Quantifying the Evidence for the Risk of Metabolic Syndrome and Its Components following Androgen Deprivation Therapy for Prostate Cancer: A Meta-Analysis

BackgroundNo meta-analysis is yet available for the risk of metabolic syndrome (MetS) following androgen deprivation therapy (ADT) for men with prostate cancer. To summarize the evidence for the link between ADT and MetS or its components quantitatively with a meta-analysis including all studies published to date.MethodsPubMed and Embase were searched using predefined inclusion criteria to perform meta-analyses on the association between metabolic syndrome, hyperglycemia, diabetes, hypertension, dyslipidemia or obesity and androgen deprivation therapy in patients with prostate cancer. Random effects methods were used to estimate pooled relative risks (RRs) and 95% confidence intervals (CI).ResultsA total of nine studies was included. There was a positive association between ADT and risk of MetS (RR: 1.75 (95% CI: 1.27–2.41)). Diabetes was the only MetS component present in more than 3 studies, and also showed an increased risk following ADT (RR: 1.36 (95% CI: 1.17–1.58)).ConclusionThis is the first quantitative summary addressing the potential risk of MetS following ADT in men with PCa. The positive RRs indicate that there is a need to further elucidate how type and duration of ADT affect these increased risks of MetS and diabetes as the number of men with PCa treated with ADT is increasing.

背景：目前尚无针对前列腺癌（prostate cancer, PCa）男性患者接受雄激素剥夺治疗（androgen deprivation therapy, ADT）后发生代谢综合征（metabolic syndrome, MetS）风险的meta分析。本研究旨在通过纳入迄今已发表的所有相关研究的meta分析，定量总结雄激素剥夺治疗与代谢综合征及其组分之间关联的现有证据。

方法：通过预设的纳入标准检索PubMed及Embase数据库，针对前列腺癌患者中代谢综合征、高血糖、糖尿病、高血压、血脂异常或肥胖与雄激素剥夺治疗的关联开展meta分析。采用随机效应模型估算合并相对危险度（relative risk, RR）及95%置信区间（confidence interval, CI）。

结果：共纳入9项研究。雄激素剥夺治疗与代谢综合征风险呈正相关（合并相对危险度：1.75，95%置信区间：1.27~2.41）。糖尿病是唯一在3项以上研究中被报道的代谢综合征组分，其在雄激素剥夺治疗后同样呈现风险升高（合并相对危险度：1.36，95%置信区间：1.17~1.58）。

结论：本研究是首个针对前列腺癌男性患者接受雄激素剥夺治疗后代谢综合征潜在风险的定量总结。由于接受雄激素剥夺治疗的前列腺癌患者数量持续增加，本研究得到的正相关相对危险度提示，需进一步阐明雄激素剥夺治疗的类型与疗程如何影响代谢综合征及糖尿病的升高风险。