Srgery Section, Durham VA Medical Center, Durham, NC 27710, USA.
Cancer Epidemiol Biomarkers Prev. 2012 Apr;21(4):576-81. doi: 10.1158/1055-9965.EPI-11-1017. Epub 2012 Feb 7.
Coronary artery disease (CAD) and prostate cancer (PCa) are not only common diseases, but share many risk factors. To date, only a few studies have explored the relationship between CAD and PCa risk, with conflicting results.
The four-year REDUCE study tested dutasteride 0.5 mg daily for PCa risk reduction in men with prostate specific antigen (PSA) of 2.5 to 10.0 ng/mL and a negative biopsy. Among men who underwent at least one on-study biopsy (n = 6,729; 82.8%), the association between CAD and overall PCa risk and disease grade was examined with logistic and multinomial logistic regression adjusting for clinicopathologic features, respectively.
Overall, 547 men (8.6%) had a history of CAD. Men with CAD were significantly older and had higher body mass index, PSA, and larger prostate volumes and were more likely to have diabetes, hypertension, and hypercholesterolemia and take aspirin and statins. On multivariate analysis, CAD was associated with a 35% increased risk of PCa diagnosis (OR = 1.35, 95% CI: 1.08-1.67, P = 0.007), while elevating risk of both low- (OR = 1.34, 95% CI: 1.05-1.73, P = 0.02) and high-grade disease (OR = 1.34, 95% CI: 0.95-1.88, P = 0.09).
In a post hoc hypothesis developing secondary analysis of the REDUCE study, CAD was significantly associated with increased PCa diagnosis.
If confirmed in other studies, this suggests CAD may be a novel PCa risk factor and suggests common shared etiologies. Whether lifestyle changes shown to reduce CAD risk (i.e., weight loss, exercise, cholesterol reduction, etc.) can reduce PCa risk, warrants further study.
冠心病（CAD）和前列腺癌（PCa）不仅是常见疾病，而且有许多共同的危险因素。迄今为止，只有少数研究探讨了 CAD 与 PCa 风险之间的关系，结果相互矛盾。
为期四年的 REDUCE 研究测试了 dutasteride 每天 0.5 毫克用于降低前列腺特异性抗原（PSA）为 2.5 至 10.0ng/mL 和阴性活检的男性的 PCa 风险。在接受了至少一次研究活检的男性中（n = 6729；82.8%），使用逻辑回归和多项逻辑回归分别调整临床病理特征后，检查了 CAD 与总体 PCa 风险和疾病分级之间的关联。
总体而言，547 名男性（8.6%）有 CAD 病史。患有 CAD 的男性年龄较大，体重指数、PSA 和前列腺体积较大，更有可能患有糖尿病、高血压、高胆固醇血症，并且服用阿司匹林和他汀类药物。多变量分析显示，CAD 与 PCa 诊断风险增加 35%相关（OR = 1.35，95%CI：1.08-1.67，P = 0.007），同时升高低风险（OR = 1.34，95%CI：1.05-1.73，P = 0.02）和高级别疾病的风险（OR = 1.34，95%CI：0.95-1.88，P = 0.09）。
在 REDUCE 研究的事后假设开发二次分析中，CAD 与 PCa 诊断显著相关。
如果在其他研究中得到证实，这表明 CAD 可能是一种新的 PCa 危险因素，并表明存在共同的发病机制。是否可以通过改变生活方式来降低 CAD 风险（即减肥、运动、降低胆固醇等）来降低 PCa 风险，还需要进一步研究。
