中老年男性体质指数与血清前列腺抗原的关系

Study on the relationship between BMI and serum prostate specific antigen in middle and old aged males

目的探讨上海市中老年男性血清前列腺特异抗原(PSA)与体质指数(BMI)的关系,评价根据BMI水平制订不同的PSA界值的必要性。方法随机选取于2010年1-7月参加上海市科学技术委员会资助项目的 591名40岁及以上、无前列腺癌史的男性作为研究对象。通过问卷调查获取调查对象的一般人口学特征、患病及用药情况。采用国际前列腺症状分数(IPSS)判断男性排尿障碍程度。对调查对象进行体格检查和前列腺B超检查,采集清晨空腹静脉血检测PSA值。采用一般线性模型及偏相关分析,探讨BMI与PSA的关系。结果调查对象年龄40～77岁,平均(58.5±7.2)岁。调整年龄,是否使用阿司匹林、利尿剂及其他抗炎药,是否有糖尿病、IPSS评分及前列腺体积(连续性变量)等混杂因素后,BMI<24、24～、≥28kg/m2的男性PSA的几何均数分别为1.01ng/ml(95%CI:0.89～1.16ng/ml)、0.84ng/ml(95%CI:0.75～0.95ng/ml)和0.77ng/m(l95%CI:0.66～0.90ng/ml)。BMI与血清PSA水平呈负相关(r=-0.158,P<0.01)。结论采用PSA值评估前列腺癌患病风险时应当考虑BMI对PSA值的影响。

Objective To explore the association between body mass index（BMI） and serum prostate specific antigen（PSA） level and to evaluate whether different PSA thresholds based on BMI were needed.Methods The subjects of present study were 591 men（≥40 years old） without a history of prostate cancer,who participated in a project funded by Shanghai Science and Technology from January to July in 2010.The demographic,anthropometric and medical history data were collected by interview.The male urinary dysfunction was assessed with the International Prostate Symptom Score（IPSS）.The prostates were measured by ultrasonography and serum PSA levels were determined in all subjects.General linear regression and partial correlation coefficient were used to evaluate the relationship between BMI and PSA levels.Results The mean age of subjects was（58.5±7.2） years old（40～70 years old）.After adjusting age,use of drugs（Aspirin,uretic and other anti-inflammatory drugs）,diabetes,IPSS scores and prostate volumes（continuous variable） of subjects,the mean geometric PSA levels in subjects with different BMI levels（BMI24 kg/m 2,24 kg/m 2 ≤BMI28 kg/m 2,and BMI≥28 kg/m 2） were 1.01 ng/ml（95%CI：0.89～1.16 ng/ml）,0.84 ng/ml（95%CI：0.75～0.95 ng/ml） and 0.77 ng/ml（95%CI：0.66～0.90 ng/ml）,respectively.There was a negative correlation between BMI and PSA levels（r=-0.158,P0.01）.Conclusion When PSA level is used to assess the risk of prostate cancer,the effect of BMI on PSA level should be considered.