Thompson M M, Garland C, Barrett-Connor E, Khaw K T, Friedlander N J, Wingard D L
Dept. of Community and Family Medicine, U. of California San Diego, La Jolla 92093.
Am J Epidemiol. 1989 Mar;129(3):511-7. doi: 10.1093/oxfordjournals.aje.a115162.
The authors studied the association between heart disease and prostatic cancer in Rancho Bernardo, California, from August 1972 to June 1987. During a 14-year follow-up of 1,776 men aged 50-84 years, 100 cases of prostatic cancer were identified, of which 54 were incident. Systolic blood pressure, cigarette smoking, and plasma cholesterol levels in cases did not differ from those in noncases. After adjustment for age and on multivariate analysis, incident cases of prostatic cancer had a nonsignificantly higher frequency of reported heart disease at baseline. History of diabetes was inversely associated with total prostatic cancer (age-adjusted estimated relative risk = 0.2, 90% confidence interval: 0.0-0.8; multivariate-adjusted relative risk = 0.3, 90% confidence interval: 0.1-1.0). The association between heart disease and prostatic cancer is compatible with diagnostic detection bias. The inverse association between diabetes and prostatic cancer is compatible with a cancer-promoting role for endogenous testosterone, the level of which is lower in diabetics, or a risk-reducing effect of antidiabetic diet or drug therapy.
1972年8月至1987年6月期间，作者对加利福尼亚州兰乔贝纳多市的心脏病与前列腺癌之间的关联进行了研究。在对1776名年龄在50 - 84岁的男性进行的14年随访中，确诊了100例前列腺癌病例，其中54例为新发病例。病例组的收缩压、吸烟情况和血浆胆固醇水平与非病例组无差异。在对年龄进行调整并进行多变量分析后，前列腺癌新发病例在基线时报告的心脏病发生率略高，但差异无统计学意义。糖尿病病史与前列腺癌总发病呈负相关（年龄调整后的估计相对风险 = 0.2，90%置信区间：0.0 - 0.8；多变量调整后的相对风险 = 0.3，90%置信区间：0.1 - 1.0）。心脏病与前列腺癌之间的关联符合诊断检测偏倚。糖尿病与前列腺癌之间的负相关符合内源性睾酮的促癌作用（糖尿病患者体内睾酮水平较低），或抗糖尿病饮食或药物治疗的风险降低作用。
