Salvador C, Planas J, Raventós C, Ropero J, Placer J, López M A, Morote J
Servicio de Urología y Trasplante Renal, Hospital Vall d'Hebron, Barcelona, España.
Actas Urol Esp. 2012 Apr;36(4):205-9. doi: 10.1016/j.acuro.2011.09.006. Epub 2011 Dec 16.
This study has aimed to analyze the changes observed in the lipid profile and atherogenic risk in prostate cancer patients subjected to androgen deprivation.
Between 2001 and 2008, serum lipoproteins (total cholesterol, HDL, LDL and triglycerides) were determined in 636 patients. Of these, 129 were treated with maximum androgen blockade and 177 patients were only treated with LHRH analogue. The control group was formed by 339 subjected to prostate biopsy (212 with prostate cancer and 127 without prostate cancer). The atherogenic risk was calculated using the Castelli formula (total cholesterol/HDL).
Mean atherogenic risk was 4.2 in the control group and 4 in the group of patients subjected to androgenic deprivation, p>0.05. The mean atherogenic risk in those subjected to monotherapy with LHRH analogues was 4.1 while it was 3.9 in patients subjected to maximal androgen blockade, p=0.02. We did not found significant differences for atherogenic risk according to length of treatment, p>0.05. The multivariate analysis confirmed that the treatment modality was the only significant variable influencing atherogenic risk.
This study demonstrates that continuous androgen deprivation does not increase atherogenic risk in patients with prostate cancer. This risk also did not increase during the treatment. The association of bicalutamide to the LHRH analogue seems to have a protective effect on atherogenic risk.
本研究旨在分析接受雄激素剥夺治疗的前列腺癌患者血脂谱和动脉粥样硬化风险的变化。
2001年至2008年期间，对636例患者进行了血清脂蛋白（总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯）检测。其中，129例接受了最大雄激素阻断治疗，177例仅接受促性腺激素释放激素（LHRH）类似物治疗。对照组由339例接受前列腺活检的患者组成（212例患有前列腺癌，127例未患前列腺癌）。使用卡斯泰利公式（总胆固醇/高密度脂蛋白）计算动脉粥样硬化风险。
对照组的平均动脉粥样硬化风险为4.2，接受雄激素剥夺治疗的患者组为4，p>0.05。接受LHRH类似物单一疗法的患者平均动脉粥样硬化风险为4.1，而接受最大雄激素阻断治疗的患者为3.9，p=0.02。根据治疗时长，我们未发现动脉粥样硬化风险存在显著差异，p>0.05。多变量分析证实，治疗方式是影响动脉粥样硬化风险的唯一显著变量。
本研究表明，持续雄激素剥夺不会增加前列腺癌患者的动脉粥样硬化风险。在治疗期间，这种风险也未增加。比卡鲁胺与LHRH类似物联合使用似乎对动脉粥样硬化风险具有保护作用。
