代谢综合征组分与前列腺癌关系的研究
|
摘要
目的探讨代谢综合征(MS)各组分与前列腺癌之间的关系。方法回顾性分析2000年9月1日至2018年7月31日首都医科大学附属北京安贞医院收治的218例前列腺癌患者的临床资料,包括年龄、身高、体质量、体重指数、收缩压、舒张压、前列腺体积、前列腺特异性抗原、前列腺特异性抗原密度、血糖及血脂水平。按照MS的诊断标准分为单纯前列腺癌组(185例)和前列腺癌合并MS组(33例)。采用多因素Logistic回归模型分析前列腺癌的MS组分影响因素。结果前列腺癌合并MS组与单纯前列腺癌组比较,收缩压、体重指数、空腹血糖、三酰甘油水平高,差异均有统计学意义(均P <0. 05)。多因素二元Logistic回归分析结果显示,收缩压(比值比=1. 042,95%置信区间:1. 013～1. 073,P=0. 005)、空腹血糖(比值比=1. 361,95%置信区间:1. 120～1. 655,P=0. 002)、三酰甘油(比值比=1. 934,95%置信区间:1. 100～3. 400,P=0. 022)水平升高是罹患前列腺癌的高危因素。结论大多数前列腺癌患者未达到同时罹患MS的诊断标准,但是合并1～2种MS组分的患者较多。合并MS的前列腺癌患者较单纯前列腺癌患者的收缩压、体重指数、空腹血糖、三酰甘油升高,是前列腺癌早期诊断需要监测的指标。
Objective To explore the relation between components of metabolic syndrome( MS) and prostate cancer. Methods Clinical data of 218 patients with prostate cancer admitted to Beijing Anzhen Hospital,Capital Medical University from September 1 st,2000 to July 31 st,2018 were retrospectively analyzed,including age,height,weight,body mass index,blood pressure,prostate volume,prostate specific antigen,prostate-specific antigen density,blood glucose and lipids. The patients were divided into prostate cancer group( 185 cases) and prostate cancer with MS group( 33 cases). Risk factors associated with MS in patients with prostate cancer were analyzed by multivariate logistic regression. Results Systolic blood pressure,body mass index,fasting blood glucose and triglyceride in prostate cancer with MS group were significantly higher than those in prostate cancer group( all P < 0. 05). Logistic regression analysis showed that elevated levels of systolic blood pressure( odds ratio= 1. 042,95% confidence interval: 1. 013-1. 073,P = 0. 005),fasting blood glucose( odds ratio = 1. 361,95% confidence interval: 1. 120-1. 655,P = 0. 002) and triglyceride( odds ratio = 1. 934,95% confidence interval:1. 100-3. 400,P = 0. 022) were risk factors of prostate cancer. Conclusions Most patients with prostate cancer did not meet the diagnostic criteria of MS,but there are many patients with 1-2 components of MS. Patients with prostate cancer complicated with MS have high systolic blood pressure,body mass index,fasting blood glucose and triglyceride; these indicators need close monitoring in the early diagnosis of prostate cancer.
Objective To explore the relation between components of metabolic syndrome( MS) and prostate cancer. Methods Clinical data of 218 patients with prostate cancer admitted to Beijing Anzhen Hospital,Capital Medical University from September 1 st,2000 to July 31 st,2018 were retrospectively analyzed,including age,height,weight,body mass index,blood pressure,prostate volume,prostate specific antigen,prostate-specific antigen density,blood glucose and lipids. The patients were divided into prostate cancer group( 185 cases) and prostate cancer with MS group( 33 cases). Risk factors associated with MS in patients with prostate cancer were analyzed by multivariate logistic regression. Results Systolic blood pressure,body mass index,fasting blood glucose and triglyceride in prostate cancer with MS group were significantly higher than those in prostate cancer group( all P < 0. 05). Logistic regression analysis showed that elevated levels of systolic blood pressure( odds ratio= 1. 042,95% confidence interval: 1. 013-1. 073,P = 0. 005),fasting blood glucose( odds ratio = 1. 361,95% confidence interval: 1. 120-1. 655,P = 0. 002) and triglyceride( odds ratio = 1. 934,95% confidence interval:1. 100-3. 400,P = 0. 022) were risk factors of prostate cancer. Conclusions Most patients with prostate cancer did not meet the diagnostic criteria of MS,but there are many patients with 1-2 components of MS. Patients with prostate cancer complicated with MS have high systolic blood pressure,body mass index,fasting blood glucose and triglyceride; these indicators need close monitoring in the early diagnosis of prostate cancer.
