title: 5-alpha-reductase inhibitors and the risk of diabetes mellitus: A nationwide population-based study.
abstract: BACKGROUND
  This nationwide population-based study investigated the risk of type 2 diabetes mellitus (DM) after 5-alpha-reductase inhibitor (5ARI) therapy for benign prostate hyperplasia (BPH) using the National Health Insurance Research Database (NHIRD) in Taiwan.
  
  
  METHODS
  In total, 1,298 adult patients newly diagnosed with BPH and who used more than 28 cumulative defined daily doses (cDDD) of 5ARI were recruited as the therapy group cohort, along with 1,2887 subjects who did not use more than 28 cDDD of 5ARI as a control group from 2002 to 2009. Each patient was monitored for 5 years (from 2003 to 2008) to identify those who subsequently developed type 2 DM. A Cox proportional hazards model was used to compare the risk of type 2 DM between the study and comparison cohorts after adjusting for possible confounding risk factors.
  
  
  RESULTS
  Patients who received 5ARI therapy had a lower cumulative rate of type 2 DM than those who did not receive 5ARI during the five-year follow-up period (3.5% vs. 5.3%, P = 0.003). In sub-group analysis, among the BPH patients aged <65 years, the five-year type 2 DM events hazard ratio (HR) of 5ARI users was lower than that of nonusers (HR: 0.47, 95% confidence interval (CI): 0.24-0.91; P = 0.026).
  
  
  CONCLUSIONS
  Therapy with 5ARI may decrease the five-year risk of type 2 DM in the BPH patients younger than 65 years. Further mechanistic research is warranted to validate the results.
authors.affiliation: Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.|School of Medicine, Tzu Chi University, Hualian, Taiwan.
authors.forename: Shang-Sen
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Department of Neurology, China Medical University Hospital Taichung, Taiwan.|School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Yu-Wan
authors.initials: YW
authors.lastname: Yang
authors.affiliation: Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.|School of Medicine, Tzu Chi University, Hualian, Taiwan.
authors.forename: Tsung-Hsun
authors.initials: TH
authors.lastname: Tsai
authors.affiliation: Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
authors.forename: Yu-Hung
authors.initials: YH
authors.lastname: Kuo
authors.affiliation: Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
authors.forename: Hsun-Yang
authors.initials: HY
authors.lastname: Chuang
authors.affiliation: School of Medicine, Tzu Chi University, Hualian, Taiwan.|Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.|Department of Education, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.|Center for Clinical Epidemiology and Biostatistics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
authors.forename: Ching-Chih
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.|School of Medicine, Tzu Chi University, Hualian, Taiwan.
authors.forename: Teng-Fu
authors.initials: TF
authors.lastname: Hsieh
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015986:Confounding Factors, Epidemiologic; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D058891:5-alpha Reductase Inhibitors
keywords: 5-alpha-reductase inhibitor; benign prostate hyperplasia; diabetes mellitus; prostate; risk