{"title":"探索性激素结合球蛋白水平与前列腺癌风险之间的联系：一项全面的系统回顾和荟萃分析。","authors":"Prakasini Satapathy, Shilpa Gaidhane, Ashok Kumar Bishoyi, Subbulakshmi Ganesan, Karthikeyan Jayabalan, Swati Mishra, Manpreet Kaur, Ganesh Bushi, Muhammed Shabil, Rukshar Syed, Sonam Puri, Sunil Kumar, Sabah Ansar, Sanjit Sah, Diptismita Jena, Zaid Khan, Quazi Syed Zahiruddin, Khang Wen Goh","doi":"10.1007/s11255-025-04370-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sex hormone-binding globulin (SHBG) plays a critical role in regulating androgen bioavailability and has been hypothesized to influence prostate cancer risk, though existing evidence is inconsistent. This systematic review and meta-analysis aimed to evaluate the association between SHBG levels and prostate cancer risk.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed, Embase, and Web of Science for studies published up to December 1, 2024. Observational studies assessing SHBG levels and prostate cancer risk were included. Effect sizes were pooled using random-effects meta-analysis. Heterogeneity was evaluated using the I<sup>2</sup> statistic, and quality assessment was performed using the Newcastle-Ottawa Scale. Statistical analysis was performed using R software version 4.4.</p><p><strong>Results: </strong>Sixteen studies, including 720,298 participants and 90,799 prostate cancer cases, were analyzed. The pooled odds ratio (OR) for prostate cancer risk per unit increase in SHBG was 0.907 (95% CI 0.799-1.030), indicating no statistically significant association. Substantial heterogeneity was observed among the included studies (I<sup>2</sup> = 79%; P < 0.0001). Subgroup analyses showed no significant variation in effect sizes by study design. However, a Mendelian randomization analysis conducted in 140,254 European-descent males, including 79,148 prostate cancer cases, suggested a modest protective effect of higher SHBG levels, with an OR of 0.944 (95% CI 0.897-0.993). Sensitivity analyses confirmed the robustness of the pooled findings.</p><p><strong>Conclusion: </strong>This meta-analysis showed a complex relationship between SHBG levels and prostate cancer risk. While overall findings do not support a statistically significant association, higher SHBG levels may confer a protective role in specific contexts. Further research is needed to elucidate mechanisms, reduce heterogeneity, and validate SHBG as a biomarker for risk stratification.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1673-1687"},"PeriodicalIF":1.8000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exploring the link between sex hormone-binding globulin levels and prostate cancer risk: a comprehensive systematic review and meta-analysis.\",\"authors\":\"Prakasini Satapathy, Shilpa Gaidhane, Ashok Kumar Bishoyi, Subbulakshmi Ganesan, Karthikeyan Jayabalan, Swati Mishra, Manpreet Kaur, Ganesh Bushi, Muhammed Shabil, Rukshar Syed, Sonam Puri, Sunil Kumar, Sabah Ansar, Sanjit Sah, Diptismita Jena, Zaid Khan, Quazi Syed Zahiruddin, Khang Wen Goh\",\"doi\":\"10.1007/s11255-025-04370-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sex hormone-binding globulin (SHBG) plays a critical role in regulating androgen bioavailability and has been hypothesized to influence prostate cancer risk, though existing evidence is inconsistent. This systematic review and meta-analysis aimed to evaluate the association between SHBG levels and prostate cancer risk.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed, Embase, and Web of Science for studies published up to December 1, 2024. Observational studies assessing SHBG levels and prostate cancer risk were included. Effect sizes were pooled using random-effects meta-analysis. Heterogeneity was evaluated using the I<sup>2</sup> statistic, and quality assessment was performed using the Newcastle-Ottawa Scale. Statistical analysis was performed using R software version 4.4.