Stevens Victoria L, Jacobs Eric J, Sun Juzhong, Gapstur Susan M
Authors' Affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
Cancer Epidemiol Biomarkers Prev. 2014 May;23(5):890-2. doi: 10.1158/1055-9965.EPI-14-0114. Epub 2014 Mar 1.
Obesity is associated with a higher risk of aggressive prostate cancer and alters circulating levels of insulin and adiponectin, two hormones that influence biologic processes implicated in carcinogenesis. Results of some studies showed associations of circulating levels of adiponectin, insulin, and c-peptide (a marker of insulin secretion) with aggressive prostate cancer, but the size of these studies was limited.
A nested case-control study of 272 aggressive prostate cancer cases [Gleason score ≥ 7 (4+3) or T3-T4] and 272 age- and race-matched controls from the Cancer Prevention Study II Nutrition Cohort was conducted to determine the associations of prediagnostic plasma levels of c-peptide and adiponectin with risk of aggressive prostate cancer.
Neither circulating adiponectin nor c-peptide was associated with risk of aggressive prostate cancer. In analyses of the highest-risk aggressive prostate cancer (Gleason score ≥ 8 or T3-T4), the highest quartile of c-peptide, compared with the lowest, was associated with an OR of 1.41 [95% confidence interval (CI), 0.72-2.78].
Our findings provide no support for the hypothesis that adiponectin is associated with risk of aggressive prostate cancer but a possible association of high levels of c-peptide with particularly high-risk prostate cancer cannot be ruled out.
These results indicate that changes in circulating levels of adiponectin and c-peptide do not play an important role in risk of aggressive prostate cancer.
肥胖与侵袭性前列腺癌风险较高相关,且会改变胰岛素和脂联素的循环水平,这两种激素会影响致癌过程中涉及的生物学过程。一些研究结果显示脂联素、胰岛素和C肽(胰岛素分泌标志物)的循环水平与侵袭性前列腺癌有关,但这些研究规模有限。
开展了一项巢式病例对照研究,纳入来自癌症预防研究II营养队列的272例侵袭性前列腺癌病例[ Gleason评分≥7(4+3)或T3-T4]以及272例年龄和种族匹配的对照,以确定诊断前血浆C肽和脂联素水平与侵袭性前列腺癌风险的关联。
循环脂联素和C肽均与侵袭性前列腺癌风险无关。在对最高风险的侵袭性前列腺癌(Gleason评分≥8或T3-T4)的分析中,C肽最高四分位数与最低四分位数相比,其比值比为1.41[95%置信区间(CI),0.72-2.78]。
我们的研究结果不支持脂联素与侵袭性前列腺癌风险相关的假说,但不能排除高水平C肽与特别高风险前列腺癌可能存在关联。
这些结果表明,脂联素和C肽循环水平的变化在侵袭性前列腺癌风险中不发挥重要作用。