Gacci Mauro, Sebastianelli Arcangelo, Salvi Matteo, De Nunzio Cosimo, Vignozzi Linda, Corona Giovanni, Jaeger Tommaso, Chini Tommaso, Russo Giorgio Ivan, Maggi Mario, Morgia Giuseppe, Tubaro Andrea, Carini Marco, Serni Sergio
Department of Urology, University of Florence, Careggi Hospital, Florence, Italy.
Department of Urology, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy.
BMC Urol. 2017 Apr 4;17(1):22. doi: 10.1186/s12894-017-0211-9.
In last years Metabolic Syndrome (MetS) has been closely associated to Benign Prostatic Enlargement (BPE) Aim of our study is to evaluate the effect of MetS and each single MetS parameter on prostate growth in men surgically treated for BPE.
Overall, 379 men were prospectively enrolled in two tertiary referral centers. Calculated prostate volume (PV) was measured with transrectal US defining the antero-posterior (AP), the cranio-caudal (CC) and the latero-lateral (LL) diameters through the ellipsoid formula, while raw PV was calculated by suprapubic US. MetS was defined according to the NCEP-ATPIII criteria.
One-hundred and forty men (36.9%) were affected by MetS. The number of MetS parameters (0 to 5) and the presence of MetS were correlated with the calculated PV. The number of MetS parameters were also directly related to increasing prostate diameters. At the binary logistic regression, MetS resulted associated to high (>60 cc) raw and calculated PV. Moreover, multivariate analysis suggested that AP diameter was mainly correlated with HDL cholesterol (r:-0.3103, p = 0.002) CC diameter with triglycerides (r:-0.191, p = 0.050) and LL diameter with systolic blood pressure (r:0.154, p = 0.044). However, at the binary logistic regression, only low HDL Cholesterol was the main determinant for the enlargement of all diameters and consequently of the whole PV.
Metabolic factors, specially dyslipidemia, could play a central role in the pathogenesis and progression of BPE/LUTS. Interventional studies are needed to evaluate the impact of early treatment of dyslipidemia on progression of LUTS/BPH.
近年来,代谢综合征(MetS)与良性前列腺增生(BPE)密切相关。我们研究的目的是评估MetS及每个单一的MetS参数对因BPE接受手术治疗的男性前列腺生长的影响。
总体而言,379名男性前瞻性地纳入了两个三级转诊中心。经直肠超声测量计算得出的前列腺体积(PV),通过椭圆公式确定前后径(AP)、头尾径(CC)和左右径(LL),而耻骨上超声计算得出原始PV。根据NCEP-ATPIII标准定义MetS。
140名男性(36.9%)患有MetS。MetS参数的数量(0至5个)和MetS的存在与计算得出的PV相关。MetS参数的数量也与前列腺直径增加直接相关。在二元逻辑回归分析中,MetS与高(>60 cc)原始PV和计算得出的PV相关。此外,多变量分析表明,AP直径主要与高密度脂蛋白胆固醇相关(r:-0.3103,p = 0.002),CC直径与甘油三酯相关(r:-0.191,p = 0.050),LL直径与收缩压相关(r:0.154,p = 0.044)。然而,在二元逻辑回归分析中,只有低高密度脂蛋白胆固醇是所有直径增大以及整个PV增大的主要决定因素。
代谢因素,特别是血脂异常,可能在BPE/LUTS的发病机制和进展中起核心作用。需要进行干预性研究来评估早期治疗血脂异常对LUTS/BPH进展的影响。