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40至75岁男性甲状腺刺激激素(TSH)与前列腺特异性抗原(PSA)血液水平之间存在显著负相关。

[An inverse significant association between thyroid stimulatory hormone (TSH) and prostate specific antigen (PSA) blood levels in males 40-75 years of age 40-75 years of age].

作者信息

Tóth Zoltán, Gyarmati Béla, Szabó Tamás, Vásárhelyi Barna

机构信息

Urológiai Osztály, Uzsoki Utcai Kórház Budapest.

Szülészet-Nőgyógyászati Osztály, Uzsoki Utcai Kórház Budapest.

出版信息

Orv Hetil. 2019 Sep;160(35):1376-1379. doi: 10.1556/650.2019.31340.

DOI:10.1556/650.2019.31340
PMID:31448641
Abstract

Recent experiments and clinical studies indicate the contribution of thyroid hormones to prostate pathology. In our retrospective analyzis of university patient population, we evaluated the association between thyroid stimulatory hormone (TSH) and prostate specific antigen (PSA). From the Laboratory Information System we retrieved the data of male patients between 40 and 75 years of age who had been subjected to simultaneous TSH and PSA measurements during the last 12 years (n = 7279). The association between logTSH and logPSA levels was tested with multiple regression analysis and adjusted for age. Significant associations between logPSA and logTSH and age (r = 0.297 and 0.472, respectively) were detected. PSA levels were higher in patients with TSH below (n = 405) than in those with TSH within reference range (TSH 0,35-4,95 mU/ml) (n = 6698) (PSA level: 1.118 [0.639-2.338] vs. 0.920 [0.508-1.826] ng/ml, p<0.016). Based on estimates, a 10% decrease in TSH is associated with a 0.42% increase in PSA levels in our population. This corresponds to a 42% increase in PSA levels in the same patient if he would present with 0.2 mU/ml instead of 2.0 mU/ml TSH. The finding that hyperthyreosis might be associated with higher PSA levels indicates that PSA reference ranges would differ in hyperthyreotic and in euthyreotic patients. Probably the PSA clinical decision limits is also recommended to be modified according to the patient's thyroid status. Orv Hetil. 2019; 160(35): 1376-1379.

摘要

近期的实验和临床研究表明甲状腺激素对前列腺病变有影响。在我们对大学患者群体的回顾性分析中,我们评估了促甲状腺激素(TSH)与前列腺特异性抗原(PSA)之间的关联。从实验室信息系统中,我们检索了40至75岁男性患者的数据,这些患者在过去12年中同时进行了TSH和PSA测量(n = 7279)。通过多元回归分析测试了logTSH与logPSA水平之间的关联,并对年龄进行了校正。检测到logPSA与logTSH和年龄之间存在显著关联(r分别为0.297和0.472)。TSH低于参考范围(n = 405)的患者的PSA水平高于TSH在参考范围内(TSH 0.35 - 4.95 mU/ml)的患者(n = 6698)(PSA水平:1.118 [0.639 - 2.338] vs. 0.920 [0.508 - 1.826] ng/ml,p<0.016)。根据估计,在我们的人群中,TSH降低10%与PSA水平升高0.42%相关。如果同一患者的TSH为0.2 mU/ml而不是2.0 mU/ml,则PSA水平会升高42%。甲状腺功能亢进可能与较高的PSA水平相关这一发现表明,甲状腺功能亢进患者和甲状腺功能正常患者的PSA参考范围会有所不同。可能也建议根据患者的甲状腺状态修改PSA临床决策限值。《匈牙利医学周报》。2019年;160(35): 1376 - 1379。

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