Gass R
Institute of Social and Preventive Medicine, Epidemiology, University of Zurich, Zurich, Switzerland.
BJU Int. 2002 Nov;90(7):649-54. doi: 10.1046/j.1464-410x.2002.03001.x.
To assess several lifestyle factors influencing benign prostatic enlargement and therefore the severity of benign prostatic hyperplasia (BPH).
In age-stratified cohorts from population-based random samples of 882 men (aged 65, 70, 75 and 80 years) each participant completed a standardized questionnaire, including weight, height, socio-economic status, use of cigarettes, alcohol and coffee consumption. The questionnaire also elicited detailed information on the medical history of prostatic and (over the past month) lower urinary tract symptoms, applying all questions from the American Urology Association instrument. The lifestyle variables were evaluated for confounding by multiple logistic regression, controlling for age, relative weight and professional education, with those classified as having BPH analysed as the dependent variable.
The prevalence of surgery for BPH increased with age from 15% at 65 years to 41% at 80 years. There was a strong inverse association between alcohol intake and men treated surgically for BPH or in 'watchful waiting' for surgical intervention, but a positive correlation with coffee consumption, and although not significantly, with the number of cigarettes smoked. Nevertheless, those who had never smoked have a slightly greater risk of BPH than current smokers. The body mass index and professional education were not associated with the risk of BPH.
Given the opposite effects of coffee and moderate alcohol consumption, together with the increased risk for clinical BPH in men with coronary heart disease, coffee constituents, which increase the serum concentration of low-density lipoprotein cholesterol, may be involved in the pathophysiology of BPH. Further epidemiological studies are needed to evaluate whether avoiding coffee intake reduces the risk of BPH.
评估影响良性前列腺增生及良性前列腺增生症（BPH）严重程度的多种生活方式因素。
在基于人群的随机样本中，按年龄分层选取了882名男性（年龄分别为65、70、75和80岁），每位参与者均完成了一份标准化问卷，内容包括体重、身高、社会经济状况、吸烟情况、饮酒量及咖啡摄入量。该问卷还依据美国泌尿外科学会的所有问题，详细询问了前列腺病史及（过去一个月内）下尿路症状。通过多因素逻辑回归分析评估生活方式变量的混杂因素，以年龄、相对体重和职业教育作为控制变量，将被归类为患有BPH的人群作为因变量进行分析。
BPH手术患病率随年龄增长而升高，从65岁时的15%增至80岁时的41%。饮酒量与接受BPH手术治疗或“观察等待”手术干预的男性之间存在强烈的负相关，但与咖啡摄入量呈正相关，与吸烟量虽无显著相关性，但从不吸烟者患BPH的风险略高于当前吸烟者。体重指数和职业教育与BPH风险无关。
鉴于咖啡和适量饮酒的相反作用，以及冠心病男性患临床BPH风险增加，可能是咖啡成分增加了低密度脂蛋白胆固醇的血清浓度，进而参与了BPH的病理生理过程。需要进一步开展流行病学研究，以评估避免摄入咖啡是否能降低BPH风险。
