Zhao Sicong, Chen Chao, Chen Zongping, Xia Ming, Tang Jianchun, Shao Sujun, Yan Yong
Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Urol J. 2016 Jun 28;13(3):2717-26.
To investigate the association between metabolic syndrome (MetS) and the predictors of the progression of benign prostatic hyperplasia (BPH) and the corresponding frequency and severity of lower urinary tract symptoms (LUTS).
A total of 530 men with moderate to severe International Prostate Symptom Score (IPSS) > 7 were recruited in the present study. The predictors for clinical BPH progression were defined as the total prostate volume (TPV) ≥ 31 cm3, prostate-specific antigen level (PSA) ≥ 1.6 ng/mL, maximal flow rate (Qmax) < 10.6 mL/s, postvoid residual urine volume (PVR) of ≥ 39 mL, and age 62 years or older. LUTS were defined according to the IPSS and MetS with the National Cholesterol Education Program-Adult Treatment Panel III guidelines. The Mantel-Haenszel extension test and the multivariate logistic regression analyses were used to statistically examine their relationships.
The percentage of subjects with ≥ 1 predictors for clinical BPH progression, the percentage of subjects with a TPV ≥ 31 cm3, the percentage of subjects with a PVR ≥ 39 mL, and the percentage of subjects with a Qmax < 10.6 mL/s increased significantly with the increasing in the number of MetS components (all P < .05). After adjusting for age and serum testosterone level, the MetS were independently associated with the presence of TPV ≥ 31 cm3 (OR = 17.030, 95% CI: 7.495-38.692). Moreover, MetS was positively associated with the severity of LUTS (P < .001) and voiding scores (P < .001), and each individual MetS component appeared as an independent risk factor for severe LUTS (IPSS > 19, all P < .001).
Our data have shown that the MetS significantly associated with the predictors for clinical BPH progression and the frequency and severity of LUTS, especially the voiding symptoms. The prevention of such modifiable factors by promotion of dietary changes and regular physical activity practice may be of great importance for public health. .
探讨代谢综合征（MetS）与良性前列腺增生（BPH）进展的预测因素以及下尿路症状（LUTS）相应频率和严重程度之间的关联。
本研究共纳入530名国际前列腺症状评分（IPSS）>7的中重度男性患者。临床BPH进展的预测因素定义为前列腺总体积（TPV）≥31 cm³、前列腺特异性抗原水平（PSA）≥1.6 ng/mL、最大尿流率（Qmax）<10.6 mL/s、残余尿量（PVR）≥39 mL以及年龄62岁及以上。LUTS根据IPSS和符合美国国家胆固醇教育计划成人治疗小组第三次报告指南的MetS进行定义。采用Mantel-Haenszel扩展检验和多因素逻辑回归分析对它们之间的关系进行统计学检验。
随着MetS组分数量的增加，具有≥1个临床BPH进展预测因素的受试者百分比、TPV≥31 cm³的受试者百分比、PVR≥39 mL的受试者百分比以及Qmax<10.6 mL/s的受试者百分比均显著增加（所有P<.05）。在调整年龄和血清睾酮水平后，MetS与TPV≥31 cm³独立相关（OR = 17.030，95%CI：7.495-38.692）。此外，MetS与LUTS的严重程度（P<.001）和排尿评分（P<.001）呈正相关，并且每个单独的MetS组分均表现为严重LUTS（IPSS>19）的独立危险因素（所有P<.001）。
我们的数据表明，MetS与临床BPH进展的预测因素以及LUTS的频率和严重程度显著相关，尤其是排尿症状。通过促进饮食改变和定期进行体育锻炼来预防这些可改变因素可能对公众健康非常重要。
