Wang Jinru, An Hengqing, Tao Ning
College of Public Health, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi, China.
Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi, China.
BMC Cancer. 2025 Apr 28;25(1):795. doi: 10.1186/s12885-025-13839-0.
PURPOSE: Insulin resistance and prostate cancer (PCa) association results remain controversial. However, few studies have compared the role of various non-insulin-based insulin resistance (NI-IR) indices and mean platelet volume (MPV) in PCa. METHODS: We conducted a cross-sectional study, the case group included 354 patients with PCa, and the control group included 1,498 non-PCa participants. We performed inverse probability weighting to reduce the impact of differences in baseline information between the case and control groups on results. Weighted logistic regression analysis for assessing the relationship between NI-IR indices and PCa risk. Fitting 4-point restricted cubic spline (RCS) plots to show the trend of NI-IR indices with PCa risk. The interaction between insulin resistance and platelet volume based on generalized additive model (GAM) to reveal the impact of the interaction between insulin resistance and cardiovascular risk on PCa. In the end, we performed three sensitivity analyses to verify the stability of results. RESULTS: Weighted logistic regression analysis revealed that all NI-IR indices were associated with PCa. When NI-IR indices were evaluated as continuous variables, in the all variables adjusted model (model 3), the adjusted OR of ZJU index was 1.337 (95%CI: 1.296-1.379), the adjusted OR of TyG index was 5.300 (95%CI:4.208-6.675), the adjusted OR of TG/HDL-c was 1.431 (95%CI:1.335-1.534), and the adjusted OR of METS-IR was 1.129 (95%CI:1.110-1.149). When NI-IR indices were analyzed as categorical variables, also in model 3, using Q1 as reference, the adjusted OR of ZJU index in Q5 was 15.592 (95%CI:10.809-22.492), the adjusted OR of TyG index in Q5 was 7.306 (95%CI:5.182-10.301), the adjusted OR of TG/HDL-c in Q5 was 4.790 (95%CI:3.459-6.632), and the adjusted OR of METS-IR in Q5 was 9.844 (95%CI:6.862-14.121). RCS displayed that PCa risk tended to increase as the ZJU index, TyG index, TG/HDL-c, and METS-IR increased. The interaction test based on the GAM indicated that the value of the interaction between TG/HDL-c and MPV on the PCa risk was χ = 6.924(P = 0.009). With the increase in TG/HDL-c and the decrease in MPV, the PCa risk progressively increases. The sensitivity analysis further confirmed the robustness of the results. CONCLUSIONS: NI-IR indices were associated with an increased PCa risk. The interaction between MPV and insulin resistance may further contribute to the PCa risk.
目的：胰岛素抵抗与前列腺癌（PCa）的关联结果仍存在争议。然而，很少有研究比较各种非胰岛素基胰岛素抵抗（NI-IR）指标和平均血小板体积（MPV）在前列腺癌中的作用。 方法：我们进行了一项横断面研究，病例组包括354例前列腺癌患者，对照组包括1498名非前列腺癌参与者。我们进行了逆概率加权，以减少病例组和对照组之间基线信息差异对结果的影响。采用加权逻辑回归分析评估NI-IR指标与前列腺癌风险之间的关系。拟合4点受限立方样条（RCS）图以显示NI-IR指标与前列腺癌风险的趋势。基于广义相加模型（GAM）分析胰岛素抵抗与血小板体积之间的相互作用，以揭示胰岛素抵抗与心血管风险之间的相互作用对前列腺癌的影响。最后，我们进行了三项敏感性分析以验证结果的稳定性。 结果：加权逻辑回归分析显示，所有NI-IR指标均与前列腺癌相关。当将NI-IR指标作为连续变量进行评估时，在所有变量调整模型（模型3）中，浙江大学（ZJU）指数的调整优势比（OR）为1.337（95%置信区间：1.296-1.379），甘油三酯与葡萄糖乘积（TyG）指数的调整OR为5.300（95%置信区间：4.208-6.675），甘油三酯/高密度脂蛋白胆固醇（TG/HDL-c）的调整OR为1.431（95%置信区间：1.335-1.534），代谢综合征胰岛素抵抗（METS-IR）的调整OR为1.129（95%置信区间：1.110-1.149）。当将NI-IR指标作为分类变量进行分析时，同样在模型3中，以第一四分位数（Q1）为参照，第五四分位数（Q5）中ZJU指数的调整OR为15.592（95%置信区间：10.809-22.492），Q5中TyG指数的调整OR为7.306（95%置信区间：5.182-10.301），Q5中TG/HDL-c的调整OR为4.790（95%置信区间：3.459-6.632），Q5中METS-IR的调整OR为9.844（95%置信区间：6.862-14.121）。RCS显示，随着ZJU指数、TyG指数、TG/HDL-c和METS-IR的增加，前列腺癌风险呈上升趋势。基于GAM的相互作用检验表明，TG/HDL-c与MPV之间的相互作用对前列腺癌风险的影响值为χ=6.924（P=0.009）。随着TG/HDL-c的增加和MPV的降低，前列腺癌风险逐渐增加。敏感性分析进一步证实了结果的稳健性。 结论：NI-IR指标与前列腺癌风险增加相关。MPV与胰岛素抵抗之间的相互作用可能进一步增加前列腺癌风险。
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