Allott Emma H, Howard Lauren E, Vidal Adriana C, Moreira Daniel M, Castro-Santamaria Ramiro, Andriole Gerald L, Freedland Stephen J
Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina.
Cancer Prev Res (Phila). 2017 Jun;10(6):319-326. doi: 10.1158/1940-6207.CAPR-17-0019. Epub 2017 May 9.
Statin use is associated with lower advanced prostate cancer risk. In addition to cholesterol lowering, statins have systemic anti-inflammatory properties. However, their effect on histologic prostate inflammation is not well understood, particularly among men at increased prostate cancer risk but with a negative prostate biopsy. We examined associations between serum lipid levels, statin use, and histologic prostate inflammation using data from 6,655 men with a negative baseline prostate biopsy in the REduction by DUtasteride of prostate Cancer Events (REDUCE) trial. Statin use and lipid levels [total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides] were assessed at baseline. Inflammation was assessed by central review. Logistic regression was used to examine the effects of lipids and statin use on presence and extent of chronic and acute prostate inflammation [none, moderate (<20%), severe (≥20% biopsy cores)]. Chronic and acute inflammation affected 77% and 15% of men, respectively. Men with high HDL (≥60 vs. <40 mg/dL) had reduced presence of acute inflammation [OR, 0.79; 95% confidence interval (CI), 0.63-0.99] and were less likely to have severe acute inflammation (OR, 0.66; 95% CI, 0.45-0.97), but there were no other associations between lipids and inflammation. Statin users had reduced presence of chronic inflammation (OR, 0.81; 95% CI, 0.69-0.95) and were less likely to have severe chronic (OR, 0.80; 95% CI, 0.68-0.95) and severe acute inflammation (OR, 0.73; 95% CI, 0.53-1.00), relative to non-users. Given the possible role for inflammation in prostate cancer, the inverse association between statins and prostate inflammation suggests a mechanism linking statins with lower advanced prostate cancer risk. .
使用他汀类药物与降低晚期前列腺癌风险相关。除了降低胆固醇外，他汀类药物还具有全身性抗炎特性。然而，它们对前列腺组织炎症的影响尚未完全了解，尤其是在前列腺癌风险增加但前列腺活检结果为阴性的男性中。我们使用来自“度他雄胺降低前列腺癌事件”（REDUCE）试验中6655名基线前列腺活检结果为阴性的男性的数据，研究了血清脂质水平、他汀类药物使用与前列腺组织炎症之间的关联。在基线时评估他汀类药物的使用情况和脂质水平[总胆固醇、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、甘油三酯]。炎症通过中心审查进行评估。使用逻辑回归分析脂质和他汀类药物使用对慢性和急性前列腺炎症的存在及程度的影响[无、中度（<20%）、重度（≥20%活检核心）]。慢性和急性炎症分别影响了77%和15%的男性。高密度脂蛋白水平高（≥60 vs.<40 mg/dL）的男性急性炎症的发生率降低[比值比（OR），0.79；95%置信区间（CI），0.63 - 0.99]，且发生严重急性炎症的可能性较小（OR，0.66；95%CI，0.45 - 0.97），但脂质与炎症之间没有其他关联。与未使用者相比，他汀类药物使用者慢性炎症的发生率降低（OR，0.81；95%CI，0.69 - 0.95），发生严重慢性炎症（OR，0.80；95%CI，0.68 - 0.95）和严重急性炎症的可能性较小（OR，0.73；95%CI，0.53 - 1.00）。鉴于炎症在前列腺癌中可能发挥的作用，他汀类药物与前列腺炎症之间的负相关关系提示了一种将他汀类药物与降低晚期前列腺癌风险联系起来的机制。
