Mối liên hệ giữa cholesterol huyết tương và việc sử dụng thuốc hạ cholesterol với các hormone steroid giới tính trong huyết tương ở nam giới trong nghiên cứu NHANES III

Cancer Causes & Control - Tập 21 - Trang 1575-1583 - 2010
Alison M. Mondul1, Elizabeth Selvin1,2, Sabine Rohrmann3, Andy Menke1,2, Manning Feinleib1, Norma Kanarek4,5, Nader Rifai6, Adrian S. Dobs7, Elizabeth A. Platz8,5,9
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA;
2Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, USA
3Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
4Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
5Sidney Kimmel Comprehensive Cancer, Johns Hopkins Medical Institutions, Baltimore, USA
6Department of Laboratory Medicine, Children’s Hospital Boston and Harvard Medical School, Boston, USA
7Department of Endocrinology, Johns Hopkins School of Medicine, Baltimore, USA
8Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
9Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, USA

Tóm tắt

Mức cholesterol thấp và việc sử dụng thuốc statin có thể bảo vệ chống lại ung thư tuyến tiền liệt với tiên lượng xấu hơn. Cơ chế bảo vệ của chúng chưa rõ ràng, nhưng đã được giả thuyết liên quan đến vai trò của cholesterol như một tiền chất hormone steroid giới tính. Chúng tôi đánh giá xem testosterone và estradiol có khác nhau theo mức cholesterol hoặc việc sử dụng thuốc hạ cholesterol hay không. Mức testosterone và estradiol được đo ở 1.457 nam giới tham gia Khảo sát sức khỏe và dinh dưỡng quốc gia lần thứ ba. Chúng tôi ước tính nồng độ hormone trung bình hình học điều chỉnh nhiều biến theo các nhóm quintile của nồng độ cholesterol và việc sử dụng thuốc hạ cholesterol. Qua các quintile cholesterol, mức testosterone không khác biệt (trung bình, khoảng tin cậy 95% (CI); Q1: 5,25, 5,02–5,49, Q5: 5,05, 4,76–5,37 ng/ml; p-trend = 0,32), trong khi mức estradiol thấp hơn (Q1: 38,7, 36,9–40,5; Q5: 33,1, 31,8–34,5 pg/ml; p-trend < 0,0001). Cả testosterone (không: 5,12, 4,94–5,30, có: 4,91, 4,33–5,57 ng/ml, p = 0,57) và estradiol (không: 35,9, 34,8–37,1; có: 33,9, 29,4–39,2 pg/ml; p = 0,39) đều không khác nhau theo việc sử dụng thuốc hạ cholesterol. Testosterone không thay đổi theo cholesterol hoặc việc sử dụng thuốc hạ cholesterol. Estradiol thấp hơn ở những người có cholesterol cao hơn, nhưng không khác nhau theo việc sử dụng thuốc hạ cholesterol. Kết quả của chúng tôi cho thấy rằng nguy cơ ung thư tuyến tiền liệt giai đoạn tiến triển thấp hơn ở những người sử dụng statin không thể dễ dàng giải thích bởi tác động của statin trung gian cholesterol lên mức hormone giới tính.

Từ khóa

#cholesterol #hormone steroid giới tính #thuốc hạ cholesterol #ung thư tuyến tiền liệt #statin

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