目的 探討去勢療法是否會增加前列腺癌（PCa）患者罹患糖尿病的風(fēng)險(xiǎn)。方法 系統(tǒng)檢索Medline、Embase、Cochrane Library Central關(guān)于去勢療法（ADT）應(yīng)用于PCa并報(bào)道該治療與糖尿病相關(guān)性的臨床試驗(yàn)研究，對文獻(xiàn)進(jìn)行數(shù)據(jù)提取及Meta分析。結(jié)果 共8項(xiàng)臨床研究，涉及65 695名應(yīng)用ADT及91 893名未應(yīng)用去勢療法（non-ADT）的PCa患者納入分析。應(yīng)用ADT的患者其糖尿病的發(fā)病率較non-ADT者高出39%[RR=1.39，95%CI（1.27~1.53），P<0.01]；亞組分析發(fā)現(xiàn)，不同的ADT對糖尿病發(fā)病率亦有不同的相關(guān)性，促雄性激素釋放激素抑制劑能明顯增加PCa患者罹患糖尿病的風(fēng)險(xiǎn)[RR=1.45，95%CI（1.36~1.54），P<0.01]；促雄性激素釋放激素抑制劑聯(lián)合口服抗雄性激素藥物[RR=1.40，95%CI（1.01~1.93），P<0.01]，以及睪丸切除術(shù)也可明顯增加糖尿病患病的風(fēng)險(xiǎn)[RR=1.34，95%CI（1.20~1.50），P<0.01]，而單純服用抗雄性激素的藥物則與糖尿病無明顯相關(guān)性[RR=1.33，95%CI（0.75~2.36），P=0.33]。結(jié)論 ADT可明顯增加PCa罹患糖尿病的風(fēng)險(xiǎn)，提示臨床應(yīng)用該療法需考慮采取相應(yīng)的預(yù)防措施。

Objective To examine whether androgen deprivation therapy (ADT) is associated with increased risk of diabetes in men with prostate cancer (PCa). Methods The study data were systematically searched from Medline, Embase, and Cochrane Library Central Register. Studies comparing ADT vs control aimed at treating PCa, reporting diabetes as outcome were included. Results Eight studies met inclusion criteria with a total of 65 695 ADT users and 91 893 non-ADT users investigating the relationship between ADT and diabetes. The incidence of diabetes was 39% higher in ADT groups, and significant association was observed in overall analysis[RR=1.39, 95%CI(1.27-1.53), P < 0.01]. In subgroup-analyses stratified by ADT types, diabetes was found to be significantly associated with gonadotropin-releasing hormone (GnRH) alone[RR=1.45, 95%CI(1.36-1.54), P < 0.01), GnRH plus oral anti-androgen (AA)[RR=1.40, 95%CI(1.01-1.93), P < 0.01] and Orchiectomy[RR=1.34, 95%CI(1.20-1.50), P < 0.01], but not with AA alone[RR=1.33, 95%CI(0.75-2.36), P=0.33]. Conclutions ADT, especially GnRH alone, GnRH plus AA and orchiectomy can increase the incidence of diabetes in patients with PCa.