Serum testosterone and the risk of prostate cancer: Potential implications for testosterone therapy
Serum testosterone and the risk of prostate cancer: Potential implications for testosterone therapy
复制标题
DOI：
10.1158/1055-9965.epi-04-0715
复制
发表时间：
2005-09-01
影响因子：
3.8
通讯作者：
Metter, EJ
中科院分区：
文献类型：
--
作者：
Parsons, JK;Carter, HB;Metter, EJ
目的：睾酮替代疗法的一个潜在风险是前列腺癌发病率增加，但尚不清楚较高水平的血清睾酮是否与较高的前列腺癌风险相关。我们前瞻性地评估了血清雄激素浓度和前列腺癌风险。方法：纳入了巴尔的摩老龄纵向研究的 794 名成员。我们通过将血清总睾酮、硫酸氢表雄酮、性激素结合球蛋白、计算出的游离睾酮和游离睾酮指数 (FTI) 的一系列测量值输入 Cox 比例风险回归模型并进行简单更新来估计前列腺癌的发病率比 (RR)。结果：计算出的游离睾酮较高与年龄调整后的前列腺癌风险增加相关{按四分位数划分的 RR：1.00、1.52 [95% 置信区间(95% CI), 0.93-2.501, 1.16 (95% CI, 0.61-2.20), 2.59 (95% Cl, 1.285.25); P 趋势 = 0.031，在排除 < 45 岁男性的测量后仍然存在[按四分位数划分的 RR：1.00、1.33 (95% CI，0.78-2.25)、1.26 (95% CI，0.68-2.33)、1.89 (95% CI，0.99-3.61)；趋势 = 0.031。与性腺功能正常的 FTI 男性 (>= 0.153) 相比，性腺功能低下的 FTI 男性患前列腺癌的风险降低（RR，0.51；95% CI，0.31-0.82）。结论：计算出的血清游离睾酮水平较高与前列腺癌风险增加相关。这些发现表明，接受睾酮治疗的男性应定期监测前列腺癌情况，并强调需要进行睾酮治疗前瞻性试验，将前列腺癌的发生率作为主要安全终点。
Objective: A potential risk of testosterone replacement therapy is an increase in the incidence of prostate cancer, but it is unclear whether higher levels of serum testosterone are associated with a higher risk of prostate cancer. We prospectively evaluated serum androgen concentrations and prostate cancer risk.Method: Included were 794 members of the Baltimore Longitudinal Study of Aging. We estimated the rate ratio (RR) of prostate cancer by entering serial measures of serum total testosterone, clehydroepiandrosterone sulfate, sex hormone binding globulin, calculated free testosterone, and free testosterone index (FTI) into a Cox proportional hazards regression model with simple updating.Results: Higher calculated free testosterone was associated with an increased age-adjusted risk of prostate cancer {RRs by quartile: 1.00, 1.52 [95% confidence interval (95% CI), 0.93-2.501, 1.16 (95% Cl, 0.61-2.20), 2.59 (95% Cl, 1.285.25); P-trend = 0.031, which persisted after excluding measures in men < 45 years of age [RRs by quartile: 1.00, 1.33 (95% CI, 0.78-2.25), 1.26 (95% CI, 0.68-2.33), 1.89 (95% Cl, 0.99-3.61); Ptrend = 0.031. Compared to men with eugonadal FTI (>= 0.153), men with hypogonadal FTI had a decreased risk of prostate cancer (RR, 0.51; 95% CI, 0.31-0.82).Conclusion: Higher levels of calculated serum free testosterone are associated with an increased risk of prostate cancer. These findings suggest that men receiving testosterone therapy should be regularly monitored for prostate cancer and underscore the need for prospective trials of testosterone therapy incorporating incidence of prostate cancer as a primary safety end point.