The present study, for the first time to our knowledge, demonstrates the significant association of postDM, but not preDM, with the progression to CRPC, and also ascertains the impact of initial diagnostic characteristics of PC, including high PSA levels, GS, high risk in NCCN’s classification and stages, in addition to metastasis, on CRPC progression, in agreement with the recent study13. This evidence concerns the gene KLK3 and pachyonychia congenita.