引文
[1]Siegel RL,Miller KD,Jemal A.Cancer statistics,2018[J].CACancer J Clin,2018,68(1):7-30.DOI:10.3322/caac.21442.
[2]韩苏军,张思维,陈万青,等.中国前列腺癌发病现状和流行趋势分析[J].临床肿瘤学杂志,2013,18(4):330-334.DOI:10.3969/j.issn.1009-0460.2013.04.009.Han SJ,Zhang SW,Chen WQ,et al.Analysis of the status and trends of prostate cancer incidence in China[J].Chinese Clinical Oncology,2013,18(4):330-334.DOI:10.3969/j.issn.1009-0460.2013.04.009.
[3]朱绍兴,李昌桂.代谢综合征与前列腺癌发病风险的相关性[J].上海医学,2012,35(5):392-395.Zhu SX,Li CG.Correlation study on metabolic syndrome and risk of prostate cancer[J].Shanghai Medical Journal,2012,35(5):392-395.
[4]张中攀,拜合提亚·阿扎提,李晓东,等.代谢综合征与前列腺癌的相关性研究[J].现代泌尿外科杂志,2018,22(6):443-446.DOI:10.3969/j.issn.1009-8291.2018.06.011.Zhang ZP,Baihetiya AZT,Li XD,et al.The correlation between metabolic syndrome and prostate cancer[J].Journal of Modern Urology,2018,22(6):443-446.DOI:10.3969/j.issn.1009-8291.2018.06.011.
[5]中华医学会糖尿病学分会代谢综合征研究协作组.中华医学会糖尿病学分会关于代谢综合征的建议[J].中国糖尿病杂志,2004,12(3):156-161.DOI:10.3321/j.issn:1006-6187.2004.03.002.Metabolism Syndrome Research and Collaboration Group,Chinese Diabetes Society.Suggestions on metabolism syndrome from Chinese Diabetes Society[J].Chinese Journal of Diabetes,2004,12(3):156-161.DOI:10.3321/j.issn:1006-6187.2004.03.002.
[6]张妙妙,贾俊亚,林珊.代谢综合征诊断的演变及研究进展[J].临床内科杂志,2018,35(8):574-576.DOI:10.3969/j.issn.1001-9057.2018.08.024.Zhang MM,Jia JY,Lin S.Evolution and research progress in diagnosis of metabolic syndrome[J].Journal of Clinical Internal Medicine,2018,35(8):574-576.DOI:10.3969/j.issn.1001-9057.2018.08.024.
[7]付俊玲,肖新华.代谢综合征的定义和流行病学[J].临床内科杂志,2018,35(1):5-9.DOI:10.3969/j.issn.1001-9057.2018.01.001.Fu JL,Xiao XH.Definition and epidemiology of metabolic syndrome[J].Journal of Clinical Internal Medicine,2018,35(1):5-9.DOI:10.3969/j.issn.1001-9057.2018.01.001.
[8]Tande AJ,Platz EA,Folsom AR.The metabolic syndrome is associated with reduced risk of prostate cancer[J].Am J Epidemiol,2006,164(11):1094-1102.DOI:10.1093/aje/kwj320.
[9]Lund Hheim L,Wislff TF,Holme I,et al.Metabolic syndrome predicts prostate cancer in a cohort of middle-aged Norwegian men followed for 27 years[J].Am J Epidemiol,2006,164(8):769-774.DOI:10.1093/aje/kwj284.
[10]Rodriguez C,Freedland SJ,Deka A,et al.Body mass index,weight change,and risk of prostate cancer in the Cancer Prevention StudyⅡNutrition Cohort[J].Cancer Epidemiol Biomarkers Prev,2007,16(1):63-69.DOI:10.1158/1055-9965.EPI-06-0754.
