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目的:探讨晚期前列腺癌间歇性雄激素剥夺治疗(IADT)和持续性雄激素剥夺治疗(CADT)两种不同方式与继发糖尿病(DM)和糖耐量异常(IGT)风险的相关性。方法:对2013年1月至2015年12月于我院进行雄激素剥夺治疗(ADT)的PCa患者进行回顾性病例对照研究。通过监测患者空腹血糖、餐后2 h血糖及口服糖耐量试验,结合患者相关临床症状,对IADT和CADT引起DM和IGT的风险进行统计学分析,并分析组内体质量指数(BMI)、高血压、吸烟、饮酒等因素与继发性DM和IGT的关系。结果:IADT组53例(46.5%),平均(69.1±4.3)岁;CADT组61例(53.5%),平均(70.2±5.7)岁,两组在临床特点方面均无明显差异(P均>0.05);IADT组BMI、高血压、吸烟、饮酒等因素对DM、IGT的发生均无明显影响(P均>0.05),CADT组BMI、高血压、吸烟、饮酒因素对DM、IGT的发生均无明显影响(P均>0.05);IADT组与CADT组比较,DM的发生无统计学意义(P=0.64);但IGT的发生有统计学意义(P=0.03)。结论:IADT与CADT比较,PCa患者的IGT发生风险更低,安全性更高。
Objective: To investigate the relationship between two different modalities of intermittent androgen deprivation (IADT) and continuous androgen deprivation (CADT) in patients with advanced prostate cancer and the risk of secondary diabetes mellitus (DM) and impaired glucose tolerance (IGT). METHODS: A retrospective case-control study of PCa patients undergoing androgen deprivation therapy (ADT) in our hospital from January 2013 to December 2015 was conducted. The risk of DM and IGT caused by IADT and CADT were analyzed by monitoring fasting blood glucose, 2-hour postprandial blood glucose and oral glucose tolerance test, combined with the clinical symptoms of the patients. The body mass index (BMI) and high Blood pressure, smoking, drinking and other factors with secondary DM and IGT relationship. Results: 53 cases (46.5%) were in IADT group (mean age was 69.1 ± 4.3), 61 cases (53.5%) in CADT group were average (70.2 ± 5.7) years old. There was no significant difference in clinical features between the two groups (P> 0.05). The incidence of DM and IGT in both IADT group and control group were significantly lower than those in IADT group (P <0.05). BMI, hypertension, smoking and alcohol consumption in CADT group had no significant effect on the occurrence of DM and IGT (P> 0.05). There was no significant difference in DM between IADT group and CADT group (P = 0.64). However, the incidence of IGT was statistically significant (P = 0.03). Conclusion: Compared with CADT, IADT is associated with lower risk and safety in patients with PCa.