Statins and Prostate Cancer Diagnosis and Grade in a Veterans Population
Statins and Prostate Cancer Diagnosis and Grade in a Veterans Population
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DOI：
10.1093/jnci/djr108
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发表时间：
2011-06-01
影响因子：
10.3
通讯作者：
Gaziano, J. Michael
中科院分区：
文献类型：
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作者：
Farwell, Wildon R.;D'Avolio, Leonard W.;Gaziano, J. Michael
背景虽然前列腺癌是常见的诊断，很少有高级别前列腺癌的危险因素是已知的，很少有预防策略存在。他汀类药物已被提出作为一种可能的治疗，以防止prostate cancer.Methods使用电子和行政文件从退伍军人事务部新英格兰医疗保健系统，我们确定了55 875名男子服用他汀类药物或抗高血压药物。我们使用年龄和多变量校正的考克斯比例风险模型计算服用他汀类药物的患者（n = 41 078）与服用降压药物的患者（n = 14 797）相比前列腺癌发病率的风险比（HR）和95%置信区间（CI）。我们对所有血脂参数（包括总胆固醇）进行了类似的分析，将每个血脂参数作为连续变量并按四分位数进行检查。结果与服用抗高血压药物的男性相比，他汀类药物使用者被诊断为前列腺癌的可能性降低31%（HR = 0.69，95%CI = 0.52 ~ 0.90）。此外，与抗高血压药物使用者相比，他汀类药物使用者被诊断为低度前列腺癌的可能性降低14%（HR = 0.86，95% CI = 0.62至1.20），被诊断为高度前列腺癌的可能性降低60%（HR = 0.40，95% CI = 0.24至0.65）。总胆固醇水平的增加也与总胆固醇水平和总胆固醇水平有关。（HR = 1.02，95% CI = 1.00 - 1.05）和高级别（HR = 1.06，95% CI = 1.02 - 1.10）前列腺癌发生率，但不包括低级别前列腺癌发生率结论他汀类药物的使用可显著降低前列腺癌和高级别前列腺癌的发病风险，而血清胆固醇水平的升高可增加前列腺癌和高级别前列腺癌的发病风险。这些发现表明，他汀类药物预防前列腺癌的临床试验是必要的。
Background Although prostate cancer is commonly diagnosed, few risk factors for high-grade prostate cancer are known and few prevention strategies exist. Statins have been proposed as a possible treatment to prevent prostate cancer.Methods Using electronic and administrative files from the Veterans Affairs New England Healthcare System, we identified 55 875 men taking either a statin or antihypertensive medication. We used age-and multivariable-adjusted Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for prostate cancer incidence among patients taking statins (n = 41 078) compared with patients taking antihypertensive medications (n = 14 797). We performed similar analyses for all lipid parameters including total cholesterol examining each lipid parameter as a continuous variable and by quartiles. All statistical tests were two-sided.Results Compared with men taking an antihypertensive medication, statin users were 31% less likely (HR = 0.69, 95% CI = 0.52 to 0.90) to be diagnosed with prostate cancer. Furthermore, statin users were 14% less likely (HR = 0.86, 95% CI = 0.62 to 1.20) to be diagnosed with low-grade prostate cancer and 60% less likely (HR = 0.40, 95% CI = 0.24 to 0.65) to be diagnosed with high-grade prostate cancer compared with antihypertensive medication users. Increased levels of total cholesterol were also associated with both total (HR = 1.02, 95% CI = 1.00 to 1.05) and high-grade (HR = 1.06, 95% CI = 1.02 to 1.10) prostate cancer incidence but not with low-grade prostate cancer incidence (HR = 1.01, 95% CI = 0.98 to 1.04).Conclusions Statin use is associated with statistically significantly reduced risk for total and high-grade prostate cancer, and increased levels of serum cholesterol are associated with higher risk for total and high-grade prostate cancer. These findings indicate that clinical trials of statins for prostate cancer prevention are warranted.