胰高血糖素样肽-1受体激动剂对降低前列腺癌风险的影响：一项系统评价和荟萃分析。
Effect of GLP-1 receptor agonists on prostate cancer risk reduction: a systematic review and meta-analysis.
作者信息
Sharma Nikhil, Khatib Mahalaqua Nazli, Balaraman Ashok Kumar, Roopashree R, Kaur Mandeep, Srivastava Manish, Barwal Amit, Prasad G V Siva, Rajput Pranchal, Syed Rukshar, Sharma Gajendra, Kumar Sunil, Singh Mahendra Pratap, Bushi Ganesh, Chilakam Nagavalli, Pandey Sakshi, Brar Manvinder, Mehta Rachana, Sah Sanjit, Gaidhane Abhay M, Shabil Muhammed
机构信息
Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Guwahati, 781101, India.
Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India.
出版信息
Int Urol Nephrol. 2025 Apr;57(4):1039-1049. doi: 10.1007/s11255-024-04266-4. Epub 2024 Nov 4.
BACKGROUND
Prostate cancer is one of the most prevalent malignancies among men globally. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), primarily used for type 2 diabetes mellitus (T2DM) management, have been investigated for their potential effects on cancer risks. This systematic review and meta-analysis aimed to assess the association between GLP-1 RA use and risk reduction of prostate cancer.
METHODS
A comprehensive literature search was conducted across PubMed, Embase, and Web of Science up to July 30, 2024. Studies that met the inclusion criteria randomized controlled trials, cohort studies, case-control studies, and observational studies assessing the incidence of prostate cancer in GLP-1 RA-treated patients were included. The quality of studies was evaluated using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool. Meta-analysis was performed using a random effects model.
RESULTS
A total of five studies were included, analyzing data from diverse international contexts. The included studies showed a reduced risk of prostate cancer with both adjusted and unadjusted effect estimates with GLP-1 RAs. The meta-analysis revealed an RR of 0.72 (95% CI: 0.610 to 0.832), indicating a statistically significant 28% reduction in prostate cancer risk associated with GLP-1 RA use compared to placebo or other antidiabetic drugs. Moderate heterogeneity was observed (I = 51%). Sensitivity analysis confirmed the results.
CONCLUSION
The findings suggest a significant protective association between GLP-1 RA use and reduced prostate cancer risk in men, particularly those with T2DM. This supports the potential of GLP-1 RAs not only in diabetes management but also as a strategy to mitigate cancer risk. Further research is required to confirm these findings and explore the underlying mechanisms, considering different dosages, durations of therapy, and patient subgroups based on demographic and metabolic characteristics.
背景
前列腺癌是全球男性中最常见的恶性肿瘤之一。胰高血糖素样肽1受体激动剂（GLP-1 RAs）主要用于2型糖尿病（T2DM）的管理，其对癌症风险的潜在影响已得到研究。本系统评价和荟萃分析旨在评估使用GLP-1 RA与降低前列腺癌风险之间的关联。
方法
截至2024年7月30日，在PubMed、Embase和Web of Science上进行了全面的文献检索。纳入符合纳入标准的研究，包括随机对照试验、队列研究、病例对照研究以及评估GLP-1 RA治疗患者前列腺癌发病率的观察性研究。使用纽卡斯尔-渥太华量表和Cochrane偏倚风险工具评估研究质量。采用随机效应模型进行荟萃分析。
结果
共纳入五项研究，分析了来自不同国际背景的数据。纳入的研究显示，无论是否进行效应估计调整，使用GLP-1 RA均降低了前列腺癌风险。荟萃分析显示相对危险度为0.72（95%置信区间：0.610至0.832），表明与使用安慰剂或其他抗糖尿病药物相比，使用GLP-1 RA与前列腺癌风险显著降低28%相关。观察到中度异质性（I² = 51%）。敏感性分析证实了结果。
结论
研究结果表明，使用GLP-1 RA与男性前列腺癌风险降低之间存在显著的保护关联，尤其是在患有T2DM的男性中。这支持了GLP-1 RA不仅在糖尿病管理方面，而且作为降低癌症风险策略的潜力。需要进一步研究来证实这些发现，并探索潜在机制，同时考虑不同剂量、治疗持续时间以及基于人口统计学和代谢特征的患者亚组。
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