■雄激素剥夺疗法(ADT),通常通过促黄体激素释放激素(LHRH)激动剂递送,是晚期前列腺癌(PC)的标准治疗方法。虽然相当有效,它与主要不良心血管事件(MACE)的风险增加相关.确切的机制尚不清楚。然而,据推测,卵泡刺激素(FSH),一种与控制正常睾酮水平有关的垂体激素,LHRH激动剂治疗会降低,可能是罪魁祸首。我们进行了一项回顾性人群水平研究,以测试FSH水平与MACE发展的联系。抗去势PC(CRPC),以及开始ADT的男性死亡。
■在开始ADT之前的2年内,所有在1999年至2018年之间具有FSH水平的男性(n=1,539)在退伍军人事务(VA)卫生系统中确定了完整的数据。FSH分为低/正常(≤8IU/mL)和高(>8IU/mL),使用既定的切点。FSH与MACE时间之间的关联,死亡,和CRPC使用对数秩检验和多变量Cox比例风险模型进行检验。
■高FSH患者年龄较大(中位数76vs.73年,P<0.001),较早开始ADT(2007年中位数与2009,P=0.027),体重指数(BMI)较低(中位数29.1vs.30.1kg/m2,P=0.004)与FSH低/正常的那些相比。在多变量分析中,FSH和从ADT到MACE的时间之间没有关联,CRPC,或死亡。
■在这项针对男性在开始ADT之前接受FSH测试的人群水平研究中,FSH水平和从ADT到MACE的时间之间没有关联,CRPC,或死亡。虽然还需要进一步的研究,这些结果不支持ADT前FSH与长期肿瘤或心血管结局之间的联系.
UNASSIGNED: Androgen deprivation therapy (ADT), commonly delivered via a luteinizing hormone-releasing hormone (LHRH) agonist, is the standard treatment for advanced prostate cancer (PC). While quite effective, it has been associated with an increased risk of major adverse cardiovascular events (MACE). The exact mechanisms are not clear. However, it has been theorized that follicle-stimulating hormone (FSH), a pituitary hormone that is involved in controlling normal testosterone levels, which is decreased with LHRH-agonist therapy, may be the culprit. We performed a retrospective population-level study to test the link of FSH levels on the development of MACE, castrate-resistant PC (CRPC), and death among men starting ADT.
UNASSIGNED: All men (n=1,539) who had an FSH level between 1999 and 2018 within 2 years prior to starting ADT and complete data were identified within the Veterans Affairs (VA) Health System. FSH was dichotomized as low/normal (≤8 IU/mL) and high (>8 IU/mL), using established cut-points. The associations between FSH and time to MACE, death, and CRPC were tested using log-rank tests and multivariable Cox proportional hazards models.
UNASSIGNED: Patients with high FSH were older (median 76 vs. 73 years, P<0.001), started ADT earlier (median 2007 vs. 2009, P=0.027), and had lower body mass index (BMI) (median 29.1 vs. 30.1 kg/m2, P=0.004) compared to those with low/normal FSH. On multivariable analysis, there was no association between FSH and time from ADT to MACE, CRPC, or death.
UNASSIGNED: In this population-level study of men receiving an FSH test prior to starting ADT, there was no association between FSH levels and time from ADT to MACE, CRPC, or death. Although further studies are needed, these results do not support a link between pre-ADT FSH and long-term oncological or cardiovascular outcomes.