摘要
目的:探讨前列腺癌(PCa)雄激素剥夺治疗(ADT)对胰岛功能和糖代谢的影响。方法:选取2015年1月~2017年9月我院接受ADT的PCa患者90例作为PCa组,根据ADT治疗方案分为间歇性ADT组(IADT组,n=59)和持续性ADT组(CADT组,n=31),选取同期医院体检中心年龄、性别相匹配的健康者50例作为对照组,检测IADT组、CADT组入院时及随访6个月血糖(PG)水平及胰岛功能,并与对照组比较,记录IADT组、CADT组继发性糖尿病、葡萄糖耐量异常(IGT)发生率。结果:PCa组随访6个月空腹血糖(FBG)、餐后2hPG、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)较入组时升高,胰岛β细胞功能(HOMA-β)较入组时降低(P<0.05);PCa组入组时上述指标与对照组比较,差异无统计学意义(P>0.05)。IADT组随访6个月2hPG、HOMA-IR低于CADT组,HOMA-β高于CADT组,两组比较差异有统计学意义(P<0.05)。两组FBG、HbA1c比较,差异无统计学意义(P>0.05)。IADT组和CADT组继发性糖尿病发生率比较,差异无统计学意义(P>0.05);ADT组IGT发生率低于CADT组,两组比较差异有统计学意义(5.08%vs.19.35%,P <0.05)。结论:ADT会导致PCa患者出现PG代谢紊乱、胰岛素抵抗;与IADT比较,接受CADT的患者IGT发生率升高,但不会增加继发性糖尿病发生率。
Objective:To investigate the effect of androgen deprivation therapy(ADT)for prostate cancer(PCa)on islet function and glucose metabolism.Method:Ninety patients with PCa who underwent ADT in the hospital from January 2015 to September 2017 were selected as PCa group.According to the ADT plan,they were divided into intermittent ADT group(IADT group,59 cases)and continuous ADT group(CADT group,31 cases).Fifty healthy persons of matched age and gender in the examination center were selected as the control group during the same period.Levels of blood glucose and islet function in IADT group and CADT group were detected at admission and in 6 months of follow-up,and were compared with those in the control group.The incidence rates of secondary diabetes and impaired glucose tolerance(IGT)in IADT group and CADT group were recorded.Result:The fasting blood glucose(FBG),postprandial 2 hplasma glucose(PG),glycosylated hemoglobin(HbA1 c)and insulin resistance index(HOMA-IR)increased while the pancreatic beta cell function(HOMA-β)decreased in PCa group during 6 months of follow-up,compared with those at admission(P<0.05).There was no statistical difference between PCa group and the control group in above indicators(P>0.05).HOMA-IR and2 hPG were lower while HOMA-βwas higher in IADT group than those in CADT group(P<0.05),but there was no significant difference in FBG or HbA1 cbetween the two groups(P>0.05).There was no significant difference in the incidence of secondary diabetes between the two groups(P>0.05).The incidence rate of IGT in IADT group was lower than that in CADT group(5.08%vs.19.35%)(P<0.05).Conclusion:ADT can lead to glucose metabolism disorder and insulin resistance in patients with PCa.Compared with IADT,the incidence rate of IGT is higher in patients undergoing CADT,but not the incidence rate of secondary diabetes.
作者
杜晚林
黄国华
杨春林
雷鹏
吴嘉豪
DU Wanlin;HUANG Guohua;YANG Chunlin;LEI Peng;WU Jiahao(Department of Urology,Yuechi County People's Hospital,Yuechi,Sichuan,638300,China;Department of Urology,Guang'an People's Hospital)
出处
《临床泌尿外科杂志》
2019年第8期609-612,共4页
Journal of Clinical Urology
关键词
前列腺癌
雄激素剥夺
持续性
间歇性
血糖
胰岛功能
prostate cancer
androgen deprivation
continuous
intermittent
blood glucose
islet function
