Hall Susan A, Page Stephanie T, Travison Thomas G, Montgomery R Bruce, Link Carol L, McKinlay John B
New England Research Institutes, 9 Galen Street, Watertown, MA 02472, USA.
Cancer Epidemiol Biomarkers Prev. 2007 Aug;16(8):1587-94. doi: 10.1158/1055-9965.EPI-07-0306.
In 2005, statins were among the most commonly used prescription medications in the United States. Some data suggest statins may affect cancer risk and/or disease severity. Because cholesterol is a required intermediate in sex steroid synthesis, it is possible that statins influence prostate cancer risk through effects on steroid hormone metabolism. We investigated whether levels of circulating androgens and their carrier protein, sex hormone-binding globulin (SHBG), varied by statin exposure among a sample of 1,812 men from a population-based epidemiologic study, the Boston Area Community Health Survey.
We measured serum total testosterone, free testosterone, dehydroepiandrosterone sulfate, luteinizing hormone, and SHBG. Statin exposure was collected through participant self-report and/or interviewer-recorded information. Multivariate linear models were constructed to account for potential confounding.
The prevalence of statin use was 12.4% [95% confidence interval (95% CI), 10.3-14.9]. On average, statin users were older, had larger body mass index and more chronic illnesses, and used more medications. We found no relationship between statin use and free testosterone, dehydroepiandrosterone sulfate, or luteinizing hormone. A significant association between statin use and total testosterone was initially observed but was not robust to covariate control in a multivariate model that included age, body mass index, time since awakening, and history of cardiovascular disease and diabetes (-5.5%; 95% CI, -13.2 to 2.9%). In multivariate models adjusted similarly, SHBG levels among statin users were statistically significantly lower compared with nonusers (-10.6%; 95% CI, -18.8 to -1.6%).
In this sample, it is unlikely that statins affect circulating androgens and prostate cancer risk through a hormonal mechanism.
2005年，他汀类药物是美国最常用的处方药之一。一些数据表明，他汀类药物可能会影响癌症风险和/或疾病严重程度。由于胆固醇是性类固醇合成所需的中间体，因此他汀类药物有可能通过影响类固醇激素代谢来影响前列腺癌风险。我们在一项基于人群的流行病学研究——波士顿地区社区健康调查的1812名男性样本中，研究了循环雄激素及其载体蛋白性激素结合球蛋白（SHBG）的水平是否因他汀类药物暴露而有所不同。
我们测量了血清总睾酮、游离睾酮、硫酸脱氢表雄酮、促黄体生成素和SHBG。通过参与者自我报告和/或访谈者记录的信息收集他汀类药物暴露情况。构建多变量线性模型以考虑潜在的混杂因素。
他汀类药物的使用 prevalence为12.4%[95%置信区间（95%CI），10.3 - 14.9]。平均而言，他汀类药物使用者年龄更大，体重指数更高，慢性病更多，并且使用的药物更多。我们发现他汀类药物的使用与游离睾酮、硫酸脱氢表雄酮或促黄体生成素之间没有关系。最初观察到他汀类药物的使用与总睾酮之间存在显著关联，但在包含年龄、体重指数、醒来后的时间以及心血管疾病和糖尿病病史的多变量模型中，这种关联在控制协变量后并不稳健（-5.5%；95%CI，-13.2至2.9%）。在类似调整的多变量模型中，他汀类药物使用者的SHBG水平与非使用者相比在统计学上显著降低（-10.6%；95%CI，-18.8至-1.6%）。
在这个样本中，他汀类药物不太可能通过激素机制影响循环雄激素和前列腺癌风险。
