在一个种族多样化的美国退伍军人晚期前列腺癌队列中，诊断后使用二甲双胍和他汀类药物可提高生存率。

Improved survival with post-diagnostic metformin and statin use in a racially diverse cohort of US Veterans with advanced prostate cancer.

机构信息

Research Service, St. Louis Veterans Affairs Medical Center, St. Louis, MO, USA.

Epidemiology Program, College of Heath Sciences, University of Delaware, Newark, DE, USA.

出版信息

Prostate Cancer Prostatic Dis. 2022 Apr;25(4):707-712. doi: 10.1038/s41391-021-00475-5. Epub 2021 Nov 22.

DOI:10.1038/s41391-021-00475-5

PMID:34811499

Abstract

OBJECTIVE

To examine the association between post-diagnostic metformin or statin use with all-cause and prostate cancer (PCa)-specific mortality in men with advanced prostate cancer.

METHODS

Our study consisted of 4572 men (Black = 1352, White = 3192, Other Race = 28) diagnosed with advanced cancer (T4/M1/N1) between 1999 and 2013 in the Veteran Health Administration. The association between post-diagnostic (1) metformin and (2) statin use with all-cause and PCa-specific mortality was examined using multivariable, time-varying Cox Proportional Hazard Models. In a secondary analysis, models were stratified by race.

RESULTS

Post-diagnostic metformin use was associated with a reduced risk of all-cause (Hazard Ratio (HR) 0.84, 95% Confidence Interval (CI): 0.73, 0.96) and PCa-specific death (HR: 0.76, 95% CI: 0.63, 0.91). In stratified analyses, the inverse association between post-diagnostic metformin use and both all-cause PCa-specific mortality was limited to White men. Post-diagnostic statin use was associated with a reduced risk of all-cause (HR: 0.75, 95% CI: 0.68, 0.83) and PCa-specific mortality (HR: 0.72; 95% CI: 0.64, 0.81). In stratified analyses, similar inverse associations were observed for post-diagnostic statin use and all-cause and PCa-specific mortality in both Black and White men.

CONCLUSION

Post diagnostic metformin and statin use may prevent progression to lethal prostate cancer in men with advanced prostate cancer.

摘要

目的

研究诊断后使用二甲双胍或他汀类药物与晚期前列腺癌男性全因和前列腺癌（PCa）特异性死亡率的相关性。

方法

我们的研究纳入了 1999 年至 2013 年期间在退伍军人健康管理局诊断为晚期癌症（T4/M1/N1）的 4572 名男性（黑人=1352，白人=3192，其他种族=28）。使用多变量、时变 Cox 比例风险模型研究诊断后（1）二甲双胍和（2）他汀类药物使用与全因和 PCa 特异性死亡率的相关性。在二次分析中，根据种族对模型进行分层。

结果

诊断后使用二甲双胍与全因（风险比 (HR) 0.84，95%置信区间 (CI)：0.73，0.96）和 PCa 特异性死亡（HR：0.76，95% CI：0.63，0.91）风险降低相关。在分层分析中，诊断后使用二甲双胍与全因和 PCa 特异性死亡率之间的反比关系仅限于白人男性。诊断后使用他汀类药物与全因（HR：0.75，95% CI：0.68，0.83）和 PCa 特异性死亡率（HR：0.72；95% CI：0.64，0.81）风险降低相关。在分层分析中，在黑人男性和白人男性中，诊断后使用他汀类药物与全因和 PCa 特异性死亡率均观察到类似的反比关系。