Russo Giorgio Ivan, Cimino Sebastiano, Castelli Tommaso, Favilla Vincenzo, Gacci Mauro, Carini Marco, Condorelli Rosita A, La Vignera Sandro, Calogero Aldo E, Motta Fabio, Puzzo Lidia, Caltabiano Rosario, Morgia Giuseppe
Department of Urology, University of Catania, Catania, Italy.
Department of Urology, Careggi Hospital, University of Florence, Italy.
Prostate. 2016 Dec;76(16):1528-1535. doi: 10.1002/pros.23237. Epub 2016 Jul 25.
The prevalence of prostatic inflammation (PI) is very frequent in patients affected by benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). To investigate the relationship between prostatic inflammation (PI) and the presence of MetS and non-alcoholic fatty liver disease (NAFLD) in a cohort of patients affected by BPH/LUTS.
We conducted a prospective study from January 2012 to June 2014 on 264 consecutive patients, who underwent transurethral resection of the prostate for bladder outlet obstruction. Metabolic syndrome (MetS) has been defined according to the International Diabetes Federation (IDF). Prior to surgery, each patient has been evaluated for the presence of MetS and NAFLD. All surgical specimens were investigated for the presence of an inflammatory infiltrate, according to the Irani score.
The prevalence of patients affected by MetS alone was 13.8% (32/232), 13.8% (32/232) by NAFLD alone, and 42.7% (99/232) by both diseases. The rate of subjects affected by MetS + NAFLD and severe PI was significantly greater than those with only one metabolic alteration (75.8% vs. 24.2%, P < 0.01). The multivariate logistic regression analysis revealed that FLI was independently associated with high PI (Irani score ≥ 4) (odds ratio [OR]: 1.04; P < 0.01). Further, the combination between MetS and NAFLD was associated severe PI (OR: 4.5; P < 0.01) while not MetS as a single alteration.
Patients with BPH/LUTS and metabolic aberration exhibited grater PI. The coexistence of MetS and NAFLD exerted a greater detrimental effect on prostate gland by increasing severity of inflammation. Prostate 76:1528-1535, 2016. © 2016 Wiley Periodicals, Inc.
前列腺炎症（PI）在良性前列腺增生（BPH）和下尿路症状（LUTS）患者中非常常见。本研究旨在探讨一组BPH/LUTS患者中前列腺炎症（PI）与代谢综合征（MetS）及非酒精性脂肪性肝病（NAFLD）之间的关系。
我们于2012年1月至2014年6月对264例因膀胱出口梗阻接受经尿道前列腺切除术的连续患者进行了一项前瞻性研究。代谢综合征（MetS）根据国际糖尿病联盟（IDF）的标准进行定义。手术前，对每位患者进行MetS和NAFLD的评估。根据伊朗尼评分，对所有手术标本进行炎症浸润检查。
单纯患有MetS的患者患病率为13.8%（32/232），单纯患有NAFLD的患者患病率为13.8%（32/232），两种疾病均患的患者患病率为42.7%（99/232）。患有MetS + NAFLD和严重PI的患者比例显著高于仅有一种代谢改变的患者（75.8%对24.2%，P < 0.01）。多因素逻辑回归分析显示，脂肪肝指数（FLI）与高PI（伊朗尼评分≥4）独立相关（比值比[OR]：1.04；P < 0.01）。此外，MetS和NAFLD的组合与严重PI相关（OR：4.5；P < 0.01），而单独的MetS作为一种单一改变则不然。
患有BPH/LUTS和代谢异常的患者表现出更严重的PI。MetS和NAFLD的共存通过增加炎症严重程度对前列腺产生更大的有害影响。《前列腺》76:1528 - 1535，2016年。©2016威利期刊公司。
