Exploring the association between use of gonadotropin releasing hormones agonists and prostate cancer diagnosis per se and diabetes control in men with type 2 diabetes mellitus: a nationwide, population-based cohort study

BMC Cancer

Jan Adolfsson¹  Björn Zethelius²  Pär Stattin³  E. Lin⁴  Hans Garmo⁴  Mieke Van Hemelrijck⁴  Danielle Crawley⁴ 

[1] Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden;Department of Public Health/Geriatrics, Uppsala University, Uppsala, Sweden;Department of Surgical Sciences, Uppsala University, Uppsala, Sweden;School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), King’s College London, 3rd Floor Bermondsey Wing, Guy’s Hospital, SE1 9RT, London, UK;

关键词: Prostate cancer diagnosis;    Gonadotropin-releasing hormone agonists;    Diabetes;   

DOI  :  10.1186/s12885-021-08941-y

来源: Springer

【 摘 要 】

BackgroundGonadotropin Releasing Hormones agonists (GnRH), which are first line treatment for metastatic prostate cancer (PCa), increase risk of type 2 diabetes mellitus (T2DM). This study aims to quantify the association of use of GnRH with diabetes control in PCa men with T2DM.MethodsNationwide population-based cohort study in the Swedish National Diabetes Register and Prostate Cancer data Base Sweden 4.1, on the association between GnRH and diabetes control in T2DM men with PCa by comparing T2DM men with PCa vs. without PCa, as well as comparing T2DM men with PCa on or not on GnRH. The primary exposure was use of GnRH. Worsening diabetes control was the primary outcome, defined as: 1) HbA1c rose to 58 mmol/mol or higher; 2) HbA1c increase by 10 mmol/mol or more; 3) Start of antidiabetic drugs or switch to insulin. We also combined all above definitions. Cox proportional hazards regression was used to analyze the association.ResultsThere were 5714 T2DM men with PCa of whom 692 were on GnRH and 28,445 PCa-free men with T2DM with similar baseline characteristics. Diabetes control was worse in men with GnRH vs. PCa-free men (HR: 1.24, 95% CI: 1.13–1.34) as well as compared with PCa men without GnRH (HR:1.58, 95% CI: 1.39–1.80), when we defined the worsening control of diabetes by combining all definitions above.ConclusionUse of GnRH in T2DM men with PCa was associated with worse glycemic control. The findings highlight the need to closely monitor diabetes control in men with T2DM and PCa starting GnRH.

【 授权许可】

CC BY