胰岛素样生长因子1和胰岛素抵抗与老年男性下尿路症状的相关性研究

Correlations of insulin-like growth factor-1 and insulin resistance with lower urinary tract symptoms in elderly male patients

目的研究血清胰岛素样生长因子1（IGF-I）、胰岛素抵抗与老年男性下尿路症状（LUTS）的相关性。方法选取2012年12月至2013年8月我院就诊的患有良性前列腺增生（BPH）患者96例，根据患者的LUTS、国际前列腺症状评分（IPSS）及经腹超声前列腺体积测定分为观察组54例：有较明显的LUTS且经IPSS评分为中重度症状；对照组42例：无明显LUTS或经IPSS评分仅为轻度症状。比较、分析两组间的一般资料和生化指标及其相关性。结果观察组和对照组空腹血糖分别为（6．3±0．7）mmol／L比（4．9±0．5）mmol／L、空腹胰岛素（11．9±3．1）mU／L比（8．0±2．O）mU／L、胰岛素抵抗指数（3．5±1．3）比（1．8±0．5）、低密度脂蛋白胆固醇（3．9±0．3）mmol／L比（2．2±0．4）mmol／L、前列腺体积（38．9±6．4）ml比（23．2±1．3）ml，差异有统计学意义（P〈0．05或P〈O．01）；IGF-I为（114．6±25．6）μg／L比（165．3±48．6）μg／L、高密度脂蛋白胆固醇（1．1±0．3）mmol／L比（1．9±0．2）mmol／L，低于对照组（P〈0．01）。血清IGF-I水平与年龄、空腹血糖、空腹胰岛素、胰岛素抵抗指数及低密度脂蛋白胆固醇水平呈负相关（P〈0．05）；前列腺体积与年龄、空腹血糖、空腹胰岛素和胰岛素抵抗指数呈正相关（P〈0．05），与高密度脂蛋白胆固醇水平呈负相关（P〈O．01）。结论血清IGF-I水平、胰岛素抵抗与BPH的程度有关，可能参与了BPH的发生、发展。

Objective To investigate the correlations of serum insulin-like growth factor-1 （IGF-I） and insulin resistance with lower urinary tract symptoms （LUTS） in elderly male patients. Methods 96 old-elderly patients with benign prostatic hyperplasia （BPH） were divided into two groups according to international prostate symptoms score （IPSS） and abdominal ultrasound- measured prostate volume： experimental group（n： 54, patients with obvious LUTS and IPSS score- assessed severe symptoms） and control group（n= 42, patients without obvious LUTS and slight symptoms assessed by IPSS scores）. Clinical data and biochemical characteristics were compared between the two groups. The correlations between the indicators were analyzed. Results There were significant differences in levels of fasting blood glucose and fasting serum insulin, homeostasis model assessment- insulin resistance, low-density lipoprotein level, prostate volume between experimental and control groups [（6.3±0. 7） mmol/L vs （4.94±0. 5） mmol/L, （11.9±3. 1） mU/L vs （8.0±2.0） mU/L, （3.5±1.3） vs （1.8±0.5） , （3.9±0.3） mmol/L vs （2.2±0.4） mmol/L and （38.9±6.4） ml w （23.2± 1.3） ml, all P〈0.05, respectively）. Serum levels of IGF-I and high-density lipoprotein cholesterol were lower in experimental than in control group [（114.6 ± 25.6） μg/Lvs （165.3 ± 48.6）μg/L） and （1.1±0.3） mmol/L vs （1.9±0.2） mmol/L, both P（0.01, respectively）. The serum IGF-I level was negatively correlated with age, levels of fasting blood glucose, and fastingserum insulin, homeostasis model assessment- insulin resistance and low-density lipoprotein level （all P〈0.05）. The prostate volume was positively correlated with age, levels of fasting blood glucose, fasting serum insulin, and homeostasis model assessment - insulin resistance （all P〈0.05）, while negatively correlated with high-density lipoprotein cholesterol level （P^0.01）. Conclusions The level of serum IGF-I and insulin resistance have a relation with BPH severity and might participate in the development of BPH.