HMG-CoA 还原酶治疗对血清 PSA 的影响。

The impact of HMG-CoA reductase therapy on serum PSA.

机构信息

Department of Urology, University of Rochester/Strong Memorial Hospital, Rochester, New York, USA.

出版信息

Prostate. 2010 May 1;70(6):608-15. doi: 10.1002/pros.21095.

DOI:10.1002/pros.21095

PMID:19998369

Abstract

BACKGROUND

3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors, otherwise known as statins, inhibit the enzyme that controls the conversion of HMG-CoA to mevalonate, a precursor for cholesterol. Statins may be important to prostate cancer biology by inhibiting cell growth, inflammation, and oxidative stress. The purpose of this study was to assess the influence of statin therapy on serum prostate-specific antigen (PSA) levels.

METHODS

The computerized medical records at the University of Rochester Medical Center were used to identify men who filled statin prescriptions between May 31st, 2008 and September 30th, 2008. Men with at least one PSA assay performed within 2 years before and at least one PSA assay performed within 1 year after starting a statin medication were included. The primary endpoint was the change in PSA concentration computed as the difference between PSA levels before and after starting a statin medication. Paired t-tests were used to analyze the mean differences in PSA values.

RESULTS

A total of 962 patients were identified. The mean difference in serum PSA level after statin administration was -0.29 ng/ml (-8.04%). Subgroup analyses for mean PSA concentration change before and after statin administration by age group revealed: 50-59 years old (-0.1609, 95% CI: -0.2444, -0.0775, P < 0.0002), 60-69 years old (-0.3393, 95% CI: -0.4641, -0.2145, P < 0.0001), and >70 years old (-0.351, 95% CI: -0.490, -0.212, P < 0.0001).

CONCLUSIONS

These observations suggest a statistically significant reduction in serum PSA level that is associated with the onset of statin therapy.

摘要

背景

3-羟基-3-甲基戊二酰辅酶 A（HMG-CoA）还原酶抑制剂，也称为他汀类药物，可抑制控制 HMG-CoA 转化为胆固醇前体甲羟戊酸的酶。他汀类药物可能通过抑制细胞生长、炎症和氧化应激对前列腺癌生物学具有重要意义。本研究旨在评估他汀类药物治疗对血清前列腺特异性抗原（PSA）水平的影响。

方法

罗切斯特大学医学中心的计算机化医疗记录被用来确定 2008 年 5 月 31 日至 2008 年 9 月 30 日期间服用他汀类药物的男性。至少有两次 PSA 检测，一次在开始服用他汀类药物前 2 年内，一次在开始服用他汀类药物后 1 年内。主要终点是计算的 PSA 浓度变化，即开始服用他汀类药物前后 PSA 水平之间的差异。采用配对 t 检验分析 PSA 值的均值差异。

结果

共确定了 962 名患者。服用他汀类药物后血清 PSA 水平的平均差异为-0.29ng/ml（-8.04%）。按年龄组进行的他汀类药物治疗前后平均 PSA 浓度变化的亚组分析显示：50-59 岁组（-0.1609，95%CI：-0.2444，-0.0775，P <0.0002），60-69 岁组（-0.3393，95%CI：-0.4641，-0.2145，P <0.0001）和>70 岁组（-0.351，95%CI：-0.490，-0.212，P <0.0001）。