Male infertility and prostate cancer risk: a nested case-control study
Male infertility and prostate cancer risk: a nested case-control study
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DOI：
10.1007/s10552-010-9592-8
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发表时间：
2010-10-01
影响因子：
2.3
通讯作者：
Giwercman, Yvonne L.
中科院分区：
文献类型：
--
作者：
Ruhayel, Yasir;Giwercman, Aleksander;Giwercman, Yvonne L.
前列腺癌的发病机制尚不清楚，尽管实验证据表明雄激素起着重要作用。不育男性经常患有某种程度的性腺功能减退症，因此可以假设患前列腺癌的风险低于有生育能力的男性。为了验证这一假设，我们在瑞典进行了一项嵌套在“马尔莫饮食与癌症研究”队列中的病例对照研究，邀请了661例前列腺癌病例和661例年龄匹配的对照参与。在975名（74%）受访者中，我们排除了84名生育状况不明的无子女男性。因此，纳入了891名男性，提供了445例前列腺癌病例和446例对照。其中，841名（94%）男性是亲生父亲，50名（6%）男性不育。Logistic回归分析显示，不育男性被诊断为前列腺癌的风险显著低于生育男性（比值比，0.45; 95%置信区间，0.25-0.83）。有条件和无条件的多变量模型，调整社会经济，人体测量和健康状况相关的因素，提供了类似的估计。我们的结论是，持久的男性不育症与前列腺癌的风险降低，从而证实了理论，正常的睾丸功能，因此最有可能足够的类固醇生成，是一个重要的因素，这种恶性肿瘤的后期发展。
The pathogenesis of prostate cancer is unclear, although experimental evidence implicates androgens as playing an important role. Infertile men frequently suffer from some degree of hypogonadism and may hence be hypothesized to be at lower risk of developing prostate cancer than fertile men. To test this hypothesis, we conducted a case-control study nested within "the Malmo Diet and Cancer Study" cohort in Sweden, inviting 661 prostate cancer cases and 661 age-matched controls to participate. Of the 975 (74%) respondents, we excluded 84 childless men with unknown fertility status. Thus, 891 men were included, providing 445 prostate cancer cases and 446 controls. Of these, 841 (94%) men were biological fathers and 50 (6%) men were infertile. Logistic regression showed that the infertile men were at significantly lower risk of being diagnosed with prostate cancer than the fertile men (odds ratio, 0.45; 95% confidence interval, 0.25-0.83). Conditional and unconditional multivariate models, adjusting for socioeconomic, anthropometric, and health-status-related factors, provided similar estimates. We conclude that enduring male infertility is associated with a reduced prostate cancer risk, thus corroborating the theory that normal testicular function, and hence most probably sufficient steroidogenesis, is an important contributing factor to the later development of this malignancy.