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老年良性前列腺增生与糖脂代谢异常的关系研究

Relationship between benign prostatic hyperplasia and abnormal glucose and lipid metabolism in the elderly

    摘要
  • 摘要:
    目的 探讨老年良性前列腺增生(BPH)与糖脂代谢异常的关系。
    方法 选取152例老年BPH患者作为研究对象, 检测其空腹血糖(FPG)、糖负荷后2 h血糖(2 hPG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)和前列腺特异性抗原(PSA)水平，测量收缩压(SBP)、舒张压(DBP), 计算前列腺体积(PV)和前列腺年增长率，并评估国际前列腺症状评分(IPSS)。分别根据血糖、血脂、IPSS, 将患者分为血糖正常组99例与高血糖组53例、血脂正常组112例与血脂异常组40例、中度症状组91例与重度症状组61例。比较各组患者的临床特征，分析糖脂代谢异常与BPH患者下尿路症状严重程度的关系。
    结果 与血糖正常组比较，高血糖组患者年龄、SBP、前列腺年增长率、IPSS和FPG、2 hPG、FINS、PSA水平均更高, PV更大, HDL-C水平更低，差异均有统计学意义(P < 0.05); 与血脂正常组比较，血脂异常组BPH患者的年龄、SBP、前列腺年增长率、IPSS和FPG、FINS、TC、TG、LDL-C、UA水平更高，腰围、PV更大, HDL-C水平更低，差异有统计学意义(P < 0.05); 与中度症状组比较，重度症状组患者的年龄、BMI、SBP、前列腺年增长率及FPG水平更高，高血糖、血脂异常发生率更高, PV更大，HDL-C水平更低，差异有统计学意义(P < 0.05)。多因素Logistic回归分析结果显示，年龄≥70岁、SBP≥140 mmHg、高血糖、血脂异常、PV增大及前列腺年增长率升高均为BPH患者出现重度下尿路症状的独立危险因素(P < 0.05)。
    结论 老年BPH与糖脂代谢异常密切相关，且糖脂代谢异常是导致下尿路症状加重的危险因素。

     

    Abstract:
    Objective To investigate the relationship of benign prostatic hyperplasia(BPH) with abnormal glucose and lipid metabolism in the elderly.
    Methods A total of 152 elderly patients with BPH were selected as study subjects. The levels of fasting plasma glucose (FPG), 2-hour postprandial glucose (2 hPG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), blood uric acid (UA), and prostate-specific antigen (PSA) were measured. Their systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also measured. Prostate volume (PV) and annual prostate growth rate were calculated, and the International Prostate Symptom Score (IPSS) was assessed. Based on blood glucose, blood lipids, and IPSS, the patients were divided into normal blood glucose group(99 cases) and hyperglycemia group(53 cases), normal blood lipid group(112 cases) and dyslipidemia group(40 cases), and moderate symptom group(91 cases) and severe symptom group(61 cases). The clinical characteristics of patients in each group were compared, and the relationships of abnormal glucose and lipid metabolism with the severity of lower urinary tract symptoms in patients with BPH were analyzed.
    Results Compared with the normal blood glucose group, patients in the hyperglycemia group had higher age, SBP, annual prostate growth rate, IPSS, and levels of FPG, 2 hPG, FINS, and PSA, larger PV, and lower HDL-C level (P < 0.05). Compared with the normal blood lipid group, patients with BPH in the dyslipidemia group had higher age, SBP, annual prostate growth rate, IPSS, and levels of FPG, FINS, TC, TG, LDL-C, and UA, larger waist circumference and PV, and lower HDL-C level (P < 0.05). Compared with the moderate symptom group, patients in the severe symptom group had higher age, BMI, SBP, annual prostate growth rate, and FPG levels, higher incidence rates of hyperglycemia and dyslipidemia, larger PV, and lower HDL-C levels (P < 0.05). Multivariate Logistic regression analysis indicated that age ≥70 years, SBP ≥140 mmHg, hyperglycemia, dyslipidemia, increased PV, and elevated annual prostate growth rate were all independent risk factors for the occurrence of severe lower urinary tract symptoms in patients with BPH (P < 0.05).
    Conclusion Elderly BPH is closely related to abnormal glucose and lipid metabolism, and abnormal glucose and lipid metabolism are risk factors for the exacerbation of lower urinary tract symptoms.

     

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