前列腺癌患者手术去势对代谢综合征发病的影响

Impact of surgical castration on the pathogenesis of metabolic syndrome in males of prostate cancer

目的比较前列腺癌患者手术去势及根治术后代谢综合征（MS）发病情况，分析睾酮水平对MS的影响。方法选取50例早期前列腺癌患者行根治性切除术、50例晚期前列腺癌患者行手术去势，另选行健康体检的50例老年男性，随访至少18个月，监测其血液中睾酮浓度及MS各相关指标，比较MS发病情况并分析睾酮水平对MS的影响。结果手术去势组的体质量、体质量指数（BMI）、腰围、甘油三酯（TG）、空腹血糖（FPG）及血压（收缩压DBP，舒张压SBP）明显高于根治组和正常组（P〈0．01），而血清总睾酮（TT）、高密度脂蛋白（HDL）明显低于根治组和正常组（P〈0．01），三组间总胆固醇（TC）、低密度脂蛋白差异无统计学意义（P〉0．05）。结论前列腺癌患者手术去势后MS发病率明显增加，提示MS的发生与低睾酮水平明显相关。

Objective Compare the incidence of metabolic syndrome after surgical castration and radical surgery in males with prostate cancer, and analyze the effect of testosterone on metabolic syndrome. Methods Fifty patients with early prostate cancer patients who underwent radical resection and 50 patients with advanced prostate cancer who received surgical castration and 50 healthy elderly men were enrolled in the study. They were followed-up at least 18 months, and their testosterone level and the indicators of metabolic syndrome were monitored. Results Weight,body mass index（BMI）, waist circumference（WC）, triglycerides（TG）, fasting blood glucose（FBG） and blood pressure in surgical castration group were significantly higher than those in radical resection group and normal control group（P〈0.01）,whereas their total serum testosterone level and high density lipoprotein（LDL） level were significantly lower than that of radical resection group and normal control group（P〈0.01）. There were no significant differences in cholesterol and low density lipoprotein（LDL） among those groups（P〉0.05）. Conclusion Incidence of metabolic syndrome increased significantly after surgical castration,suggesting that the occurrence of metabolic syndrome was associated with low testosterone level.