代谢综合征与前列腺癌危险性的相关性分析

Relationship between the metabolic syndrome and the risk of prostate cancer

目的探讨代谢综合征（MS）与前列腺癌危险性的相关性。方法回顾性分析首都医科大学附属北京友谊医院2013年2月-2017年9月收治的118例原发性前列腺癌患者的临床资料。参照MS诊断标准，将患者分为MS组（n=50）和非MS组（n=68）。依据Gleason评分和TNM分期将患者分为低风险前列腺癌和高风险前列腺癌。收集研究对象的临床资料，包括年龄、体重指数、血压值、空腹血糖、甘油三酯、高密度脂蛋白、低密度脂蛋白、前列腺体积、前列腺特异抗原PSA值、Gleason评分和TNM分期。所得数据进行统计学分析，计数资料的比较采用，检验，计量资料采用（x±s）表示，组间比较采用t检验。各变量因素与前列腺癌之间的关系，采用多变量的logistic回归分析。结果两组患者的年龄、血压值、甘油三酯、低密度脂蛋白、Gleason评分的差异无统计学意义（P〉0．05）；MS组患者的体重指数、空腹血糖、前列腺体积[（26．62±16．43）kg／m^2、（8．1±1．7）mmol／L、（50．1±12．2）ml]均高于非MS组[（22．16±15．64）kg／m^2、（6．3±1．5）mmol／L、（40．3±14．1）ml]，而高密度脂蛋白、PSA值[（0．9±0．4）mmol／L、（21．4±7．9）ng／dl]低于非MS组[（1．40±0．64）mmol／L、（36．2±8．2）ng/dl]，差异具有统计学意义（P〈0．05）。MS组中高风险前列腺癌的比例（62％，31／50）明显高于非MS组（33．8％，23／68），P〈0．05。logistic回归分析提示，体重指数及高密度脂蛋白是影响前列腺癌危险因素的独立因素。结论MS可增加高风险前列腺癌的发病风险。临床中应重视MS尤其是体重指数和高密度脂蛋白这两项指标。

Objective To evaluate the relationship between the metabolic syndrome and the risk of prostate cancer. Methods The clinical data of 118 patients with primary prostate cancer who were admitted to the Beijing Friendship Hospital, Capital Medical University from February 2013 to September 2017 were retrospectively analyzed. All the patients were divided into metabolic syndrome group （ n = 50） and non- metabolic syndrome group （n = 68） according to the diagnosed standard of metabolic syndrome. The patients＇ clinical data were expressed as percentage（ % ） and collected including age between the two groups, body mass index, blood pressure, fasting blood glucose, triglyceride, high density lipoprotein, low density lipoprotein, prostate volume, prostate specific antigen （PSA） value, Gleason score and TNM staging. The data were analysed by the statistical analysis method. Chi- square test was used to compare the enumeration data. Measurement data were expressed as （x ± s） , and using t test comparison between groups. The relationship between various variable factors and prostate cancer used multivariate logistic regression analysis. Results There was no significantly difference between the two groups including age, blood pressure, triglyceride, low density lipoprotein and Gleason score （P 〉 0.05）. The body mass index, fasting blood glucose and prostate volume in the metabolic syndrome group [（ 26.62 ±16.43 ） kg/m2, （8.1 ± 1.7） mmoL/L, （50. 1± 12.2） ml] are significantly higher than in the non-metabolic syndrome group [ （22.16 ± 15.64） kg/m^2, （6.3 ±1.5） mmol/L, （40.3 ± 14.1 ） ml] （P 〈0.05）. The high density lipoprotein and PSA value in the metabolic syndrome group [（0.9 ±0.4 ） mmol/L, （ 21.4 ±7.9 ） ng/dl ] were significantly lower than in the non-metabolic syndrome group [ （1.40 ±0.64） mmol/L, （36.2 ±8.2 ） ng/dl] （P 〈 0.05 ）. The proportion of high-risk prostate cancer in the metabolic syndrome group（ 62% ,31/50） was significantly higher than that in the non-metabolic syndrome group（33.8% ,23/68） , P 〈 0. 05. Logistic regression analysis showed that the body mass index and high density lipoprotein hypertension had a positive correlation with high risk of prostate cancer. Conclusions The metabolic syndrome might increase the incidence risk of high risk of prostate cancer. The two components of metabolic syndrome, body mass index and high density lipoprotein, should be paid attention in clinical practice.