[11]周毅,姚远,杨剑文,等.老年前列腺癌并存代谢综合征患者的临床相关性研究[J].中华老年医学杂志,2014,33(2):172-174.DOI:10.3760/cma.j.issn.0254-9026.2014.02.016.Zhou Y,Yao Y,Yang JW,et al.Clinical correlation between prostate cancer and metabolic syndrome in the elderly[J].Chinese Journal of Geriatrics,2014,33(2):172-174.DOI:10.3760/cma.j.issn.0254-9026.2014.02.016.
[12]Martin RM,Vatten L,Gunnell D,et al.Components of the metabolic syndrome and risk of prostate cancer:the HUNT 2cohort,Norway[J].Cancer Causes Control,2009,20(7):1181-1192.DOI:10.1007/s10552-009-9319-x.
[13]Wallner LP,Morgenstern H,Mc Gree ME,et al.The effects of metabolic conditions on prostate cancer incidence over 15 years of follow-up:results from the Olmsted County Study[J].BJU Int,2011,107(6):929-935.DOI:10.1111/j.1464-410X.2010.09703.x.
[14]郭敏,白槟,余鹏飞,等.肥胖介导慢性炎性反应机制的研究进展[J].中国医药,2017,12(6):946-949.DOI:10.3760/cma.j.issn.1673-4777.2017.06.037.Guo M,Bai B,Yu PF,et al.Research progress on mechanisms of chronic inflammation mediated by obesity[J].China Medicine,2017,12(6):946-949.DOI:10.3760/cma.j.issn.1673-4777.2017.06.037.
[15]Veierd MB,Laake P,Thelle DS.Dietary fat intake and risk of prostate cancer:a prospective study of 25,708 Norwegian men[J].Int J Cancer,2015,73(5):634-638.
[16]Rundle A,Jankowski M,Kryvenko ON,et al.Obesity and future prostate cancer risk among men after an initial benign biopsy of the prostate[J].Cancer Epidemiol Biomarkers Prev,2013,22(5):898-904.DOI:10.1158/1055-9965.EPI-12-0965.
[17]Baillargeon J,Platz EA,Rose DP,et al.Obesity,adipokines,and prostate cancer in a prospective population-based study[J].Cancer Epidemiol Biomarkers Prev,2006,28(3):1331-1335.DOI:10.3892/ijo.28.3.737.
[18]Giovannucci E,Harlan DM,Archer MC,et al.Diabetes and cancer:a consensus report[J].CA Cancer J Clin,2010,60(4):207-221.DOI:10.3322/caac.20078.
[19]Wang M,Hu RY,Wu HB,et al.Cancer risk among patients with type 2 diabetes mellitus:a population-based prospective study in China[J].Sci Rep,2015(5):11503.DOI:10.1038/srep11503.
[20]Jee SH,Ohrr H,Sull JW,et al.Fasting Serum Glucose Level and Cancer Risk in Korean Men and Women[J].JAMA,2005,293(2):194-202.DOI:10.1001/jama.293.2.194.
[21]Magura L,Blanchard R,Hope B,et al.Hypercholesterolemia and prostate cancer:a hospital-based case-control study[J].Cancer Causes Control,2008,19(10):1259-1266.DOI:10.1007/s10552-008-9197-7.
[22]Panagiotakos DB,Pitsavos C,Polychronopoulos E,et al.Total cholesterol and body mass index in relation to 40-year cancer mortality(the Corfu cohort of the seven countries study)[J].Cancer Epidemiol Biomarkers Prev,2005,14(7):1797-1801.DOI:10.1158/1055-9965.EPI-04-0907.
[23]刘书航.代谢综合征对前列腺癌发病的影响[J].临床医学,2016,36(2):16-17,18.Liu SH.Effect of metabolic syndrome on the incidence of prostate cancer[J].Clinical Medicine,2016,36(2):16-17,18.
[24]陈善苗.代谢综合征和前列腺癌发生发展的关系[J].现代实用医学,2018,30(7):869-870.DOI:10.3969/j.issn.1671-0800.2018.07.012.Chen SM.Relationship between metabolic syndrome and carcinogenesis and development of prostate cancer[J].Modern Practical Medicine,2018,30(7):869-870.DOI:10.3969/j.issn.1671-0800.2018.07.012.
