替代疗法与老年低阴腺男性前列腺疾病之间的关联
Seo Hyon Baik1, Fitsum Baye1, Kin Wah Fung1
1Division of Intramural Research, National Library of Medicine, U.S. National Institutes of Health, Bethesda, Maryland, USA.
The Journal of clinical endocrinology and metabolism
|September 9, 2025
概括
在老年男性中,替代疗法 (TRT) 与前列腺癌风险的显著降低,但良性前列腺增生风险的适度增加有关. 结果表明基于持续时间,路线和联合治疗的个性化TRT方法.
科学领域:
- 内分泌学 在内分泌学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 老年医学 老年医学
背景情况:
- 由于担心前列腺并发症,低阴腺男性经常避免替代疗法 (TRT).
- 目前关于TRT对老年男性前列腺的影响的数据有限,需要进一步调查.
研究的目的:
- 研究TRT使用与老年男性的前列腺结局 (前列腺癌和良性前列腺增生) 之间的关联.
- 分析TRT的持续时间,注射途径和芳酶抑制剂 (AI) 的联合使用如何影响这些关联.
主要方法:
- 大规模的回顾性队列研究使用医疗保险数据 (2007-2020年) 对65岁或以上的男性患有阴道腺症.
- 1:1倾向得分匹配和考克斯回归分析,按年龄组分层.
- 根据持续时间,途径 (肠道/局部) 和AI联合使用分类的TRT使用.
主要成果:
- 在各种持续时间和路线上,TRT使用与前列腺癌 (PCa) 风险降低16%有关.
- 使用TRT显示,良性前列腺增生症 (BPH) 的风险增加了13%,与局部途径相比,亲肠道风险更高.
- 长期局部TRT与BPH危险的适度增加9%有关.
结论:
- 在老年男性中,TRT与降低前列腺癌风险和适度增加良性前列腺增生风险有关.
- 这些关联的程度因TRT的持续时间,服用途径和AI的联合服用而有所不同.
- 研究结果支持针对阴茎下部男性的个性化TRT策略,平衡潜在的益处和风险.
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