胰岛素抵抗与不同年龄老年人良性前列腺增生的相关性

Relationship between benign prostatic hyperplasia and insulin resistance in elderly men of different ages

目的探讨胰岛素抵抗与不同年龄段老年人良性前列腺增生的相关性。方法选取2012年1月至6月在我院门诊的老年前列腺增生患者100例。根据年龄分为60～75岁组52例和76～93岁组48例，测定空腹血糖、空腹胰岛素、血清前列腺特异性抗原（PSA）等，运用稳态模型胰岛素抵抗指数（HOMA2-IR）软件计算胰岛素抵抗指数（IRI）；测量身高、体质量、腰围并计算体质指数，测定前列腺体积，比较两组临床资料，根据HOMA2-IR分为胰岛素抵抗（IR〉1．7）组和非胰岛素抵抗（IR〈I．7）组，并比较两组前列腺特异性抗原、前列腺体积和腰围。结果IR〉1．7）与IR〈1．7组腰围（96．6±7．2）cm与（93．1±8．9）cm（P〈0．01）和前列腺体积（50．0±9．0）ml与（46．1±7．8）ml比较，差异有统计学意义（均P〈0．05）；而前列腺特异性抗原值较低，差异有统计学意义（P〈0．05）。HOMA2-IR与前列腺体积无相关性。76～79岁组患者前列腺特异性抗原与前列腺体积、HOMA2-IR无相关性；60～75岁组前列腺特异性抗原与前列腺体积呈正相关（r=0．52，P〈0．05），与HOMA2-IR呈负相关（r=一0．38，P〈0．05）。结论年龄≤75岁的老年BPH患者前列腺特异性抗原与前列腺体积呈正相关，与胰岛素抵抗呈负相关。

Objective To explore the relationship between insulin resistance （IR） and benign prostatic hyperplasia （BPH） in elderly men of different ages. Methods Totally 100 elderly outpatients with BPH in our hospital from January 2012 to June 2012 were recruited in this study. All patients were divided into 2 groups according to age： 60-75 years（n=52） and 76-93 years （n= 48）. Fasting plasma glucose, fasting insulin （FINS） and prostate specific antigen （PSA） were assayed. Insulin resistance index （IRI） was calculated by using the homeostasis model assessment-insulin resistance （HOMA2-IR） software. The body height, body weight, waist circumference were measured and the body mass index （BMI） was calculated. Prostate volume （PV） was measured by abdominal ultrasound. Clinical data were compared between the two groups. Based on HOMA2-IR, patients were divided into insulin resistant group （IR〉1. 7） and non-insulin resistant group （IR〈1. 7） Serum PSA, PV and waist circumference were compared between the two groups. Results The waist circumference and PV were significantly larger in insulin resistant group than in non-insulin resistant group （（96.6±7.2） cm vs. （93.1±8.9） cm, （50.0±9.0） ml vs. （46.1±7.8） ml, respectively, P〈0.01, 0.05]. However, the PSA level was lower in insulin resistant group than in non-insulin resistant group （（1. 44±1. 08） μg/L vs. （ 2.1±2.0）μg/L, P〈0. 05], and no correlation was found between HOMA-IR and PV. There was no correlation between serum PSA levels and PV in patients aged 76-93 years. In patients aged 60-75 years, PSA level was positively correlated with PV （r=0.52 , P〈0.05） and negatively correlated with HOMA-IR （r=--0.38, P〈0.05）. Conclusions Serum PSA level is positively correlated with PV and negatively correlated with HOMA- IR in BPH patients under 75 years old.