Nikhil Sharma, Mahalaqua Nazli Khatib, Ashok Kumar Balaraman, R Roopashree, Mandeep Kaur, Manish Srivastava, Amit Barwal, G V Siva Prasad, Pranchal Rajput, Rukshar Syed, Gajendra Sharma, Sunil Kumar, Mahendra Pratap Singh, Ganesh Bushi, Nagavalli Chilakam, Sakshi Pandey, Manvinder Brar, Rachana Mehta, Sanjit Sah, Abhay M Gaidhane, Muhammed Shabil
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引用次数: 0
摘要
背景：前列腺癌是全球男性最常见的恶性肿瘤之一。胰高血糖素样肽1受体激动剂（GLP-1 RAs）主要用于2型糖尿病（T2DM）的治疗，其对癌症风险的潜在影响已得到研究。本系统综述和荟萃分析旨在评估使用 GLP-1 RA 与降低前列腺癌风险之间的关联：方法：对截至 2024 年 7 月 30 日的 PubMed、Embase 和 Web of Science 进行了全面的文献检索。符合纳入标准的研究包括随机对照试验、队列研究、病例对照研究以及评估 GLP-1 RA 治疗患者前列腺癌发病率的观察性研究。研究质量采用纽卡斯尔-渥太华量表和科克伦偏倚风险工具进行评估。采用随机效应模型进行了 Meta 分析：共纳入了五项研究，分析了来自不同国际背景的数据。纳入的研究显示，GLP-1 RA 经调整和未经调整的效应估计值均可降低前列腺癌风险。荟萃分析显示，RR 为 0.72（95% CI：0.610 至 0.832），表明与安慰剂或其他抗糖尿病药物相比，使用 GLP-1 RA 可使前列腺癌风险在统计学上显著降低 28%。观察到中度异质性（I2 = 51%）。敏感性分析证实了上述结果：研究结果表明，使用 GLP-1 RA 与降低男性（尤其是 T2DM 患者）患前列腺癌的风险之间存在明显的保护性关联。这支持了 GLP-1 RAs 不仅在糖尿病管理方面，而且在降低癌症风险方面的潜力。还需要进一步的研究来证实这些发现并探索其潜在机制，同时考虑不同的剂量、治疗持续时间以及基于人口和代谢特征的患者亚群。
Effect of GLP-1 receptor agonists on prostate cancer risk reduction: a systematic review and meta-analysis.
Background: Prostate cancer is one of the most prevalent malignancies among men globally. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), primarily used for type 2 diabetes mellitus (T2DM) management, have been investigated for their potential effects on cancer risks. This systematic review and meta-analysis aimed to assess the association between GLP-1 RA use and risk reduction of prostate cancer.
Methods: A comprehensive literature search was conducted across PubMed, Embase, and Web of Science up to July 30, 2024. Studies that met the inclusion criteria randomized controlled trials, cohort studies, case-control studies, and observational studies assessing the incidence of prostate cancer in GLP-1 RA-treated patients were included. The quality of studies was evaluated using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool. Meta-analysis was performed using a random effects model.
Results: A total of five studies were included, analyzing data from diverse international contexts. The included studies showed a reduced risk of prostate cancer with both adjusted and unadjusted effect estimates with GLP-1 RAs. The meta-analysis revealed an RR of 0.72 (95% CI: 0.610 to 0.832), indicating a statistically significant 28% reduction in prostate cancer risk associated with GLP-1 RA use compared to placebo or other antidiabetic drugs. Moderate heterogeneity was observed (I2 = 51%). Sensitivity analysis confirmed the results.
Conclusion: The findings suggest a significant protective association between GLP-1 RA use and reduced prostate cancer risk in men, particularly those with T2DM. This supports the potential of GLP-1 RAs not only in diabetes management but also as a strategy to mitigate cancer risk. Further research is required to confirm these findings and explore the underlying mechanisms, considering different dosages, durations of therapy, and patient subgroups based on demographic and metabolic characteristics.
期刊介绍：
International Urology and Nephrology publishes original papers on a broad range of topics in urology, nephrology and andrology. The journal integrates papers originating from clinical practice.
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