[25]Smith MR,Lee H,Nathan DM.Insulin sensitivity during combined androgen blockade for prostate cancer[J].J Clin Endocrinol Metab,2006,91(4):1305-1308.DOI:10.1210/jc.2005-2507.
[2]韩苏军,张思维,陈万青,等.中国前列腺癌发病现状和流行趋势分析[J].临床肿瘤学杂志,2013,18(4):330-334.DOI:10.3969/j.issn.1009-0460.2013.04.009.Han SJ,Zhang SW,Chen WQ,et al.Analysis of the status and trends of prostate cancer incidence in China[J].Chinese Clinical Oncology,2013,18(4):330-334.DOI:10.3969/j.issn.1009-0460.2013.04.009.
[3]朱绍兴,李昌桂.代谢综合征与前列腺癌发病风险的相关性[J].上海医学,2012,35(5):392-395.Zhu SX,Li CG.Correlation study on metabolic syndrome and risk of prostate cancer[J].Shanghai Medical Journal,2012,35(5):392-395.
[4]张中攀,拜合提亚·阿扎提,李晓东,等.代谢综合征与前列腺癌的相关性研究[J].现代泌尿外科杂志,2018,22(6):443-446.DOI:10.3969/j.issn.1009-8291.2018.06.011.Zhang ZP,Baihetiya AZT,Li XD,et al.The correlation between metabolic syndrome and prostate cancer[J].Journal of Modern Urology,2018,22(6):443-446.DOI:10.3969/j.issn.1009-8291.2018.06.011.
[5]中华医学会糖尿病学分会代谢综合征研究协作组.中华医学会糖尿病学分会关于代谢综合征的建议[J].中国糖尿病杂志,2004,12(3):156-161.DOI:10.3321/j.issn:1006-6187.2004.03.002.Metabolism Syndrome Research and Collaboration Group,Chinese Diabetes Society.Suggestions on metabolism syndrome from Chinese Diabetes Society[J].Chinese Journal of Diabetes,2004,12(3):156-161.DOI:10.3321/j.issn:1006-6187.2004.03.002.
[6]张妙妙,贾俊亚,林珊.代谢综合征诊断的演变及研究进展[J].临床内科杂志,2018,35(8):574-576.DOI:10.3969/j.issn.1001-9057.2018.08.024.Zhang MM,Jia JY,Lin S.Evolution and research progress in diagnosis of metabolic syndrome[J].Journal of Clinical Internal Medicine,2018,35(8):574-576.DOI:10.3969/j.issn.1001-9057.2018.08.024.
[7]付俊玲,肖新华.代谢综合征的定义和流行病学[J].临床内科杂志,2018,35(1):5-9.DOI:10.3969/j.issn.1001-9057.2018.01.001.Fu JL,Xiao XH.Definition and epidemiology of metabolic syndrome[J].Journal of Clinical Internal Medicine,2018,35(1):5-9.DOI:10.3969/j.issn.1001-9057.2018.01.001.
[8]Tande AJ,Platz EA,Folsom AR.The metabolic syndrome is associated with reduced risk of prostate cancer[J].Am J Epidemiol,2006,164(11):1094-1102.DOI:10.1093/aje/kwj320.
[9]Lund Hheim L,Wislff TF,Holme I,et al.Metabolic syndrome predicts prostate cancer in a cohort of middle-aged Norwegian men followed for 27 years[J].Am J Epidemiol,2006,164(8):769-774.DOI:10.1093/aje/kwj284.
[10]Rodriguez C,Freedland SJ,Deka A,et al.Body mass index,weight change,and risk of prostate cancer in the Cancer Prevention StudyⅡNutrition Cohort[J].Cancer Epidemiol Biomarkers Prev,2007,16(1):63-69.DOI:10.1158/1055-9965.EPI-06-0754.
[11]周毅,姚远,杨剑文,等.老年前列腺癌并存代谢综合征患者的临床相关性研究[J].中华老年医学杂志,2014,33(2):172-174.DOI:10.3760/cma.j.issn.0254-9026.2014.02.016.Zhou Y,Yao Y,Yang JW,et al.Clinical correlation between prostate cancer and metabolic syndrome in the elderly[J].Chinese Journal of Geriatrics,2014,33(2):172-174.DOI:10.3760/cma.j.issn.0254-9026.2014.02.016.
