Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Sex Med. 2011 Mar;8(3):905-13. doi: 10.1111/j.1743-6109.2010.02115.x. Epub 2010 Nov 22.
High sexual activity (SA) has been reported to reduce the risk of prostate cancer (PC). The role of sex hormones (SHs) in this regard remains controversial.
To determine the impact of SA and SHs on PC development.
In a multicentric hospital-based case-control study, 194 newly diagnosed PC patients along with 317 age-matched controls were studied. Sociodemographic and medical characteristics of participants were recorded. History of vasectomy and sexually transmitted infection (STI), marital status, age at first intercourse, premarital sex, and the current frequency of sexual intercourses per month (SPM) were evaluated. Total testosterone (TT), free testosterone (FT), estradiol (ES), sex hormone binding globulin, and albumin were also measured. Logistic regression model was used to identify independent risk factors for PC.
(i) The association between SA, SHs, and the risk of PC; (ii) The correlation between SHs and SA; (iii) The interaction between SHs and SA and established risk factors for PC and erectile dysfunction in determining the risk of PC; and (iv) The correlation between SHs and SA in determining the risk of PC in different decades of life.
Vasectomy, STI, and marital status did not differ significantly between two cohorts. Controls reported premarital sex more commonly than cases (P < 0.001). Cases had the first intercourse at older age (P = 0.03) and had less SPM (P < 0.001). TT, FT, and ES were higher in controls (P < 0.001). In multivariate analysis, TT, calculated FT, SPM >4, and age at time of marriage <24 were protective against PC. The protective effect of high SA and SHs increased as patients' age increased.
High SA as well as TT and FT were protective against PC. Their protective role enhances by each decade of increasing age. The protective effect of high SA was independent from circulating levels of SHs.
高性生活活跃度（SA）已被报道可降低前列腺癌（PC）的风险。在这方面，性激素（SHs）的作用仍存在争议。
确定 SA 和 SHs 对 PC 发展的影响。
在一项多中心医院为基础的病例对照研究中，研究了 194 名新诊断的 PC 患者和 317 名年龄匹配的对照者。记录了参与者的社会人口统计学和医学特征。评估了输精管切除术和性传播感染（STI）、婚姻状况、首次性交年龄、婚前性行为以及每月性行为频率（SPM）。还测量了总睾酮（TT）、游离睾酮（FT）、雌二醇（ES）、性激素结合球蛋白和白蛋白。使用逻辑回归模型确定 PC 的独立危险因素。
（i）SA、SHs 与 PC 风险之间的关联；（ii）SHs 和 SA 之间的相关性；（iii）SHs 和 SA 与已确立的 PC 危险因素和勃起功能障碍在确定 PC 风险方面的相互作用；（iv）SHs 和 SA 在确定不同年龄段 PC 风险方面的相关性。
两组间输精管切除术、STI 和婚姻状况无显著差异。对照组报告婚前性行为比病例组更常见（P<0.001）。病例组首次性交年龄较大（P=0.03），SPM 较少（P<0.001）。对照组 TT、计算的 FT 和 ES 较高（P<0.001）。在多变量分析中，TT、计算的 FT、SPM>4 和结婚年龄<24 是 PC 的保护因素。高 SA 和 SHs 的保护作用随着患者年龄的增加而增加。
高 SA 以及 TT 和 FT 对 PC 具有保护作用。随着年龄每增加十年，其保护作用增强。高 SA 的保护作用独立于循环 SHs 水平。
