老年前列腺癌并存代谢综合征患者的临床相关性研究

Clinical correlation between prostate cancer and metabolic syndrome in the elderly

目的通过对老年前列腺癌并存代谢综合征（MS）患者的临床相关性进行研究，为前列腺癌的预防及治疗提供参考。方法收集2007年9月至2013年3月在我院就诊并病理诊断为前列腺癌患者196例的临床资料，包括患者年龄、身高、体质量、腰围、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、空腹血糖（FPG）、前列腺特异性抗原（PSA）、收缩压、舒张压和病理Gleason评分；按MS诊断标准进行分组。结果前列腺癌合并MS组与单纯前列腺癌组的年龄、TG、收缩压、舒张压、Gleason评分水平差异均无统计学意义（P〉0．05），而BMI、腰围、FPG、HDL—C、PSA、PV水平差异有统计学意义（t=2．89、2．67、3．13、-3．16、-3．13、3．14，均P％0．05）。肥胖者和TG水平升高者中血清PSA较非肥胖者和非TG升高者降低（t=4．27、3．89，均P〈0．01，）；FPG升高者和HDL-C降低者中血清PSA水平也显示较FPG正常者和HDL-C正常者有所降低，但差异无统计学意义（P均〉0．05）；而舒张压升高者中血清PSA水平则较舒张压正常者升高（t=0．138，P〈0．01）。PSA与年龄、舒张压呈正相关（r=0．21、0．18，均P〈0．01），与BMI、FPG、TG呈负相关（r=-0．12、-0．18、-0．03，均P〈0．01），与腰围、HDL—C、收缩压无显著相关性（P〉0．05）。结论MS与前列腺癌的发生、发展可能存在一定的相关性，且血清PSA水平与MS同样存在相关性，血清PSA水平受到年龄、舒张压、BMI、FPG、TG的影响。

Objective To provide evidence for the clinical prevention and treatment of prostate cancer by the clinical study in elderly patients with prostate cancer and metabolic syndrome（MS）. Methods 196 patients diagnosed as prostate cancer in our hospital from July 2007 to March 2013 were recruited. Clinical data, including age, height, body weight, waistline, triacylglycerol（TG）, high density lipoprotein cholesterol （ HDL-C）, fasting blood glucose （FPG）, prostate specific antigen （PSA）, prostate volume（PV）, systolic and diastolic blood pressures and pathological Gleason score, were analyzed. Patients were divided into two groups of prostate cancer with and without MS. Results The prostate cancer with MS group showed no statistical differences from simple prostate cancer group in the levels of age, TG, systolic pressure（SBP）, diastolic pressure（DBP） and Gleason score（all P〉0.05）, but had statistical differences in the levels of BMI, waistline, FPG, HDL-C, PSA and PV（t=2.89, 2.67, 3.13, -3.16, -3.13, 3.14, respectively, all P〈0. 05）. Serum PSA level was lower in patients with obesity and high level of TG than in patients without obesity and high level of TG（t=4.27 and 3.89,all P〈0.01）, while serum PSA level was lower in men with high FPG and low HDL than in men with normal levels of FPG and HDL-C, but had no statistically significant differences（all P〉0.05）. Serum PSA level was higher in patients with high diastolic pressure than with normal diastolic pressure level（t= 0. 138, P〈0.01）. PSA was positively correlated with age and DBP（r=0.21 and 0.18,both P〈0.01） and negatively correlated with BMI, FPG, TG（r= -0.12, -0.18,-0.03, respectively, all P〈0.01）, but had no significant correlations with waistline, HDL- C, and SBP. Conclusions The correlation of the occurrence and development of prostate cancerwith metabolic syndrome may exist, and the level of serum PSA is also correlated with MS. Serum PSA level is affected by age, DBP, BMI, FPG and TG.