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糖尿病与不同分级或分期前列腺癌风险:系统评价和荟萃分析。

Diabetes mellitus and prostate cancer risk of different grade or stage: a systematic review and meta-analysis.

机构信息

Department of Urology, Huashan Hospital, Fudan University, Shanghai, PR China.

出版信息

Diabetes Res Clin Pract. 2013 Mar;99(3):241-9. doi: 10.1016/j.diabres.2012.12.003. Epub 2013 Jan 5.

Abstract

AIM

Prior studies have reported that diabetes mellitus might reduce the overall prostate cancer risk. We examined this association by conducting a detailed meta-analysis of the studies published in peer-reviewed literature on the association between diabetes mellitus and prostate cancer risk of different stage or grade.

METHODS

A comprehensive search for articles of MEDLINE and EMBASE databases and bibliographies of retrieved articles published up to October 23, 2012 was performed. Methodological quality assessment of the trials was based on the Newcastle-Ottawa Scale. Meta-analysis was performed using STATA 12.0.

RESULTS

We included 9 studies in the meta-analysis (5 studies examining the relation of different stage only, 2 studies for grade only, and 2 studies for both grade and stage), and found an inverse association between diabetes mellitus and prostate cancer of different stage or grade. The relative risk (RRs) was moderately stronger for low grade (RR 0.74, 95% confidence interval (CI), 0.64-0.86) and localized disease (RR 0.72, 95% CI 0.67-0.76) compared with high grade (RR 0.78, 95% CI 0.67-0.90) and advanced disease (RR 0.85, 95% CI 0.75-0.97).

CONCLUSION

This study suggests an inverse relationship between diabetes mellitus and prostate cancer of different stage or grade. Possible biases underlying this association are discussed.

摘要

目的

先前的研究报告称,糖尿病可能会降低总体前列腺癌风险。我们通过对已发表的同行评议文献中关于糖尿病与不同分期或分级的前列腺癌风险之间的关联进行详细的荟萃分析,来检验这种关联。

方法

对 MEDLINE 和 EMBASE 数据库的文章进行全面检索,并对截至 2012 年 10 月 23 日检索到的文章的参考文献进行检索。根据纽卡斯尔-渥太华量表对试验的方法学质量进行评估。使用 STATA 12.0 进行荟萃分析。

结果

我们将 9 项研究纳入荟萃分析(5 项研究仅考察不同分期的关系,2 项研究仅考察分级,2 项研究同时考察分级和分期),发现糖尿病与不同分期或分级的前列腺癌之间存在负相关。与高级别(RR 0.78,95%置信区间(CI)0.67-0.90)和晚期疾病(RR 0.85,95%CI 0.75-0.97)相比,低级别(RR 0.74,95%CI 0.64-0.86)和局限性疾病(RR 0.72,95%CI 0.67-0.76)的相对风险(RRs)更强。

结论

本研究表明,糖尿病与不同分期或分级的前列腺癌之间存在负相关。讨论了这种关联背后可能存在的偏倚。

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