Welcome to Study of the Week from Patient Worthy. In this segment, we select a study we posted about from the previous week that we think is of particular interest or importance and go more in-depth. In this story we will talk about the details of the study and explain why it’s important, who will be impacted, and more.

If you read our short form research stories and find yourself wanting to learn more, you’ve come to the right place.

This week’s study is…

Plasma prostasin: a novel risk marker for incidence of diabetes and cancer mortality

We previously published about this research in a story titled “New Study Highlights a Protein With the Potential to Predict Cancer Deaths and Type 2 Diabetes Risk” which can be found here. The study was originally published in the scientific journal Diabetologia. You can read the full text of the study here. 

This research team was a collaboration of Chinese and Swedish scientists.

What Happened?

Diabetes increases a person’s risk of developing cancer. Type two diabetes in particular is linked to a greater risk of liver cancer, endometrial cancer, and pancreatic cancer. However, medications that address high blood sugar can help curb this risk. Prior research has also revealed that the protein prostasin, classified as an epithelial sodium channel stimulator, is associated with the metabolism of glucose, tumor suppression, and the pathology of hyperglycemia-associated tumors. This study sought to understand the relationship diabetes, prostasin, and cancer mortality, a subject that has not received much scrutiny. 

The scientists looked at samples from 4,658 adults, including 361 patients with diabetes. The data was drawn from the 1991-1994 period of the Malmö Diet and Cancer Study Cardiovascular Cohort. After adjusting for several factors that are associated with the development of diabetes, the research team found that people with elevated levels of prostasin were more likely to have diabetes. In fact, people with the highest levels were two times more likely to have diabetes than those people with the lowest levels.

The team then evaluated the continued data from the cohort through to 2019, excluding the known diabetes patients. 702 more people developed diabetes during that time, and those with high prostasin were 76 percent more likely to get the disease. The protein was a better predictor of diabetes development in younger people. 

With an average follow up of 24 years, a total of 651 people died from cancer. The people with the highest prostasin levels were 43 percent more likely to die as a result of cancer. Furthermore, every time the levels of prostasin were doubled, risk of cancer death increased 139 percent in people with elevated glucose and 24 percent in those without elevated glucose. These findings led the researchers to conclude that elevated prostasin is a risk factor for cancer death and the development of diabetes, particularly for people with elevated blood glucose.

Why Does it Matter?

The findings from this research further illustrate the connection between diabetes and cancer, and suggest that much more research in this area is warranted. In addition, the discovery of a easily traceable risk marker, the protein prostasin, will give physicians an important tool that can help inform decisions around a patient’s future health regarding these serious and life-limiting diseases.

“Prostasin may be just an indicator that disease might occur, or could be causally relevant, which is exciting because it raises the possibility of targeting this protein with future treatments for both diabetes and cancer.” – Professor Gunnar Engström, M.D., Ph.D., Lund University, co-lead author

“It is easily accessible, which enhances its potential to serve as a warning marker in the future.” – Xue Bao, Ph.D., The Affiliated Hospital of Nanjing University Medical School, first author