老年前列腺癌去势治疗对血清脂联素及胰岛素抵抗的影响

Effects of castration on serum Adiponectin level and insulin resistance in patients with prostate carcinoma

摘要:

目的 探讨内源性睾酮缺失对血清脂联素（Adip）及胰岛素抵抗（IR）的影响。方法 观察32例老年前列腺癌睾丸全切患者与30例前列腺次全切或全切以及30例正常对照组患者的空腹血糖（FPG）、胰岛素（ISN）和C肽、血清Adip以及IR指数（HOMA-IR）和胰岛素敏感指数（QUICKI）。结果 去势组Adip水平较正常对照组明显降低[（1.43±0.79）vs（2.38±0.77）mg/L, P＜0.05], HOMA-IR明显高于正常对照组[（1.75±4.84）vs（1.10±3.45）, P＜0.01]; 总睾酮与ISN（r =－0.17, P = 0.043）、C肽（r =－0.249, P = 0.32）和HOMA-IR（r =－0.781, P＜0.01）呈负相关, 与Adip水平（r = 0.819, P＜0.01）和QUICK（r = 0.420, P = 0.026）呈正相关。结论 内源性睾酮缺乏可能通过对IR及Adip水平的影响参与调节男性心血管疾病的发生发展。

Abstract:

Objective To determine the effects of testosterone deprivation therapy on Adiponectin(Adip) level and insulin resistance (IR) in patients with prostate cancer. Methods The levels of fasting plasma glucose(FPG), insulin(ISN), C-peptide(CP), total testosterone(TT), free testosterone(FT), Adip, insulin resistance (HOMA-IR) and quantitative insulin-sensitivity check index(QUICKI) were measured in 32 patients with prostatie carcinoma under castration(CAS group), 30 patients with prostate hypertrophy under total or subtotal prostatectomy (PH group) and 30 age-matched controls (control group). Results The Adip level was lower in CAS group than in control group[ (1.43±0.79)mg/L vs (2.38±0.77)mg/L, P＜0.05)]. HOMA-IR was higher significantly in CAS group than in control group[（1.75±4.84）vs（1.10±3.45）, P＜0.01]. TT was negatively correlated with INS (r = ?0.17; P = 0.043), CP(r = ?0.249, P = 0.32) and HOMA-IR (r = ?0.781; P＜0.01); positively correlated with Adip(r = 0.819, P＜0.01) and QUICKI(r = 0.420, P=0.026). Conclusion Endogenous testosterone deprivation may be involved in development of cardiovascular diseases in males by regulating insulin resistance and Adip level.