Morote Juan, Celma Anna, Planas Jacques, Placer José, de Torres Inés, Olivan Mireia, Carles Juan, Reventós Jaume, Doll Andreas
Department of Urology, Vall d'Hebron University Hospital and Autonomous University of Barcelona, Barcelona 08035, Spain.
Research Unit in Biomedicine and Translational Oncology, Vall d'Hebron Research Institute and Hospital and Autonomous University of Barcelona, Barcelona 08035, Spain.
Int J Mol Sci. 2014 Aug 6;15(8):13615-23. doi: 10.3390/ijms150813615.
The aim of this study was to analyze the relationship between statin use along with serum cholesterol levels and prostate cancer (PCa) detection and aggressiveness. Statin users of three years or more and serum cholesterol levels (SC) were assessed in 2408 men scheduled for prostate biopsy. SC was classified as normal (NSC: <200 mg/dL) or high (HSC: >200 mg/dL). High-grade PCa (HGPCa) was considered if the Gleason score was greater than 7. Statin users comprised 30.9% of those studied. The PCa detection rate was 31.2% of men on statins and 37% of non-statin users (p<0.006). The PCa detection rate was 26.3% in men with NSC and 40.6% in those with HSC (p<0.001). In the subset of NSC men, the PCa rate was 26.5% for statin users and 26.2% for non-users (p=0.939), while in men with HSC, the PCa rate was 36.4% for statin users and 42.0% for non-statin users (p=0.063). The HGPCa rate was 41.8% for statin users and 32.5% for non-users (p=0.012). NSC men had a 53.8% rate of HGPCa, while the rate was only 27.6% in HSC men (p<0.001). NSC men on statins had an HGPCa rate of 70.2%, while non-statin users had a rate of 41.2% (p<0.001). The HGPCa rate for HSC men on statins was 18.8%, while the rate was 30.0% (p=0.011) for non-users. Logistic regression analysis suggested that serum cholesterol levels could serve as an independent predictor of PCa risk, OR 1.87 (95% CI 1.56-2.24) and HGPCa risk, OR 0.31 (95% CI 0.23-0.44), while statin usage could not. Statin treatment may prevent PCa detection through serum cholesterol-mediated mechanisms. A disturbing increase in the HGPCa rate was observed in statin users who normalized their serum cholesterol.
本研究的目的是分析他汀类药物使用情况与血清胆固醇水平和前列腺癌（PCa）检测及侵袭性之间的关系。对2408名计划进行前列腺活检的男性评估了使用三年或更长时间他汀类药物的情况以及血清胆固醇水平（SC）。SC分为正常（NSC：<200mg/dL）或高（HSC：>200mg/dL）。如果Gleason评分大于7，则考虑为高级别PCa（HGPCa）。他汀类药物使用者占研究对象的30.9%。服用他汀类药物男性的PCa检出率为31.2%，未服用他汀类药物男性的检出率为37%（p<0.006）。NSC男性的PCa检出率为26.3%，HSC男性为40.6%（p<0.001）。在NSC男性亚组中，他汀类药物使用者的PCa发生率为26.5%，未使用者为26.2%（p=0.939），而在HSC男性中，他汀类药物使用者的PCa发生率为36.4%，未服用他汀类药物者为42.0%（p=0.063）。他汀类药物使用者的HGPCa发生率为41.8%，未使用者为32.5%（p=0.012）。NSC男性的HGPCa发生率为53.8%，而HSC男性中该发生率仅为27.6%（p<0.001）。服用他汀类药物的NSC男性的HGPCa发生率为70.2%，未服用他汀类药物者为41.2%（p<0.001）。服用他汀类药物的HSC男性的HGPCa发生率为18.8%，未使用者为30.0%（p=0.011）。逻辑回归分析表明，血清胆固醇水平可作为PCa风险的独立预测因子，OR为1.87（95%CI 1.56 - 2.24）和HGPCa风险的OR为0.31（95%CI 0.23 - 0.44），而他汀类药物的使用情况则不能。他汀类药物治疗可能通过血清胆固醇介导的机制阻止PCa的检测。在血清胆固醇恢复正常的他汀类药物使用者中观察到HGPCa发生率令人不安的增加。
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