代谢综合征对前列腺特异性抗原的影响分析

Influence of metabolic syndrome and its components on serum prostate-specific antigen levels

目的探讨不同年龄段代谢综合征相关因素对前列腺特异性抗原(PSA)的影响。方法收集2011年1月至2022年5月于太原市人民医院体检科就诊的6006例男性的临床资料,排除并发症和资料不完整者,根据年龄分为<40岁1819例、40~59岁2781例、60~79岁1162例、≥80岁244例。比较各组有无代谢综合征、有无体质指数≥25 kg/m^(2)(超重)、有无空腹血糖≥6.1 mmol/L(高血糖)、有无收缩压/舒张压≥140/90 mm Hg(高血压)、有无甘油三酯≥1.7 mmol/L及(或)高密度脂蛋白<0.9 mmol/L(血脂紊乱)的PSA值,行Mann-Whitney U检验,并对60~79岁组采用多因素Logistic回归法分析代谢综合征相关因素对PSA≥4 ng/ml的影响。结果各年龄段合并代谢综合征者并不影响PSA值。40~59岁组,血脂紊乱者较正常者PSA值降低(0.78ng/ml vs 0.84 ng/ml);60~79岁组,超重者PSA值降低(1.05 ng/ml vs 1.23 ng/ml),高血压者PSA值升高(1.26 ng/ml vs 1.03 ng/ml),血脂紊乱者PSA值降低(0.98 ng/ml vs 1.24 ng/ml);≥80岁组,高血糖者PSA值降低(1.38 ng/ml vs 1.78 ng/ml),且差异均有统计学意义(P<0.05)。高血压是60~79岁者PSA≥4 ng/ml的独立危险因素(OR=2.290)。结论不同年龄段PSA筛查时,需注意超重、血脂紊乱、高血糖、高血压对PSA值的影响,可适当放宽PSA复查指征,减少因PSA水平波动而遗漏临床对前列腺癌的诊断。对于60~79岁男性,合并高血压者可能需要优先筛查PSA。

Objective To investigate the influence of metabolic syndrome and its risk components on serum prostate-specific antigen(PSA)level.Methods A retrospective analysis was performed on 6006 men who were admitted to the department of physical examination,Taiyuan People's Hospital from January 2011 to May 2022.Patients with other complications and incomplete data were excluded.Included patients were divided into four groups according to age:<40 years old(1819 cases),40-59 years old(2781 cases),60-79 years old(1162 cases),≥80 years old(244 cases).Metabolic syndrome,body mass index≥25 kg/m 2(overweight),fasting blood glucose≥6.1 mmol/L(hyperglycemia),systolic blood pressure/diastolic blood pressure≥140/90 mmHg(high blood pressure),the triglycerides≥1.7 mmol/L and(or)high density lipoprotein<0.9 mmol/L(dyslipidemia)were compared among the four groups.The Mann-Whitney U test was used for these groups.The multivariable logistic regression was used to analyze the factors of metabolic syndrome on PSA≥4 ng/ml in the 60-79 years group.Result The PSA level was not affected by metabolic syndrome in all aged groups.In the patients with dyslipidemia aged 40 to 59 years group,the PSA value was lower than those without dyslipidemia(0.78 ng/ml vs 0.84 ng/ml).In the 60-79 years group,PSA was decreased in overweight patients(1.05 ng/ml vs 1.23 ng/ml),increased in hypertensive patients(1.26 ng/ml vs 1.03 ng/ml),and decreased in dyslipidemia patients(0.98 ng/ml vs 1.24 ng/ml).In the more than 80 y ears group,PSA was decreased in hyperglycemia patients(1.38 ng/ml vs 1.78 ng/ml).All these date were statistically significant(P<0.05).Hypertension was an independent risk factor of PSA≥4 ng/ml in the 60-79 years group(OR=2.290).Conclusions The possible effects of blood lipid,BMI,blood glucose,and hypertension on the PSA value should be paid attention to among different ages,and the indication of PSA review could be appropriately relaxed to reduce the omission of clinical diagnosis of prostate cancer.PSA screening may be recommended in priority for patients aged 60 to 79 years with hypertension.