Kopp Wolfgang
Former head of the Diagnostikzentrum Graz, Graz, Austria.
Nutr Metab Insights. 2018 May 8;11:1178638818773072. doi: 10.1177/1178638818773072. eCollection 2018.
Benign prostatic hyperplasia and hypertension are common age-related comorbidities. Although the etiology of benign prostatic hyperplasia (BPH) is still largely unresolved and poorly understood, a significant age-independent association was found between BPH and hypertension, indicating a common pathophysiological factor for both diseases. It has previously been suggested that the development of essential hypertension may be related to diet-induced hyperinsulinemia. This study follows the question, whether BPH may develop due to the same mechanism, thereby explaining the well-known comorbidity of these 2 disorders. The scientific evidence presented shows that BPH and hypertension share the same pathophysiological changes, with hyperinsulinemia as the driving force. It further shows that significant dietary changes during human history cause disruption of a finely tuned metabolic balance that has evolved over millions of years of evolution: high-insulinemic food, typical of current "Western" diets, has the potential to cause hyperinsulinemia and insulin resistance, as well as an abnormally increased activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system, alterations that play a pivotal role in the pathogenesis of BPH and hypertension.
良性前列腺增生和高血压是常见的与年龄相关的合并症。尽管良性前列腺增生(BPH)的病因在很大程度上仍未得到解决且了解不足,但在BPH与高血压之间发现了一种与年龄无关的显著关联,这表明这两种疾病存在共同的病理生理因素。此前曾有人提出,原发性高血压的发生可能与饮食诱导的高胰岛素血症有关。本研究探讨了BPH是否可能由于相同的机制而发生,从而解释这两种疾病众所周知的合并症。所提供的科学证据表明,BPH和高血压具有相同的病理生理变化,高胰岛素血症是驱动力。它进一步表明,人类历史上显著的饮食变化导致了经过数百万年进化而形成的精细调节的代谢平衡被打破:当前“西方”饮食典型的高胰岛素血症食物有可能导致高胰岛素血症和胰岛素抵抗,以及交感神经系统和肾素-血管紧张素-醛固酮系统的异常激活增加,这些改变在BPH和高血压的发病机制中起关键作用。