氧化应激标志物与前列腺增生和前列腺癌的相关性

Relationship between oxidative stress markers with prostatic hyperplasia and prostate cancer

目的探讨外周血氧化应激标志物[谷胱甘肽过氧化物酶(GPX)、超氧化物歧化酶(SOD)、总抗氧化状态(TAS)、丙二醛(MDA)、谷胱甘肽还原酶(GR)]水平与前列腺增生和前列腺癌的相关性。方法选取前列腺增生患者222例(前列腺增生组)、前列腺癌患者136例(前列腺癌组)、健康体检者194名(正常对照组)。检测所有对象GPX、SOD、GR、TAS和MDA水平。根据Gleason评分将前列腺癌患者分为6~7分组、8分组、9~10分组。采用二元Logistic回归分析评估氧化应激标志物与前列腺增生和前列腺癌的关系。结果正常对照组、前列腺增生组、前列腺癌组SOD和TAS水平依次降低(P<0.001),MDA水平依次升高(P<0.001)。GPX和GR水平3组之间差异无统计学意义(P>0.05)。Gleason评分6~7分组、8分组、9~10分组SOD和TAS水平依次降低(P<0.001)。GPX、GR和MDA水平3组之间差异均无统计学意义(P>0.05)。二元Logistic回归分析结果显示,以正常对照组作为参考,校正年龄、体质量指数、吸烟史、饮酒史、高血压史和糖尿病史后,SOD降低、TAS降低、MDA升高均是发生前列腺增生[比值比(OR)分别为1.014、8.117、1.020]和前列腺癌(OR值分别为1.054、22.894、1.256)的独立危险因素;以前列腺增生组作为参考,校正年龄、体质量指数、吸烟史、饮酒史、高血压史和糖尿病史后,SOD降低、TAS降低、MDA升高均是发生前列腺癌的独立危险因素(OR值分别为1.040、15.577、1.012)。结论SOD、TAS水平降低和MDA水平升高与前列腺增生和前列腺癌的发生有一定关系,氧化应激紊乱在前列腺增生和前列腺癌的发生、发展中可能具有重要作用。

Objective To investigate the relationship between oxidative stress markers of peripheral blood oxidative stress markers[glutathione peroxidase(GPX),superoxide dismutase(SOD),total antioxidant status(TAS),malondialdehyde(MDA)and glutathione reductase(GR)]with prostatic hyperplasia and prostate cancer.Methods A total of 222 patients with prostatic hyperplasia,136 patients with prostate cancer and 194 healthy subjects were enrolled.The levels of GPX,SOD,GR,TAS and MDA were determined.According to Gleason score,prostate cancer patients were classified into 6-7,8 and 9-10 groups.Binary Logistic regression analysis was used to evaluate the relationship between oxidative stress markers with prostatic hyperplasia and prostate cancer.Results The levels of SOD and TAS in healthy control group,prostatic hyperplasia group and prostate cancer group,were decreased successively(P<0.001),and MDA levels were increased(P<0.001).There was no statistical significance in GPX and GR levels among the 3 groups(P>0.05).For Gleason score 6-7,8 and 9-10 groups,SOD and TAS levels were decreased(P<0.001).There was no statistical significance in the levels of GPX,GR and MDA among the 3 groups(P>0.05).Binary Logistic regression analysis showed that with the healthy control group as a reference,and after adjusting for age,body mass index,smoking history,alcohol history,hypertension history and diabetes mellitus history,SOD decreasing,TAS decreasing and MDA increasing were independent risk factors for prostatic hyperplasia[odds ratios(OR)were 1.014,8.117 and 1.020]and prostate cancer(OR were 1.054,22.894 and 1.256,respectively).With the prostatic hyperplasia group as a reference,after adjusting for age,body mass index,smoking history,alcohol history,hypertension history and diabetes mellitus history,SOD decreasing,TAS decreasing and MDA increasing were independent risk factors for prostate cancer(OR were 1.040,15.577 and 1.012,respectively).Conclusions The decrease of SOD and TAS levels and the increase of MDA levels may be related to the occurrence of prostatic hyperplasia and prostate cancer,suggesting that oxidative stress disorder plays a role in the occurrence and development of prostatic hyperplasia and prostate cancer.