Faculty of Medicine and life Sciences, University of Tampere, Tampere, Finland.
Department of Urology, Tampere University Hospital, Tampere, Finland.
Br J Cancer. 2018 May;118(9):1248-1254. doi: 10.1038/s41416-018-0055-4. Epub 2018 Mar 22.
Diabetic men have lowered overall risk of prostate cancer (PCa), but the role of hyperglycaemia is unclear. In this cohort study, we estimated PCa risk among men with diabetic fasting blood glucose level.
Participants of the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC) were linked to laboratory database for information on glucose measurements since 1978. The data were available for 17,860 men. Based on the average yearly level, the men were categorised as normoglycaemic, prediabetic, or diabetic. Median follow-up was 14.7 years. Multivariable-adjusted Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for prostate cancer overall and separately by Gleason grade and metastatic stage.
In total 1,663 PCa cases were diagnosed. Compared to normoglycaemic men, those men with diabetic blood glucose level had increased risk of PCa (HR 1.52; 95% CI 1.31-1.75). The risk increase was observed for all tumour grades, and persisted for a decade afterwards. Antidiabetic drug use removed the risk association. Limitations include absence of information on lifestyle factors and limited information on BMI.
Untreated diabetic fasting blood glucose level may be a prostate cancer risk factor.
糖尿病男性患前列腺癌（PCa）的总体风险较低，但高血糖的作用尚不清楚。在这项队列研究中，我们评估了空腹血糖水平异常的男性患前列腺癌的风险。
芬兰前列腺癌筛查随机研究（FinRSPC）的参与者与实验室数据库相关联，以获取自 1978 年以来的葡萄糖测量信息。共有 17860 名男性的数据可供使用。根据平均年水平，男性被分为血糖正常、糖尿病前期或糖尿病。中位随访时间为 14.7 年。多变量调整的 Cox 回归用于计算前列腺癌总体和按 Gleason 分级和转移阶段分别计算的前列腺癌风险比（HR）和 95%置信区间（95%CI）。
共诊断出 1663 例前列腺癌病例。与血糖正常的男性相比，血糖水平异常的男性患前列腺癌的风险增加（HR 1.52；95%CI 1.31-1.75）。这种风险增加适用于所有肿瘤分级，并且在之后的十年中持续存在。使用抗糖尿病药物可消除风险关联。局限性包括缺乏有关生活方式因素的信息和 BMI 信息有限。
未经治疗的糖尿病空腹血糖水平可能是前列腺癌的一个风险因素。