</p><p><strong>Results: </strong>Sixteen studies, including 720,298 participants and 90,799 prostate cancer cases, were analyzed. The pooled odds ratio (OR) for prostate cancer risk per unit increase in SHBG was 0.907 (95% CI 0.799-1.030), indicating no statistically significant association. Substantial heterogeneity was observed among the included studies (I<sup>2</sup> = 79%; P < 0.0001). Subgroup analyses showed no significant variation in effect sizes by study design. However, a Mendelian randomization analysis conducted in 140,254 European-descent males, including 79,148 prostate cancer cases, suggested a modest protective effect of higher SHBG levels, with an OR of 0.944 (95% CI 0.897-0.993). Sensitivity analyses confirmed the robustness of the pooled findings.</p><p><strong>Conclusion: </strong>This meta-analysis showed a complex relationship between SHBG levels and prostate cancer risk. While overall findings do not support a statistically significant association, higher SHBG levels may confer a protective role in specific contexts. 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引用次数: 0
摘要
背景：性激素结合球蛋白（SHBG）在调节雄激素生物利用度中起着关键作用，并被假设影响前列腺癌的风险，尽管现有证据不一致。本系统综述和荟萃分析旨在评估SHBG水平与前列腺癌风险之间的关系。方法：综合检索PubMed、Embase和Web of Science，检索截止到2024年12月1日发表的研究。评估SHBG水平和前列腺癌风险的观察性研究被纳入。使用随机效应荟萃分析汇总效应大小。异质性评价采用I2统计量，质量评价采用纽卡斯尔-渥太华量表。采用R软件4.4版进行统计分析。结果：共分析了16项研究，包括720,298名参与者和90,799例前列腺癌病例。SHBG每单位增加的前列腺癌风险的合并优势比（OR）为0.907 (95% CI 0.799-1.030)，表明无统计学意义的关联。在纳入的研究中观察到大量异质性(I2 = 79%；结论：该荟萃分析显示SHBG水平与前列腺癌风险之间存在复杂关系。虽然总体研究结果不支持统计上显著的关联，但较高的SHBG水平可能在特定情况下具有保护作用。需要进一步的研究来阐明机制，减少异质性，并验证SHBG作为风险分层的生物标志物。
Exploring the link between sex hormone-binding globulin levels and prostate cancer risk: a comprehensive systematic review and meta-analysis.
Background: Sex hormone-binding globulin (SHBG) plays a critical role in regulating androgen bioavailability and has been hypothesized to influence prostate cancer risk, though existing evidence is inconsistent. This systematic review and meta-analysis aimed to evaluate the association between SHBG levels and prostate cancer risk.
Methods: A comprehensive search was conducted across PubMed, Embase, and Web of Science for studies published up to December 1, 2024. Observational studies assessing SHBG levels and prostate cancer risk were included. Effect sizes were pooled using random-effects meta-analysis. Heterogeneity was evaluated using the I2 statistic, and quality assessment was performed using the Newcastle-Ottawa Scale. Statistical analysis was performed using R software version 4.4.
Results: Sixteen studies, including 720,298 participants and 90,799 prostate cancer cases, were analyzed. The pooled odds ratio (OR) for prostate cancer risk per unit increase in SHBG was 0.907 (95% CI 0.799-1.030), indicating no statistically significant association. Substantial heterogeneity was observed among the included studies (I2 = 79%; P < 0.0001). Subgroup analyses showed no significant variation in effect sizes by study design. However, a Mendelian randomization analysis conducted in 140,254 European-descent males, including 79,148 prostate cancer cases, suggested a modest protective effect of higher SHBG levels, with an OR of 0.944 (95% CI 0.897-0.993). Sensitivity analyses confirmed the robustness of the pooled findings.
Conclusion: This meta-analysis showed a complex relationship between SHBG levels and prostate cancer risk. While overall findings do not support a statistically significant association, higher SHBG levels may confer a protective role in specific contexts. Further research is needed to elucidate mechanisms, reduce heterogeneity, and validate SHBG as a biomarker for risk stratification.
期刊介绍：
International Urology and Nephrology publishes original papers on a broad range of topics in urology, nephrology and andrology. The journal integrates papers originating from clinical practice.
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