先前测试胰岛素抵抗 (IR) 与前列腺癌 (PC) 风险之间关联的研究并不一致。我们在 REDUCE 中检查了胰岛素抵抗稳态评估（HOMA-IR；根据空腹基线胰岛素和血糖计算）与 PC 之间的关联，REDUCE 是一项为期 4 年的度他雄胺与安慰剂预防 PC 预防的随机试验。所有患者的研究前活检结果均为阴性，并且无论前列腺特异性抗原如何，均在 2 年和 4 年接受了研究规定的活检。使用多变量逻辑回归模型来研究对数转换或分类的 HOMA-IR 评分与 PC 风险之间的关联。使用多项回归来评估 HOMA-IR 评分与肿瘤分级之间的关联（低级别 [级别组 1]；高级别 [级别组 2-5]）。 在 5430 名 REDUCE 参与者中（1212 名患有 PC；856 名低级别和 356 名患者）高级别），较高的 HOMA-IR 与较低的 PC 风险相关（log-HOMA-IR：OR，0.89；95% CI，0.80-0.99；p = .03；分类 HOMA-IR：p-趋势 = .04 ）。按级别分层时，HOMA-IR 与低级别 PC 风险降低显着相关（log-HOMA-IR：OR，0.84；95% CI，0.74-0.94；p = .003；分类 HOMA-IR：p-趋势= .002），但与高级 PC 无关（log-HOMA-IR：OR，1.02；95% CI，0.86-1.21；p = .81；分类 HOMA-IR：p-趋势 = .26）。安慰剂组和治疗组的结果相似。 总之，较高的 HOMA-IR 与低级别 PC 风险降低相关，但与高级别疾病无关。解释这些发现的机制尚不清楚。© 2024 美国癌症协会。

Prior studies testing the association between insulin resistance (IR) and prostate cancer (PC) risk are inconsistent. We examined the association between Homeostatic Assessment of Insulin Resistance (HOMA-IR; calculated from fasting baseline insulin and glucose) and PC in REDUCE, a 4-year randomized trial of dutasteride vs. placebo for PC prevention.All patients had prestudy negative biopsies and underwent study mandated biopsies at 2 and 4 years regardless of prostate-specific antigen. Multivariable logistic regression models were used to investigate the associations between log-transformed or categorized HOMA-IR scores and PC risk. Multinominal regression was used to assess associations between HOMA-IR scores and tumor grade (low grade [grade group 1]; high-grade [grade groups 2-5]).Among 5430 REDUCE participants (1212 with PC; 856 low- and 356 high-grade), higher HOMA-IR was associated with lower PC risk (log-HOMA-IR: OR, 0.89; 95% CI, 0.80-0.99; p = .03; categorized HOMA-IR: p-trend = .04). When stratified by grade, HOMA-IR was significantly associated with reduced low-grade PC risk (log-HOMA-IR: OR, 0.84; 95% CI , 0.74-0.94; p = .003; categorized HOMA-IR: p-trend = .002) but was unrelated to high-grade PC (log-HOMA-IR: OR, 1.02; 95% CI, 0.86-1.21; p = .81; categorized HOMA-IR: p-trend = .26). Results were similar in placebo and treatment arms.In summary, higher HOMA-IR was associated with a reduced risk of low-grade PC but was not associated with high-grade disease. The mechanisms to explain these findings are unclear.© 2024 American Cancer Society.