体检人群代谢因素与前列腺增生的相关性分析:肥胖是其独立危险因素

Association of benign prostatic hyperplasia with metabolic factors in routine examination population-obesity is an independent risk factor

目的试探寻代谢因素与前列腺增生发生的相关性。方法收集2011年1月1日～2011年7月31日于福建省立医院常规体检男性资料。检测项目包括:身高与体重以计算BMI;采血检验:血糖、甘油三脂、胆固醇、低密度脂蛋白、高密度脂蛋白、前列腺特异性抗原(PSA);B超:测量前列腺体积。结果入选患者1 861例,前列腺体积正常与增大组间各均值比较显示年龄(47 vs.69,P=0.002)、BMI(22.1 vs.27.5,P=0.001)、PSA(0.72 vs.1.58,P=0.034)水平存在显著统计学差异。校正年龄影响,相关性单因素分析:PSA升高、超重、肥胖是前列腺体积增大的危险因素(OR值分别为5.507、P=0.028,1.565、P=0.036,2.112,P=0.003);多因素分析:肥胖是前列腺体积增大的独立危险因素,肥胖者发生前列腺增大的风险是体重正常者的2.396倍,P=0.001。而PSA升高(OR3.349,P=0.116)与体重超重(OR1.210,P=0.071)的作用被削减,为无统计学差异,并非影响前列腺体积增大的独立危险因素。结论肥胖(BMI≥28kg/m2)是前列腺增大的独立危险因素。锻炼、控制体重可以降低前列腺增生发生的风险;并可作为前列腺增生患者生活方式干预的重要措施。

Objective To determine whether the metabolic factors are associated with prostate volume. Methods A total of 1 861 men were enrolled in the study who received health examinations at the healthcare center of Fujian Provincial Hospital between 2011.1.1--2011.7.31. Their anthropometrical factors were measured and serum fasting blood glucose, triglyceride, cholesterol, high-density lipoprotein, 10w-density lipoprotein, and prostate-specific antigen levels were analyzed. Prostate volume was measured by ultrasongraphy. Results The mean prostate volume was 26.4 mL, and the mean body mass index （BMI） was 25.4 kg/m2. By age-adjusted single logistic regression, PSA〉4 ng/mL, overweight and obesity were associated with increased risk of developing prostatic hyperplasia （OR 5. 507, P=0. 028; 1. 565, P=0. 036; 2. 112, P=0. 003; respectively）. Both PSA and overweight became non-significant （ OR 3. 349, P = 0.116 ; 1.210, P = 0. 071 ; respectively）, but only obesity （BMI 〉; 28 kg/m2） was still validated by multiple logistic regression （OR 2. 396, P=0. 001）. Conclusions BMI ≥28 kg/m2 is an independent risk factor of developing prostatic hyperplasia. It supports the development of novel prevention and treatment strategies of BPH by weight control.