5-alpha 還原酶抑制劑與糖尿病的風險
謝登富、李祥生、林殿璜、劉昕和、蔡宗訓、陳至正
台中慈濟醫院泌尿科；花蓮慈濟大學醫院
5-alpha-reductase inhibitors and risk of diabetes mellitus
Teng-Fu Hsieh , Shang-Sen Lee, Tien-Huang Lin, Hsin-Ho Liu, Tsung-Hsun Tsai, Chi-Cheng Chen
Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan；School of Medicine, Tzu Chi University, Hualian, Taiwan
Purpose: The aim of this study is to investigate the risk of diabetes mellitus (DM) after 5-alpha-reductase inhibitor (5ARI) therapy for benign prostate hyperplasia (BPH) using the National Health Insurance Research Database (NHIRD) in Taiwan.
Materials and Methods: In total, 1298 adult patients newly diagnosed with BPH and who used more than 28 cumulative defined daily doses (cDDD) of 5ARI were recruited as the therapy group cohort, along with 12887 subjects who did not use more than 28 cDDD of 5ARI as a control group from 2002 to 2009. Each patient was monitored for five years (from 2003 to 2008) to identify those who subsequently developed DM. A Cox proportional hazards model was used to compare the risk of DM between the study and comparison cohorts after adjusting for possible confounding risk factors.
Results: Patients who received 5ARI therapy had a lower cumulative rate of DM than those who did not receive 5ARI during the five-year follow-up period (3.5% vs. 5.3%, p=0.003). In sub-group analysis, among the BPH patients aged <65 years, the five-year DM events hazard ratio (HR) of 5ARI users was lower than that of non-users (HR: 0.47, 95% confidence interval (CI): 0.24-0.91; p=0.026).
Conclusion: Therapy with 5ARI may decrease the five-year risk of DM in the BPH patients younger than 65 years. Further mechanistic research is warranted to validate the results.