雄激素剥夺疗法治疗前列腺癌后新发糖尿病：一项全国性倾向评分匹配四年纵向队列研究。

New-onset diabetes after androgen-deprivation therapy for prostate cancer: A nationwide propensity score-matched four-year longitudinal cohort study.

机构信息

Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

J Diabetes Complications. 2018 Jul;32(7):688-692. doi: 10.1016/j.jdiacomp.2018.03.007. Epub 2018 Mar 22.

DOI:10.1016/j.jdiacomp.2018.03.007

PMID:29909141

Abstract

INTRODUCTION

Androgen-deprivation therapy (ADT) is important in the treatment of prostate cancer. However, the relationship between ADT and the risk of diabetes remains unclear, and the association between duration and types of ADT has not been fully investigated.

AIM

To examine the risk of developing type 2 diabetes mellitus (T2DM) in men who underwent ADT for prostate cancer.

METHODS

Data were collected retrospectively from the Longitudinal Health Insurance Database of Taiwan. In total, 4604 prostate cancer patients ≥40 years old who underwent ADT were included in the study cohort, and 4604 prostate cancer patients without ADT were included as controls, after adjusting for age and other comorbidities.

RESULTS

During the four-year follow-up period, the incidence of new-onset T2DM was 27.49 and 11.13 per 1000 person-years in the ADT and ADT-never cohorts, respectively. The ADT cohort was 2.19 times more likely to develop T2DM than the control group (95% CI 1.90-2.53, P < 0.001). Furthermore, the association was particularly striking in the subgroup of patients receiving complete androgen blockade (adjusted HR 2.33, 95% CI 1.96-2.78, P < 0.001).

CONCLUSIONS

Men with prostate cancer who received ADT are at risk for developing diabetes.

摘要

简介

去势治疗（ADT）在前列腺癌的治疗中很重要。然而，ADT 与糖尿病风险之间的关系尚不清楚，ADT 的持续时间和类型之间的关联也尚未充分研究。

目的

检查接受去势治疗前列腺癌的男性发生 2 型糖尿病（T2DM）的风险。

方法

数据从台湾纵向健康保险数据库中回顾性收集。共纳入 4604 名年龄≥40 岁接受 ADT 的前列腺癌患者作为研究队列，同时纳入 4604 名未接受 ADT 的前列腺癌患者作为对照组，调整年龄和其他合并症后进行比较。

结果

在四年的随访期间，ADT 组和 ADT-从未组的新发 T2DM 发生率分别为 27.49 和 11.13/1000 人年。ADT 组发生 T2DM 的风险是对照组的 2.19 倍（95%CI 1.90-2.53，P<0.001）。此外，在接受完全雄激素阻断治疗的亚组患者中，这种关联尤为显著（调整后的 HR 2.33，95%CI 1.96-2.78，P<0.001）。