[12]Martin RM,Vatten L,Gunnell D,et al.Components of the metabolic syndrome and risk of prostate cancer:the HUNT 2cohort,Norway[J].Cancer Causes Control,2009,20(7):1181-1192.DOI:10.1007/s10552-009-9319-x.
[13]Wallner LP,Morgenstern H,Mc Gree ME,et al.The effects of metabolic conditions on prostate cancer incidence over 15 years of follow-up:results from the Olmsted County Study[J].BJU Int,2011,107(6):929-935.DOI:10.1111/j.1464-410X.2010.09703.x.
[14]郭敏,白槟,余鹏飞,等.肥胖介导慢性炎性反应机制的研究进展[J].中国医药,2017,12(6):946-949.DOI:10.3760/cma.j.issn.1673-4777.2017.06.037.Guo M,Bai B,Yu PF,et al.Research progress on mechanisms of chronic inflammation mediated by obesity[J].China Medicine,2017,12(6):946-949.DOI:10.3760/cma.j.issn.1673-4777.2017.06.037.
[15]Veierd MB,Laake P,Thelle DS.Dietary fat intake and risk of prostate cancer:a prospective study of 25,708 Norwegian men[J].Int J Cancer,2015,73(5):634-638.
[16]Rundle A,Jankowski M,Kryvenko ON,et al.Obesity and future prostate cancer risk among men after an initial benign biopsy of the prostate[J].Cancer Epidemiol Biomarkers Prev,2013,22(5):898-904.DOI:10.1158/1055-9965.EPI-12-0965.
[17]Baillargeon J,Platz EA,Rose DP,et al.Obesity,adipokines,and prostate cancer in a prospective population-based study[J].Cancer Epidemiol Biomarkers Prev,2006,28(3):1331-1335.DOI:10.3892/ijo.28.3.737.
[18]Giovannucci E,Harlan DM,Archer MC,et al.Diabetes and cancer:a consensus report[J].CA Cancer J Clin,2010,60(4):207-221.DOI:10.3322/caac.20078.
[19]Wang M,Hu RY,Wu HB,et al.Cancer risk among patients with type 2 diabetes mellitus:a population-based prospective study in China[J].Sci Rep,2015(5):11503.DOI:10.1038/srep11503.
[20]Jee SH,Ohrr H,Sull JW,et al.Fasting Serum Glucose Level and Cancer Risk in Korean Men and Women[J].JAMA,2005,293(2):194-202.DOI:10.1001/jama.293.2.194.
[21]Magura L,Blanchard R,Hope B,et al.Hypercholesterolemia and prostate cancer:a hospital-based case-control study[J].Cancer Causes Control,2008,19(10):1259-1266.DOI:10.1007/s10552-008-9197-7.
[22]Panagiotakos DB,Pitsavos C,Polychronopoulos E,et al.Total cholesterol and body mass index in relation to 40-year cancer mortality(the Corfu cohort of the seven countries study)[J].Cancer Epidemiol Biomarkers Prev,2005,14(7):1797-1801.DOI:10.1158/1055-9965.EPI-04-0907.
[23]刘书航.代谢综合征对前列腺癌发病的影响[J].临床医学,2016,36(2):16-17,18.Liu SH.Effect of metabolic syndrome on the incidence of prostate cancer[J].Clinical Medicine,2016,36(2):16-17,18.
[24]陈善苗.代谢综合征和前列腺癌发生发展的关系[J].现代实用医学,2018,30(7):869-870.DOI:10.3969/j.issn.1671-0800.2018.07.012.Chen SM.Relationship between metabolic syndrome and carcinogenesis and development of prostate cancer[J].Modern Practical Medicine,2018,30(7):869-870.DOI:10.3969/j.issn.1671-0800.2018.07.012.
[25]Smith MR,Lee H,Nathan DM.Insulin sensitivity during combined androgen blockade for prostate cancer[J].J Clin Endocrinol Metab,2006,91(4):1305-1308.DOI:10.1210/jc.2005-2507.