Hara Noboru
Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi 1, Niigata 951-8510, Japan.
Exp Diabetes Res. 2012;2012:801610. doi: 10.1155/2012/801610. Epub 2012 Jun 26.
Prostate cancer and the androgen deprivation therapy (ADT) thereof are involved in diabetes in terms of diabetes-associated carcinogenesis and ADT-related metabolic disorder, respectively. The aim of this study is to systematically review relevant literature. About 218,000 men are estimated to be newly diagnosed with prostate cancer every year in the United States. Approximately 10% of them are still found with metastasis, and in addition to them, about 30% of patients with nonmetastatic prostate cancer recently experience ADT. Population-based studies have shown that dissimilar to other malignancies, type 2 diabetes is associated with a lower incidence of prostate cancer, whereas recent large cohort studies have reported the association of diabetes with advanced high-grade prostate cancer. Although the reason for the lower prevalence of prostate cancer among diabetic men remains unknown, the lower serum testosterone and PSA levels in them can account for the increased risk of advanced disease at diagnosis. Meanwhile, insulin resistance already appears in 25-60% of the patients 3 months after the introduction of ADT, and long-term ADT leads to a higher incidence of diabetes (reported hazard ratio of 1.28-1.44). Although the possible relevance of cytokines such as Il-6 and TNF-α to ADT-related diabetes has been suggested, its mechanism is poorly understood.
前列腺癌及其雄激素剥夺疗法（ADT）分别在糖尿病相关致癌作用和ADT相关代谢紊乱方面与糖尿病相关。本研究的目的是系统回顾相关文献。在美国，估计每年有21.8万名男性被新诊断出患有前列腺癌。其中约10%仍被发现有转移，除此之外，最近约30%的非转移性前列腺癌患者接受了ADT。基于人群的研究表明，与其他恶性肿瘤不同，2型糖尿病与前列腺癌的发病率较低相关，而最近的大型队列研究报告了糖尿病与晚期高级别前列腺癌的关联。尽管糖尿病男性中前列腺癌患病率较低的原因尚不清楚，但他们较低的血清睾酮和PSA水平可以解释诊断时晚期疾病风险增加的原因。同时，在引入ADT后3个月，25%-60%的患者已经出现胰岛素抵抗，长期ADT会导致糖尿病发病率更高（报告的风险比为1.28-1.44）。尽管有人提出白细胞介素-6和肿瘤坏死因子-α等细胞因子与ADT相关糖尿病可能存在关联，但其机制尚不清楚。
