糖调节受损伴良性前列腺增生患者血清IGF-1、IGFBP-3的水平

Analysis of serum insulin-like growth factor-1 and insulin-like growth factor binding protein-3 in patients with impaired glucose regulation and benign prostate hypertrophy

目的:检测糖调节受损(IGR)合并良性前列腺增生(BPH)患者胰岛素水平、胰岛素生长因子-1(IGF-1)、胰岛素生长因子结合蛋白-3(IGFBP-3)等指标,旨在探讨IGF-1、IGFBP-3等指标与前列腺体积(PV)的相关性。方法 :选取年龄≥50岁的BPH患者109例,根据OGTT结果分为糖耐量正常(NGT)组56例、空腹血糖受损(IFG)组14例及糖耐量减低(IGT)组39例;测量各组人群常规生化指标、前列腺增生指标以及血清IGF-1、IGFBP-3浓度等。结果:3组患者血脂、同型半胱氨酸、胱抑素C、空腹胰岛素(FINS)、糖化血红蛋白、IGF-1、IGFBP-3比较均无统计学差异(P>0.05);3组患者PV、前列腺特异抗原、生活质量评分、国际前列腺症状评分比较无统计学差异(P>0.05)。IFG组空腹血糖、胰岛素抵抗指数(HOMA-IR)高于NGT组(P′<0.017)和IGT组(P′<0.017);IGT组2 h血糖、2 h胰岛素高于NGT组(P′<0.017)及IFG组(P′<0.017);多元逐步回归分析,PV与FINS呈正相关,与IGF-1、IGFBP-3无关。结论:高血清胰岛素水平是IGR合并BPH患者前列腺增生进展的危险因素,血清IGF-1、IGFBP-3与BPH无相关性,需进一步研究阐明IGF-1、IGFBP-3在BPH的作用。

Objective To study the relationship between IGF-1, IGFBP-3 and prostatic volume （PV） by examining the levels of insulin and insulin-like growth fator-1 （IGF-1） and insulin-like growth factor binding protein-3 （IGFBP-3） and other indicators in patients with impaired glucose regulation and benign prostate hypertrophy. Methods According to 75 g oral glucose tolerance test （OGTT） results, 109 BPH patients aged over 50 years were divided into three groups： normal glucose tolerance （NGT） group （n = 56）, impaired fasting glucose （IFG） group （n = 14）, impaired glucose tolerance （IGT group, n = 39）. The biochemical indicators and postatic hyperplasia related factors and IGF-1, GFBP-3 were measured. Results There were no statistical differences between the three groups in terms of blood lipids, homocysteine, urinary inhibition C, fasting insulin （FINS）, glycosylated hemoglobin, IGF-1 and IGFBP-3 （P 〉 0.05）. There were no significant differences between the groups in terms of PV, prostate specific antigen, the quality of life score and the international prostate symptom score （P 〉 0.05）. Fasting plasma glucose and insulin resistance index （HOMA IR） were higher in IFG group than NGT group （P＇ 〈 0.017） and IGT group （P＇ 〈 0.017）. 2-hour plasma glucose and 2-hour insulin were higher in IGT group than NGT group （P＇ 〈 0.017） and IFG group （P＇ 〈 0.017）. PV was positively correlated with FINS but not correlated with IGF-1, IGFBP- 3 by multiple multiple step wise regression analysis. Conclusion Oyperinsulinemia is a risk factor in the development of BPH with IGR, and IGF-1 and IGFBP-3 are not associated with BPH risk. Further investigation is needed to elucidate the role of the IGF-1 and IGFBP- 3 in BPH.