Man Kee-Ming, Chen Kuen-Bao, Chen Huey-Yi, Chiang Jen-Huai, Su Yuan-Chih, Man Samantha S, Xie Dong-Dong, Wang Yi, Zhang Zhi-Qiang, Bi Liang-Kuan, Zhang Tao, Yu De-Xin, Chen Wen-Chi
Graduate Institute of Geriatric Medicine, Anhui Medical University.
Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Medicine (Baltimore). 2018 Sep;97(39):e12459. doi: 10.1097/MD.0000000000012459.
Benign prostatic hyperplasia (BPH) is a common disorder in the aging male population. Despite evidence that thyroid status impacts the prostate, the objective of this study was to examine whether patients with hyperthyroidism were at a greater risk for BPH.This study is a retrospective nationwide population-based cohort study of the Chinese population. Data for this study were retrieved from the Taiwan National Health Insurance Research Database (NHIRD). Overall, 1032 male patients aged 40 years or older with hyperthyroidism diagnosed between 2000 and 2006 were included in the hyperthyroidism group, and 4128 matched controls without hyperthyroidism were included in the non-hyperthyroidism group. Both groups were monitored until the end of 2011. A Cox proportional hazards regression model was used to compute and compare the risk of BPH between study participants with and those without hyperthyroidism.Patients with hyperthyroidism exhibited a greater incidence of BPH (18.51% vs 15.53%) than did the controls. Furthermore, the hazard ratio (HR) of the hyperthyroidism group was 1.24 times that of the control group [95% confidence interval (95% CI 1.05-1.46)] signifying that there is a significant 24% increase in the risk of BPH with the presence of hyperthyroidism. This increased risk of BPH with hyperthyroidism, however, failed to remain significant (adjusted HR = 1.11, 95% CI = 0.94-1.3) after adjusting for covariates of age (adjusted HR = 2.72, 95% CI = 2.32-3.2), diabetes (adjusted HR = 1.4, 95% CI = 1.17-1.68), hypertension (adjusted HR = 1.74, 95% CI = 1.49-2.03), hyperlipidemia (adjusted HR = 1.25, 95% CI = 1.03-1.53), neurogenic bladder, cystitis (adjusted HR = 1.23, 95% CI = 0.58-2.59), urethral stricture (adjusted HR = 2.01, 95% CI = 0.28-14.47), urethritis (adjusted HR = 1.52, 95% CI = 0.72-3.21), and urinary tract infection (adjusted HR = 1.77, 95% CI = 1.31-2.39).After adjustment for comorbidities and covariates, hyperthyroidism was not found to be a significant risk factor of BPH in our male study subjects. Further research is warranted to validate our results and elucidate the association of the pathophysiology of these 2 diseases.
良性前列腺增生(BPH)是老年男性群体中的一种常见病症。尽管有证据表明甲状腺状态会影响前列腺,但本研究的目的是检验甲状腺功能亢进患者患BPH的风险是否更高。本研究是一项基于全国人口的中国人群回顾性队列研究。本研究的数据取自台湾国民健康保险研究数据库(NHIRD)。总体而言,甲状腺功能亢进组纳入了2000年至2006年间诊断出的1032名40岁及以上的男性甲状腺功能亢进患者,非甲状腺功能亢进组纳入了4128名匹配的无甲状腺功能亢进的对照者。两组均监测至2011年底。采用Cox比例风险回归模型计算并比较有和没有甲状腺功能亢进的研究参与者患BPH的风险。甲状腺功能亢进患者的BPH发病率(18.51%对15.53%)高于对照组。此外,甲状腺功能亢进组的风险比(HR)是对照组的1.24倍[95%置信区间(95%CI 1.05 - 1.46)],这表明甲状腺功能亢进会使BPH风险显著增加24%。然而,在对年龄(调整后HR = 2.72,95%CI = 2.32 - 3.2)、糖尿病(调整后HR = 1.4,95%CI = 1.17 - 1.68)、高血压(调整后HR = 1.74,95%CI = 1.49 - 2.03)、高脂血症(调整后HR = 1.25,95%CI = 1.03 - 1.53)、神经源性膀胱、膀胱炎(调整后HR = 1.23,95%CI = 0.58 - 2.59)、尿道狭窄(调整后HR = 2.01,95%CI = 0.28 - 十四点四七)、尿道炎(调整后HR = 1.52,95%CI = 0.72 - 3.21)和尿路感染(调整后HR = 1.77,95%CI = 1.31 - 2.39)等协变量进行调整后,甲状腺功能亢进与BPH风险增加之间不再具有统计学意义(调整后HR = 1.11,95%CI = 0.94 - 1.3)。在对合并症和协变量进行调整后,在我们的男性研究对象中未发现甲状腺功能亢进是BPH的显著风险因素。有必要进行进一步研究以验证我们的结果并阐明这两种疾病病理生理学之间的关联。