Abstract
<jats:p>Background. In prostate cancer, there are metabolic and hormonal imbalances affecting the development of a tumor. Hormone regulation plays a vital role in the pathophysiology of prostate cancer. Adropin, nesfatin-1 and sex hormones can be used as combined biomarkers of disease development. The purpose of the study was to evaluate the integrated role of adropin, nesfatin-1, and sex hormones as metabolic-endocrine biomarkers in prostate cancer development and progression. Materials and methods. A case-control study was carried out between January 2025 and February 2026 in Iraqi urology and oncology centers involving 100 patients with prostate cancer and 50 healthy controls. They were diagnosed by means of prostate-specific antigen (PSA), ultrasound, and histopathology (Gleason score). Patients who were newly diagnosed and not treated, aged 50 years or older were eligible. Blood samples (5 mL) were centrifuged and stored at –20 °C, adropin and nesfatin-1 were evaluated by enzyme-linked immunosorbent assay whereas sex hormones were determined by an automated immunoassay system. Clinical data were obtained from records and questionnaires. Results. The findings indicated that there were no significant differences in age and smoking; hence, good matching. But body mass index, hypertension and PSA were all significantly elevated in patients. The biomarkers were all significantly different (P = 0.001) with decreased adropin, nesfatin-1 and testosterone and increased estradiol and luteinizing hormone. These indicators were associated with PSA and tumor severity. The regression analysis revealed low adropin, nesfatin-1, testosterone, high estradiol, and body mass index as the independent risk predictors that demonstrated the role of metabolic-endocrine dysregulation in the development and progression of prostate cancer. Conclusions. Metabolic-endocrine imbalance, which is low adropin, nesfatin-1, and testosterone, and elevated estradiol, are linked to prostate cancer. This imbalance facilitates the processes of inflammation, oxidative stress, and disruption of hormones, which are associated with tumor development and worsening of illnesses.</jats:p>