雄性激素干扰药物与脑膜瘤的发生
Male hormone-interfering drugs and meningioma development.
作者信息
Giraldi Laura, Hansen Jørgen Vinsløv, Wohlfahrt Jan, Melbye Mads, Fugleholm Kåre, Munch Tina Nørgaard
机构信息
Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark.
Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark.
出版信息
Neurooncol Adv. 2019 Nov 14;1(1):vdz046. doi: 10.1093/noajnl/vdz046. eCollection 2019 May-Dec.
BACKGROUND
Extremely strong associations between male hormone-interfering drugs and meningiomas have been reported in two previous studies, but these findings are limited by small size of the study populations and possibly by surveillance- and selection bias. Thus, such possible and indeed very interesting association must be investigated in a large, unselected cohort. Accordingly, the aim of this study was to determine whether patients exposed to male hormone-interfering drugs had a higher risk of meningioma development in a nationwide cohort study.
METHODS
A retrospective Danish nationwide cohort study with follow-up from January 1, 1996 to December 31, 2016. Exposure was use of male hormone-interfering drugs (5-α-reductase-inhibitors, luteinizing hormone-releasing hormone agonist, steroidal antiandrogen, and nonsteroidal antiandrogen). Hazard ratio of first-time diagnosis of meningioma according to drug use was estimated using Cox proportional hazards model with adjustment for age and birth year.
RESULTS
The cohort included 244,696 men of which 64,047 had used male hormone-interfering drugs. Overall 444 meningiomas occurred during follow-up. No significant association was observed between use of male hormone-interfering drugs and the occurrence of meningioma (hazard ratio 1.02, 95% confidence interval 0.82-1.27). Similar results were observed 0-1, 2-4, and 5+ years after first use. In explorative analyses, no elevated risk association was observed for specific drugs (5-α-reductase-inhibitors, luteinizing hormone-releasing hormone agonist, steroidal antiandrogen, and nonsteroidal antiandrogen).
CONCLUSION
As opposed to previous studies, we found no evidence of an increased risk of meningioma in men treated with male hormone-interfering drugs.
背景
在之前的两项研究中报告了干扰男性激素的药物与脑膜瘤之间存在极强的关联，但这些研究结果受限于研究人群规模较小，且可能存在监测和选择偏倚。因此，必须在一个大型的、未经过筛选的队列中对这种可能且确实非常有趣的关联进行调查。相应地，本研究的目的是在一项全国性队列研究中确定接触干扰男性激素药物的患者发生脑膜瘤的风险是否更高。
方法
一项丹麦全国性回顾性队列研究，随访时间为1996年1月1日至2016年12月31日。暴露因素为使用干扰男性激素的药物（5-α还原酶抑制剂、促性腺激素释放激素激动剂、甾体类抗雄激素药物和非甾体类抗雄激素药物）。使用Cox比例风险模型估计根据药物使用情况首次诊断脑膜瘤的风险比，并对年龄和出生年份进行调整。
结果
该队列包括244,696名男性，其中64,047人使用过干扰男性激素的药物。随访期间共发生444例脑膜瘤。未观察到干扰男性激素的药物使用与脑膜瘤发生之间存在显著关联（风险比1.02，95%置信区间0.82 - 1.27）。首次用药后0 - 1年、2 - 4年和5年以上观察到类似结果。在探索性分析中，未观察到特定药物（5-α还原酶抑制剂、促性腺激素释放激素激动剂、甾体类抗雄激素药物和非甾体类抗雄激素药物）的风险升高关联。
结论
与之前的研究相反，我们没有发现接受干扰男性激素药物治疗的男性患脑膜瘤风险增加的证据。
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