Chung Shiu-Dong, Lin Herng-Ching
Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, and Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Androl. 2011 Mar-Apr;32(2):159-64. doi: 10.2164/jandrol.110.011163. Epub 2010 Aug 26.
There have been several post mortem studies focusing on the association between liver cirrhosis and benign prostate hyperplasia; however, the results are controversial. The aim of this study was to estimate the risk of benign prostatic enlargement during a 5-year follow-up period following a liver cirrhosis diagnosis, using nationwide population-based data and a retrospective cohort design. We used the "Longitudinal Health Insurance Database," derived from the Taiwan National Health Insurance program. The study cohort comprised 661 patients who had received treatment for liver cirrhosis between 1997 and 2001; the comparison cohort was composed of 3305 randomly selected patients. Stratified Cox proportional hazard regressions were performed as a means of comparing the 5-year benign prostatic enlargement survival rate for the 2 cohorts. Of the sampled patients, 808 patients (20.4%) developed benign prostatic enlargement during the follow-up period (ie, 163 individuals from the study cohort [24.7% of the patients with liver cirrhosis] and 645 individuals from the comparison cohort [19.5% of comparison cohort patients]). The log-rank test indicated that patients with liver cirrhosis had significantly lower 5-year benign prostatic enlargement-free survival rates than the controls (P < .001). The adjusted hazard ratios for benign prostatic enlargement following diagnosis with liver cirrhosis were 1.41 during the 5-year follow-up period. We conclude that the risk for benign prostatic enlargement increased after a diagnosis of liver cirrhosis. Further studies are needed to identify the underlying pathophysiology.
已有多项尸检研究聚焦于肝硬化与良性前列腺增生之间的关联;然而,结果存在争议。本研究的目的是利用全国性基于人群的数据和回顾性队列设计,评估肝硬化诊断后5年随访期内良性前列腺增生的风险。我们使用了源自台湾全民健康保险计划的“纵向健康保险数据库”。研究队列包括1997年至2001年间接受肝硬化治疗的661例患者;对照队列由随机选取的3305例患者组成。采用分层Cox比例风险回归来比较两个队列的5年良性前列腺增生生存率。在抽样患者中,808例患者(20.4%)在随访期内出现良性前列腺增生(即研究队列中的163例个体[肝硬化患者的24.7%]和对照队列中的645例个体[对照队列患者的19.5%])。对数秩检验表明,肝硬化患者的5年无良性前列腺增生生存率显著低于对照组(P <.001)。肝硬化诊断后5年随访期内良性前列腺增生的调整后风险比为1.41。我们得出结论,肝硬化诊断后良性前列腺增生的风险增加。需要进一步研究以确定潜在的病理生理学机制。