Demark-Wahnefried W, Lesko S M, Conaway M R, Robertson C N, Clark R V, Lobaugh B, Mathias B J, Strigo T S, Paulson D F
Division of Urology, Duke University Medical Center, Durham, North Carolina 27710, USA.
J Androl. 1997 Sep-Oct;18(5):495-500.
Cancer of the prostate is the leading cancer among American men, yet few risk factors have been established. Hair growth and development are influenced by androgens, and it has long been suspected that prostate cancer also is responsive to these hormones. A blinded, case-control study was undertaken to determine if hair patterning is associated with risk of prostate cancer, as well as specific hormonal profiles. The study accrued 315 male subjects who were stratified with regard to age, race, and case-control status (159 prostate cancer cases/156 controls). Hair-patterning classification and serum levels of total and free testosterone (T), sex hormone binding globulin, and dihydrotestosterone (DHT) were performed. Data indicate that hair patterning did not differ between prostate cancer cases and controls; however, significant hormonal differences were detected between the two groups. Free T was greater among cases than in controls (16.4 +/- 6.1 vs. 14.9 +/- 4.8 pg/ml, P = 0.02). Conversely, DHT-related ratios were greater among controls (P = 0.03 for DHT/T and P = 0.01 for DHT/free T). Several strong associations also were found between hormone levels and hair patterning. Men with vertex and frontal baldness had higher levels of free T (16.5 +/- 5.5 and 16.2 +/- 8.0 pg/ml, respectively) when compared to men with either little or no hair loss (14.8 +/- 4.7 pg/ml) (P = 0.01). Data suggest that increased levels of free T may be a risk factor for prostatic carcinoma. In addition, although no differences in hair patterning were detected between cases and controls within this older population, further research (i.e., prospective trials or case-control studies among younger men) may be necessary to determine if hair patterning serves as a viable biomarker for this disease, especially given the strong association between free T levels and baldness.
前列腺癌是美国男性中最常见的癌症，但目前已确定的风险因素却很少。毛发的生长和发育受雄激素影响，长期以来人们一直怀疑前列腺癌也对这些激素有反应。一项双盲病例对照研究旨在确定毛发分布模式是否与前列腺癌风险以及特定激素水平相关。该研究招募了315名男性受试者，根据年龄、种族和病例对照状态进行分层（159例前列腺癌病例/156例对照）。对毛发分布模式进行分类，并检测血清总睾酮（T）、游离睾酮、性激素结合球蛋白和双氢睾酮（DHT）水平。数据表明，前列腺癌病例组和对照组之间的毛发分布模式没有差异；然而，两组之间检测到了显著的激素差异。病例组的游离T水平高于对照组（16.4±6.1 vs. 14.9±4.8 pg/ml，P = 0.02）。相反，对照组的DHT相关比率更高（DHT/T为P = 0.03，DHT/游离T为P = 0.01）。激素水平与毛发分布模式之间也发现了一些强关联。与几乎没有或没有脱发的男性（14.8±4.7 pg/ml）相比，头顶和前额脱发的男性游离T水平更高（分别为16.5±5.5和16.2±8.0 pg/ml）（P = 0.01）。数据表明，游离T水平升高可能是前列腺癌的一个风险因素。此外，尽管在这个老年人群中病例组和对照组之间未检测到毛发分布模式的差异，但可能需要进一步研究（即对年轻男性进行前瞻性试验或病例对照研究）来确定毛发分布模式是否可作为该疾病的可行生物标志物，特别是考虑到游离T水平与脱发之间的强关联。
