Case Study

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A detailed description of the Swedish Apolipoprotein MOrtality RISk (AMORIS) cohort can be found elsewhere (14,15). Briefly, this database comprises 812,073 Swedish men and women with blood samples sent for laboratory evaluation to the Central Automation Laboratory (CALAB) in Stockholm, Sweden, during the period 1985 to 1996 (16-18). Individuals recruited were primarily from the greater Stockholm area and, were either healthy and having laboratory testing as part of a general health check or outpatients referred for laboratory testing. None of the participants were inpatients at the time of sampling. In the AMORIS cohort, the CALAB data was linked to several Swedish national registries such as the Swedish National Cancer Register, the…show more content…
In this study, we excluded men without any information on PSA levels, Gleason grade, and TNM stage (n= 5995) and those whose glucose, total cholesterol and triglycerides measurements were not taken at the same health examination (n= 2991). After exclusion, our study comprised 14,150 men aged 20 and older who were newly diagnosed with prostate cancer between 1996 and 2011. See Figure I for schematic representation of the study population. The primary exposures for our study were pre-diagnostic serum levels of glucose, triglycerides and total cholesterol. For the purpose this study we selected the most recent serum measurement. These measurements were taken on average about 14 years prior to diagnosis. Glucose was measured enzymatically with a glucose-oxidase/peroxidase method. Total cholesterol and triglycerides were measured enzymatically as previously described (21). All methods were fully automated with automatic calibration and performed at one accredited laboratory (17). Serum glucose, total cholesterol and triglycerides levels were analysed using clinical cut-off points in accordance with the American Diabetes Association and National Cholesterol Education Programme (NCEP) guidelines (22-24) and quartiles. For the clinical cut-off points, serum glucose levels were categorised as 6.9mmol/l, while serum total cholesterol was

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