Russo Giorgio Ivan, Cimino Sebastiano, Fragalà Eugenia, Privitera Salvatore, La Vignera Sandro, Condorelli Rosita, Calogero Aldo E, Chisari Mario, Castelli Tommaso, Favilla Vincenzo, Morgia Giuseppe
Department of Urology, School of Medicine Policlinico Hospital, University of Catania, Catania, Italy,
World J Urol. 2015 May;33(5):743-51. doi: 10.1007/s00345-014-1392-4. Epub 2014 Sep 5.
To investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) assessed by the fatty liver index (FLI), in lower urinary tract symptoms (LUTS) patients and to estimate its ability in predicting LUTS.
We performed a cross-sectional analysis of 448 consecutive patients affected by LUTS. LUTS were evaluated using the IPSS questionnaire and metabolic syndrome (MetS) criteria (by International Diabetes Federation). FLI, prostate volume (PV), serum prostate-specific antigen, total testosterone (TT) and homeostasis model assessment (HOMA) index were evaluated. A value of FLI ≥40 was set to predict NAFLD. Patients were divided into Group A (FLI <40) and Group B (FLI ≥40). Odds ratios (OR) for having moderate-severe LUTS were calculated. Logistic regression model was fitted adjusting for confounding factors.
Group B showed higher prevalence of MetS, IR, moderate-severe LUTS and ED, higher IPSS, IPSS-storage, IPSS-voiding, total prostate volume, insulin, HOMA and lower TT and IIEF-5. Univariate logistic regression analysis demonstrated that continuous FLI (OR = 1.03, p < 0.05) and FLI ≥40 (OR = 2.41, p < 0.01) significantly increase the risk of moderate-severe LUTS. Continuous FLI (OR = 1.12, p < 0.01) and FLI ≥40 (OR = 5.39, p < 0.01) were independent predictors of moderate-severe LUTS at the multivariate logistic regression analysis, after adjusting for confounding factors. Subjects with MetS and FLI ≥40 had 2.0-fold the risk of moderate-severe LUTS (OR = 2.10, p < 0.01).
Non-alcoholic fatty liver disease (NAFLD) subjects have higher risk of LUTS. The presence of FLI ≥40 can be used to predict subjects at high risk of LUTS.
通过脂肪肝指数（FLI）评估下尿路症状（LUTS）患者中非酒精性脂肪性肝病（NAFLD）的患病率，并评估其预测LUTS的能力。
我们对448例连续的LUTS患者进行了横断面分析。使用国际前列腺症状评分（IPSS）问卷和代谢综合征（MetS）标准（国际糖尿病联盟制定）评估LUTS。评估FLI、前列腺体积（PV）、血清前列腺特异性抗原、总睾酮（TT）和稳态模型评估（HOMA）指数。设定FLI≥40的值来预测NAFLD。患者分为A组（FLI<40）和B组（FLI≥40）。计算发生中重度LUTS的比值比（OR）。拟合逻辑回归模型以校正混杂因素。
B组MetS、胰岛素抵抗（IR）、中重度LUTS和勃起功能障碍（ED）的患病率更高，IPSS、IPSS储尿期、IPSS排尿期、前列腺总体积、胰岛素、HOMA更高，而TT和国际勃起功能指数-5（IIEF-5）更低。单因素逻辑回归分析表明，连续的FLI（OR=1.03，p<0.05）和FLI≥40（OR=2.41，p<0.01）显著增加中重度LUTS的风险。在多因素逻辑回归分析中，校正混杂因素后，连续的FLI（OR=1.12，p<0.01）和FLI≥40（OR=5.39，p<0.01）是中重度LUTS的独立预测因素。患有MetS且FLI≥40的受试者发生中重度LUTS的风险是前者的2.0倍（OR=2.10，p<0.01）。
非酒精性脂肪性肝病（NAFLD）患者发生LUTS的风险更高。FLI≥40可用于预测LUTS高危患者。
