前列腺增生和前列腺癌患者代谢综合征组分的差异性研究

Comparison of metabolic syndrome components between patients with prostate hyperplasia and prostate cancer

目的比较前列腺增生和前列腺癌患者各代谢综合征组分的差异,探讨前列腺癌发病的高危因素。方法收集2000年9月1日至2014年8月31日在首都医科大学附属北京安贞医院就诊并经病理诊断为前列腺增生患者200例(前列腺增生组)和前列腺癌患者119例(前列腺癌组)的临床资料,包括患者年龄、身高、体质量、体重指数、收缩压、舒张压、前列腺体积、前列腺特异性抗原(PSA)水平、PSA密度(PSAD)、空腹血糖、三酰甘油及总胆固醇水平。比较2组临床资料,分析代谢综合征各组分(包括体重指数、血压、空腹血糖、三酰甘油及总胆固醇)及相关指标与前列腺癌的相关性。结果前列腺增生组和前列腺癌组患者年龄及前列腺体积、PSA、PSAD比较[(72±7)岁比(75±7)岁、(61±38) cm3比(47±28) cm3、5. 5 (2. 4,9. 2)μg/L比19. 9 (8. 8,53. 4)μg/L、0. 09 (0. 05,0. 18)μg/(L·cm3)比0. 51 (0. 26,1. 17)μg/(L·cm3)],差异均有统计学意义(均P <0. 05)。代谢综合征各组分中,2组收缩压比较差异有统计学意义[(133±16) mm Hg(1 mm Hg=0. 133 k Pa)比(139±19) mm Hg](P <0. 05),而2组体重指数、舒张压、空腹血糖、三酰甘油、总胆固醇水平比较差异均无统计学意义(均P> 0. 05)。多因素二元Logistic回归分析结果显示,年龄(比值比=1. 060,95%置信区间:1. 010～1. 113,P=0. 018)、PSA(比值比=1. 107,95%置信区间:1. 037～1. 182,P=0. 002)及收缩压(比值比=1. 028,95%置信区间:1. 005～1. 051,P=0. 017)是罹患前列腺癌的高危因素;而前列腺体积(比值比=0. 962,95%置信区间:0. 941～0. 985,P=0. 001)是罹患前列腺癌的保护因素。体重指数、舒张压、空腹血糖、三酰甘油及总胆固醇水平与罹患前列腺癌无关(均P> 0. 05)。结论前列腺癌患者的代谢水平与前列腺增生患者相似。随着收缩压的升高,患前列腺癌的风险将升高。小体积的前列腺可能是前列腺癌的危险因素,而体重指数、血脂及血糖与前列腺癌的发生无明显相关性。

Objective To analyze the features of metabolic syndrome in patients with benign prostate hyperplasia and prostate cancer and to explore the risk factors of prostate cancer.Methods Clinical data of200 patients with benign prostate hyperplasia(BPH group)and 119 patients with prostate cancer(PC group)in Beijing Anzhen Hospital,Capital Medical University from September 1 st,2000 to August 31 st,2014 were collected,including age,height,weight,body mass index,systolic blood pressure,diastolic blood pressure,prostate volume,prostate specific antigen(PSA),PSA density(PSAD),levels of fasting blood glucose,triglyceride and total cholesterol.Correlation between prostate cancer and the components of metabolic syndrome(including body mass index,blood pressure,fasting blood glucose,triglyceride and total cholesterol)was analyzed.Results There were significant differences of age,prostate volume,PSA and PSAD between BPH group and PC group[(72±7)years vs(75±7)years,(61±38)cm3 vs(47±28)cm3,5.5(2.4,9.2)μg/L vs 19.9(8.8,53.4)μg/L,0.09(0.05,0.18)μg/(L·cm3)vs 0.51(0.26,1.17)μg/(L·cm3)](all P<0.05).There was significant difference of systolic blood pressure between the two groups[(133±16)mm Hg vs(139±19)mm Hg](P<0.05).There was no significant difference of body mass index,diastolic blood pressure,fasting blood glucose,triglyceride and total cholesterol between groups(all P>0.05).Multivariate binary logistic regression showed that age(odds ratio=1.060,95%confidence interval:1.010-1.113,P=0.018),PSA(odds ratio=1.107,95%confidence interval:1.037-1.182,P=0.002)and systolic blood pressure(odds ratio=1.028,95%confidence interval:1.005-1.051,P=0.017)were risk factors and prostate volume(odds ratio=0.962,95%confidence interval:0.941-0.985,P=0.001)was a protective factor of PC.Body mass index,diastolic blood pressure,fasting blood glucose,triglyceride and total cholesterol were not associated with PC(all P>0.05).Conclusions Metabolic level of patients with PC is similar to that of BPH.Risk of PC increases with systolic blood pressure.Small size of prostate may be a risk factor of PC;body mass index,blood lipid and blood glucose are not significantly correlated with the occurrence of PC.