Lage M J, Barber B L, Markus R A
HealthMetrics Outcomes Research, LLC, Groton, Connecticut, USA.
Urology. 2007 Dec;70(6):1104-8. doi: 10.1016/j.urology.2007.08.012.
Previous research has documented an increase in metabolic syndrome among patients who use androgen-deprivation therapy (ADT). Given that metabolic syndrome is related to diabetes, this research examined whether use of ADT was associated with an increase in the incidence of diabetes.
A retrospective, claims database was used to compare men diagnosed with prostate cancer who received ADT (N = 1231) with men diagnosed with prostate cancer who did not receive ADT (N = 7250). Unjustified comparisons among the cohorts were examined using chi-square statistics for categorical variables and t-statistics for continuous variables. A multivariate logistic regression was estimated to examine the association between receipt of ADT and the incidence of diabetes, while controlling for a wide range of factors that also potentially affect the probability of being newly diagnosed with diabetes.
Descriptive statistics revealed that the patients who initiated ADT were significantly older (P <0.01), in poorer health (P <0.01), and more likely to have a prior diagnosis of hypertension (P = 0.04). Results from the multivariate regression indicate that for men diagnosed with prostate cancer, demographic characteristics, comorbid conditions, prior statin use, and receipt of ADT all affect the probability of incident diabetes. While controlling for other factors, the estimated relative risk of incident diabetes associated with the receipt of ADT was 1.36 (P = 0.01).
Results from this study suggest that among prostate cancer patients, those initiating ADT are more likely to develop incident diabetes within 1 year. This finding supports previous research that established the relationship between ADT and metabolic syndrome.
先前的研究记录了接受雄激素剥夺疗法(ADT)的患者中代谢综合征的增加。鉴于代谢综合征与糖尿病相关,本研究探讨了使用ADT是否与糖尿病发病率的增加有关。
使用回顾性索赔数据库,将接受ADT的前列腺癌男性患者(N = 1231)与未接受ADT的前列腺癌男性患者(N = 7250)进行比较。使用卡方统计量分析分类变量的队列间不合理比较,使用t统计量分析连续变量的队列间不合理比较。估计多元逻辑回归以检验接受ADT与糖尿病发病率之间的关联,同时控制一系列也可能影响新诊断为糖尿病概率的因素。
描述性统计显示,开始接受ADT的患者年龄显著更大(P <0.01),健康状况更差(P <0.01),并且更有可能先前被诊断为高血压(P = 0.04)。多元回归结果表明,对于被诊断为前列腺癌的男性,人口统计学特征、合并症、先前使用他汀类药物以及接受ADT均会影响糖尿病发病的概率。在控制其他因素的情况下,与接受ADT相关的糖尿病发病估计相对风险为1.36(P = 0.01)。
本研究结果表明,在前列腺癌患者中,开始接受ADT的患者在1年内更有可能发生糖尿病。这一发现支持了先前确立ADT与代谢综合征之间关系的研究。