hyperglycemia-induced tumor growth and is associated with glucose metabolism. They found that elevated prostasin concentrations correlated with the presence of diabetes (people with protein levels in the top quartile were almost twice as likely to suffer from it than those with prostasin concentrations in the lowest quartile) and that the protein was significantly associated with both cancer and all-cause mortality. For each doubling of the prostasin concentration, the risk of cancer mortality increased by 139% and 24%, respectively, among participants with and without elevated blood glucose levels. However, no correlation was found with cardiovascular mortality. “Since prostasin plays a role in the control of various biological pathways associated with diabetes, which are also involved in the onset of some cancers, potentially – speculates Xue Bao – could mediate the process” which links a “high blood sugar level to cancer, or at least it could act as a marker of susceptibility to cancer in people with high blood sugar. To investigate this in more detail, it will be useful in future studies to trace the exact origins of prostasin.” circulating “in the blood and determining whether the association between prostasin and diabetes is causal”.
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