晚期前列腺癌不同雄激素剥夺治疗方式与继发糖尿病和糖耐量异常风险的相关性研究

Risks of diabetes mellitus and impaired glucose tolerance induced by intermittent versus continuous androgen-deprivation therapy for advanced prostate cancer

目的:探讨晚期前列腺癌间歇性雄激素剥夺治疗(IADT)和持续性雄激素剥夺治疗(CADT)两种不同方式与继发糖尿病(DM)和糖耐量异常(IGT)风险的相关性。方法:对2013年1月至2015年12月于我院进行雄激素剥夺治疗(ADT)的PCa患者进行回顾性病例对照研究。通过监测患者空腹血糖、餐后2 h血糖及口服糖耐量试验,结合患者相关临床症状,对IADT和CADT引起DM和IGT的风险进行统计学分析,并分析组内体质量指数(BMI)、高血压、吸烟、饮酒等因素与继发性DM和IGT的关系。结果:IADT组53例(46.5%),平均(69.1±4.3)岁;CADT组61例(53.5%),平均(70.2±5.7)岁,两组在临床特点方面均无明显差异(P均>0.05);IADT组BMI、高血压、吸烟、饮酒等因素对DM、IGT的发生均无明显影响(P均>0.05),CADT组BMI、高血压、吸烟、饮酒因素对DM、IGT的发生均无明显影响(P均>0.05);IADT组与CADT组比较,DM的发生无统计学意义(P=0.64);但IGT的发生有统计学意义(P=0.03)。结论:IADT与CADT比较,PCa患者的IGT发生风险更低,安全性更高。

Objective： To investigate the correlation of intermittent androgen-deprivation therapy （IADT） and continuous an- drogen-deprivation therapy （CADT） for advanced prostate cancer （PCa） with the risks of secondary diabetes mellitus （DM） and im- paired glucose tolerance （IGT）. Methods ： We conducted a retrospective case-control study of the advanced PCa patients treated by IADT or CADT in our hospital from January 2013 to December 2015. Based on the levels fasting blood glucose and 2-hour postprandial blood glucose, results of oral glucose tolerance test, and clinical symptoms of the patients, we statistically analyzed the IADT- or CADT-related risk factors for DM and IGT and the relationship of the body mass index （BMI） , hypertension, smoking, and alcohol consumption with secondary DM and 1GT. Results： IADT was given to 53 （46.5%） of the patients, aged （69. 1 ± 4.3） years, and CADT to 61 （53.5%）, aged （70.2± 5.7） years. No statistically significant differences were observed in clinical characteristics between the two groups of patients （P 〉 0.05）. BMI, blood pressure, smoking and drinking exhibited no significant influence on the development of DM or IGT either in the IADT （ P 〉 0.05 ） or the CADT group. The incidence of IGT was significantly lower in the IADT than in the CADT group （ P = 0.03 ）, but that of DM showed no statistically significant difference between the two groups （ P =0.64）. Conclusion ： Compared with CADT, IADT has a lower risk of IGT and a higher safety in the treatment of advanced prostate cancer.