University of California, San Diego, CA; VA Center of Excellence for Stress and Mental Health, San Diego, CA.
University of Washington, Seattle, WA.
Urology. 2019 Jul;129:54-59. doi: 10.1016/j.urology.2019.04.005. Epub 2019 Apr 13.
To evaluate the genetic and environmental relationship among prostatitis and other urological conditions, including benign prostatic hyperplasia (BPH) and prostate cancer (CaP), a classical twin design and biometric modeling was used. While prostatitis-characterized by pain and voiding symptoms, no clear etiology, and functional and quality of life impairments-co-occurs with other urinary conditions, the degree of shared overlapping etiologic processes among them remains unclear. We examined the contribution of genetic and environmental factors to these conditions and the etiology of their associations at the level of genetic and environmental influences.
4380 monozygotic and dizygotic male twin pairs from the Vietnam Era Twin Registry reported lifetime physician-diagnosed prostatitis (combined acute and chronic), bladder problems, enlarged prostate/BPH, and CaP. Multivariate biometrical modeling estimated the magnitude of genetic and environmental influences for each condition, as well as their genetic and environmental covariance. The common pathway model tested the assumption that covariation among these urinary conditions is determined by a single latent factor.
Overall prevalence of prostatitis was 2.7%. Heritability estimates ranged from 19% for bladder problems to 42% for CaP. Significant shared environmental influences were present for CaP (12%), enlarged prostate/BPH (10%) but were smaller than genetic influences. A reduced one factor common pathway model provided the best fit, suggesting that covariation among the conditions is determined by a shared latent factor.
We identified a common, genetically-influenced factor that accounts for much of the comorbidity among these 4 disease conditions. Nonshared environmental factors also make a significant contribution.
评估前列腺炎与其他泌尿科疾病（包括良性前列腺增生症（BPH）和前列腺癌（CaP））之间的遗传和环境关系，使用经典的双胞胎设计和生物计量建模。虽然前列腺炎以疼痛和排尿症状为特征，没有明确的病因，并且会损害功能和生活质量，但它与其他尿路疾病同时发生，其共同发病过程的程度尚不清楚。我们研究了遗传和环境因素对这些疾病的贡献，以及遗传和环境影响水平上它们之间关联的病因。
来自越南时代双胞胎登记处的 4380 对同卵和异卵男性双胞胎报告了终身诊断的前列腺炎（包括急性和慢性）、膀胱问题、前列腺增大/BPH 和 CaP。多变量生物计量建模估计了每种疾病的遗传和环境影响的大小，以及它们的遗传和环境协方差。共同途径模型检验了这些尿路状况之间的协变是由单一潜在因素决定的假设。
前列腺炎的总体患病率为 2.7%。遗传率估计值从膀胱问题的 19%到 CaP 的 42%不等。CaP（12%）和前列腺增大/BPH（10%）存在显著的共享环境影响，但小于遗传影响。简化的单因素共同途径模型提供了最佳拟合，表明这些疾病之间的协变是由共同的潜在因素决定的。
我们确定了一个共同的、受遗传影响的因素，它解释了这些 4 种疾病状况之间的大部分共病。非共享环境因素也有很大贡献。
