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Aims/Introduction  The current literature suggests that men with diabetes have a lower prostate‐specific antigen concentration than men without diabetes, but the causal association remains unclear. We aimed to investigate the association between serum prostate‐specific antigen concentrations and the risk of type 2 diabetes mellitus in a cohort study of a Chinese population.    Materials and Methods  We designed a cohort study that comprised 16,811 initially non‐diabetic Chinese men who received annual health checkups between 2009 and 2016. The outcome of this study was type 2 diabetes mellitus, identified by medical diagnosis, self‐reportage, medication use, fasting glucose, 2‐h post oral glucose or glycated hemoglobin measurements. Cox proportional hazards models were carried out to evaluate the association.    Results  During a median follow‐up period of 3.8 years (interquartile range 1.91–5.73 years), 1,260 participants developed incident type 2 diabetes mellitus. The multivariable model, adjusted for various potential confounders, showed that serum prostate‐specific antigen concentrations were inversely related to type 2 diabetes mellitus risk ( P  for trend = 0.014). Compared with the lowest quartile of serum prostate‐specific antigen, the hazard ratio and 95% confidence intervals of type 2 diabetes mellitus risk for quartile 2–4 were 0.84 (0.66–1.07), 0.75 (0.59–0.94) and 0.77 (0.62–0.96), respectively. Subgroup analyses suggested the inverse relationship was more prominent in overweight or obese participants ( P  for interaction = 0.013).    Conclusions  High serum prostate‐specific antigen concentration was associated with a low risk of type 2 diabetes mellitus in Chinese men. Future studies are required to confirm these findings and investigate underlying mechanisms.

Association between serum prostate‐specific antigen concentrations and the risk of developing type 2 diabetes mellitus in Chinese men: A cohort study