高脂血症与临床良性前列腺增生风险增加相关。
Hyperlipidemia is associated with an increased risk of clinical benign prostatic hyperplasia.
作者信息
Shih Hung-Jen, Huang Chun-Jen, Lin Jui-An, Kao Ming-Chang, Fan Yen-Chun, Tsai Pei-Shan
机构信息
Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
出版信息
Prostate. 2018 Feb;78(2):113-120. doi: 10.1002/pros.23451. Epub 2017 Nov 9.
BACKGROUND
A high fat diet is associated with risk of benign prostatic hyperplasia (BPH). However, whether hyperlipidemia is associated with BPH remains unclear. This population-based cohort study elucidated whether hyperlipidemia is associated with an increased risk of BPH.
METHODS
We used a new-exposure design and analyzed data retrieved from the Taiwan National Health Insurance Database between January 1, 2000 and December 31, 2013. The cohort of men with newly diagnosed hyperlipidemia and the age- and index-date-matched (1:3) nonhyperlipidemia cohort were tracked for incidence of BPH during a 1- to 14-year follow-up. Diagnosis of BPH using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, and the occurrence of BPH diagnosis plus the use of alpha-blockers or 5-alpha reductase inhibitors or receipt of transurethral resection of the prostate were the primary and secondary endpoints, respectively. The confounders in this study were diabetes mellitus, hypertension, coronary heart disease, obesity, liver cirrhosis, nonsteroidal anti-inflammatory drugs, metformin, aspirin, and number of urologist visits. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a multivariate Cox proportional hazards regression model adjusted for the propensity score.
RESULTS
A total of 35 860 subjects (aged 40-99 years)-including the hyperlipidemia cohort (n = 8,965) and nonhyperlipidemia cohort (n = 26 895)-were identified. Our data revealed that the hyperlipidemia cohort had significantly higher incidences of developing BPH (24.6% vs 12.3%, P < 0.001) and treated BPH (13% vs 5.7%, P < 0.001) compared with the nonhyperlipidemia cohort. The risk of developing BPH in the hyperlipidemia cohort was significantly higher than that in the nonhyperlipidemia cohort (HR = 1.73, 95% CI = 1.63-1.83, P < 0.001) after adjustment for the propensity score.
CONCLUSIONS
Hyperlipidemia is associated with an increased risk of clinical BPH.
背景
高脂饮食与良性前列腺增生（BPH）风险相关。然而，高脂血症是否与BPH相关仍不清楚。这项基于人群的队列研究阐明了高脂血症是否与BPH风险增加相关。
方法
我们采用新暴露设计，分析了2000年1月1日至2013年12月31日从台湾国民健康保险数据库中检索到的数据。对新诊断为高脂血症的男性队列以及年龄和索引日期匹配（1:3）的非高脂血症队列进行为期1至14年的随访，以追踪BPH的发病率。分别以国际疾病分类第九版临床修订本代码诊断BPH，以及BPH诊断的发生加上使用α受体阻滞剂或5α还原酶抑制剂或接受经尿道前列腺切除术作为主要和次要终点。本研究中的混杂因素包括糖尿病、高血压、冠心病、肥胖、肝硬化、非甾体抗炎药、二甲双胍、阿司匹林以及泌尿科就诊次数。使用倾向评分调整的多变量Cox比例风险回归模型估计风险比（HR）和95%置信区间（CI）。
结果
共纳入35860名受试者（年龄40 - 99岁），包括高脂血症队列（n = 8965）和非高脂血症队列（n = 26895）。我们的数据显示，与非高脂血症队列相比，高脂血症队列发生BPH（24.6%对12.3%，P < 0.001）和接受治疗的BPH（13%对5.7%，P < 0.001）的发生率显著更高。在调整倾向评分后，高脂血症队列发生BPH的风险显著高于非高脂血症队列（HR = 1.73，95% CI = 1.63 - 1.83，P < 0.001）。
结论
高脂血症与临床BPH风险增加相关。
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