SGLT2 抑制剂对前列腺癌的影响：基于电子医疗保健和队列数据的孟德尔随机化和观察性分析。
The effect of SGLT2 inhibition on prostate cancer: Mendelian randomization and observational analysis using electronic healthcare and cohort data.
机构信息
Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK.
Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Cell Rep Med. 2024 Aug 20;5(8):101688. doi: 10.1016/j.xcrm.2024.101688.
We evaluated the effect of sodium-glucose cotransporter 2 (SGLT2) inhibition on prostate cancer by evidence triangulation. Using Mendelian randomization, we found that genetically proxied SGLT2 inhibition reduced the risk of overall (odds ratio = 0.56, 95% confidence interval [CI] = 0.38 to 0.82; 79,148 prostate cancer cases and 61,106 controls), advanced, and early-onset prostate cancer. Using electronic healthcare data (n = 24,155; n = 24,155), we found that the use of SGLT2 inhibitors was associated with a 23% reduced risk of prostate cancer (hazard ratio = 0.77, 95% CI = 0.61 to 0.99) in men with diabetes. Using data from two prospective cohorts (n = 57,779; n = 165,430), we found little evidence to support the association of HbA with prostate cancer, implying a non-glycemic effect of SGLT2 inhibition on prostate cancer. In summary, this study provides multiple layers of evidence to support the beneficial effect of SGLT2 inhibition on reducing prostate cancer risk. Future trials are warranted to investigate whether SGLT2 inhibitors can be recommended for prostate cancer prevention.
我们通过证据综合评估了钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂对前列腺癌的影响。通过孟德尔随机化分析，我们发现，遗传相关性 SGLT2 抑制降低了总体前列腺癌（比值比=0.56，95%置信区间[CI]为 0.38 至 0.82；79148 例前列腺癌病例和 61106 例对照）、晚期和早期发病前列腺癌的风险。使用电子医疗保健数据（n=24155；n=24155），我们发现，糖尿病患者使用 SGLT2 抑制剂与前列腺癌风险降低 23%相关（风险比=0.77，95%CI 为 0.61 至 0.99）。通过两项前瞻性队列研究（n=57779；n=165430）的数据，我们几乎没有证据支持 HbA 与前列腺癌之间的关联，这表明 SGLT2 抑制对前列腺癌的影响可能与血糖无关。总之，本研究提供了多层次的证据，支持 SGLT2 抑制对降低前列腺癌风险的有益作用。需要进行未来的临床试验来研究 SGLT2 抑制剂是否可以用于预防前列腺癌。
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