间歇性雄激素阻断与晚期前列腺癌患者胰岛素抵抗的关系

目的探讨间歇性雄激素阻断与晚期前列腺癌患者胰岛素抵抗的相关性。方法将72例晚期前列腺癌患者根据BMI分为超重组（32例）和非超重组（40例），两组患者均采用间歇性雄激素阻断方法治疗又称之为去势治疗。分别测定两组患者治疗前及治疗后6、12个月时的空腹血糖（FPG）、空腹胰岛素水平（FNS），并计算胰岛素抵抗指数（IRI），然后作组间比较及相关分析。结果去势后6个月两组患者FNS水平均较治疗前显著升高（均P〈0．01）；去势后12个月超重组患者FNS水平仍较治疗前明显升高（均P〈0．05），但较去势后6个月显著下降（P〈0．01），非超重组患者FNS水平较去势后6个月显著下降（P〈0．01）。两组患者去势后6个月IRI均显著升高（P〈0．01）；去势后12个月超重组患者IRI仍较去势前明显升高（P〈005），但去势后6个月显著下降（P〈0．01），非超重组患者IRI较去势后6个月显著下降（P〈0．01）。结论间歇性雄激素阻断会促使晚期前列腺癌患者发生胰岛素抵抗，但进入治疗间歇期后胰岛素抵抗又可逐渐恢复正常。

Insulin resistance in men with advanced prostate carcinoma under intermittent androgen blockade

Objective To investigate the correlation of insulin resistance with intermittent androgen blockade in patients with advanced prostate carcinoma. Methods A total of 72 patients with advanced prostate cancer treated with intermittent androgen blockade were enrolled in the study, including 32 men with BMI ≥24/ （group A） and 40 men with BMI 〈 24/ （group B）. Fasting blood glucose （FPG） and the fasting serum insulin （FNS） were determined; the insulin resistance index （IRI） was evaluated before and 6, 12 months after treatment. Results The two groups had significantly higher FNS 6 months after treatment respectively（ group A, p〈0.01; group B, p〈0.01 ）. The FNS 6 months after treatment in group A was higher that before treatments （p〈0.05 ）,but lower than that after 6 months （p〈0.01）; the FNS in group B was significantly lower than that after 6 months of treatment（ p〈0.01 ）. IRI in two groups was significantly higher 6 months after treatment（ group A, p〈0.01; group B, p〈0.01 ）. The IRI 12 months after treatment in group A was higher than that before treatment （p〈0.05）, but lower than that 6 months after treatment（p〈0.01 ）; IRI in group B was significantly lower than that after 6 months of treatment（ p〈0.01 }. Conclusion The results suggest that men with advanced prostate cancer who receive intermittent androgen blockade are at risk for developing insulin resistance, which can be reversed during the intermission of therapy.