Egan Kathryn B, Burnett Arthur L, McVary Kevin T, Ni Xiao, Suh Minhyung, Wong David G, Rosen Raymond C
New England Research Institutes, Inc., Watertown, MA.
Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
Urology. 2015 Sep;86(3):570-80. doi: 10.1016/j.urology.2015.04.054. Epub 2015 Jun 17.
To establish a descriptive profile of men with coexistent erectile dysfunction (ED) and/or benign prostatic hyperplasia (BPH), ED only or BPH only compared to those with neither condition and to identify the determinants of coexisting disease.
Self-report and/or medication use measures defining ED and BPH were assessed in men aged ≥40 years (N = 2142) between 2001 and 2004 using the National Health and Nutrition Examination Surveys. Descriptive analyses examined the ED and/or BPH covariate distribution. Logistic regressions calculated odds ratios (ORs, 95% confidence interval) comparing men with ED and/or BPH, BPH only, or ED only to men with neither condition.
Of 393 men with BPH, 57.8% had coexistent ED, confirming the moderately strong co-occurrence of the conditions (P <.0001). Coexisting ED and/or BPH occurred in 10.6% of participants, whereas 24.4% and 7.7% reported ED and BPH. After age 60, the odds of reporting ED, BPH, or ED/BPH vs neither almost tripled per decade of increasing age, corresponding to prevalence increases. The unadjusted odds of ED and/or BPH vs no disease increased 1.3 times per prostate-specific antigen unit (ng/mL) increase and 1.1 times per C-reactive protein unit (mg/dL) increase. Other predisposing factors for ED and/or BPH included higher body mass index (OR = 2.5), increased antidiabetic (OR = 2.9) or proton pump inhibitor use (OR = 2.3), increased healthcare visits (≥4; OR = 3.5), and more frequent urinary voiding difficulties (OR = 9.7).
Co-occurring ED and/or BPH is evident in ~10% of men ≥40 years old and is associated with significant clinical correlates. Clinicians need to pay greater attention to this clinically important syndrome in aging men.
建立患有勃起功能障碍(ED)和/或良性前列腺增生(BPH)、仅患有ED或仅患有BPH的男性的描述性概况,并与未患这两种疾病的男性进行比较,同时确定共存疾病的决定因素。
在2001年至2004年期间,使用美国国家健康与营养检查调查对年龄≥40岁的男性(N = 2142)进行评估,通过自我报告和/或药物使用情况来定义ED和BPH。描述性分析研究了ED和/或BPH协变量分布。逻辑回归计算比值比(OR,95%置信区间),将患有ED和/或BPH、仅患有BPH或仅患有ED的男性与未患这两种疾病的男性进行比较。
在393名患有BPH的男性中,57.8%同时患有ED,这证实了这两种疾病的中度强共现性(P <.0001)。共存的ED和/或BPH在10.6%的参与者中出现,而24.4%和7.7%的参与者分别报告患有ED和BPH。60岁以后,报告患有ED、BPH或ED/BPH而非两者都不患的几率每增加十岁几乎增加两倍,这与患病率的增加相对应。ED和/或BPH与未患病相比,未调整的几率随着前列腺特异性抗原单位(ng/mL)每增加一个单位增加1.3倍,随着C反应蛋白单位(mg/dL)每增加一个单位增加1.1倍。ED和/或BPH的其他诱发因素包括较高的体重指数(OR = 2.5)、抗糖尿病药物使用增加(OR = 2.9)或质子泵抑制剂使用增加(OR = 2.3)、医疗就诊次数增加(≥4次;OR = 3.5)以及更频繁的排尿困难(OR = 9.7)。
在≥40岁的男性中,约10%明显同时患有ED和/或BPH,且与显著的临床相关因素有关。临床医生需要更加关注老年男性中这一具有临床重要性的综合征。