Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
World J Urol. 2020 Nov;38(11):2923-2931. doi: 10.1007/s00345-020-03084-4. Epub 2020 Jan 21.
Increasing evidence shows that many metabolic factors are involved in the progression of benign prostatic hyperplasia (BPH). We aimed to assess the relationship between the status of glucose homeostasis and prostate size in aging Chinese males undergoing transurethral resection of the prostate (TURP) for BPH.
A total of 1006 medical records of BPH patients undergoing TURP were reviewed. Prostate size was measured by transrectal ultrasound. Annual total prostate (TP) and transitional zone (TZ) growth rates were calculated. According to the American Diabetes Association criteria, the patients were categorized as normoglycemic, prediabetic, or diabetic. Levels of glucose homeostasis and other variables were considered independent variables in an effort to evaluate any potential correlations using non-adjusted and multivariate-adjusted regression models.
A total of 659 individuals were included in the study. BPH patients < 70 years old and ≥ 70 years old in the normoglycemic group had a stable prostate growth rate. The change in prostate size in those younger than 70 years, however, was faster in the prediabetic and diabetic group. Further analysis revealed that abnormal glucose homeostasis was positively correlated with prostate size. In those younger than 70 years, compared with the normal glucose group, the adjusted odds ratio (OR) for TP and TZ enlargement in the prediabetic group was 2.27 (95%CI 1.29-4.00) and 3.19 (95%CI 1.78-5.72), respectively, and the adjusted ORs were 4.74 (95%CI 2.18-10.30) and 6.16 (95%CI 2.70-14.06), respectively, for men with diabetes. However there was no significant difference among men aged ≥ 70 years.
Among patients undergoing TURP, the prostate volume and growth rate were affected by different status of glucose homeostasis. Hyperglycemia may play an important role in prostate growth.
越来越多的证据表明,许多代谢因素参与了良性前列腺增生(BPH)的进展。我们旨在评估中国老年男性接受经尿道前列腺切除术(TURP)治疗 BPH 时葡萄糖稳态状态与前列腺大小之间的关系。
共回顾了 1006 例接受 TURP 的 BPH 患者的病历。通过经直肠超声测量前列腺大小。计算每年总前列腺(TP)和移行区(TZ)的增长率。根据美国糖尿病协会的标准,将患者分为血糖正常、糖尿病前期或糖尿病。将葡萄糖稳态水平和其他变量视为独立变量,使用非调整和多变量调整回归模型评估任何潜在相关性。
共有 659 人纳入研究。血糖正常组中年龄<70 岁和≥70 岁的 BPH 患者前列腺生长稳定。然而,年龄<70 岁的患者中,糖尿病前期和糖尿病组的前列腺大小变化更快。进一步分析显示,异常葡萄糖稳态与前列腺大小呈正相关。在年龄<70 岁的患者中,与正常血糖组相比,糖尿病前期组 TP 和 TZ 增大的校正优势比(OR)分别为 2.27(95%CI 1.29-4.00)和 3.19(95%CI 1.78-5.72),糖尿病组分别为 4.74(95%CI 2.18-10.30)和 6.16(95%CI 2.70-14.06)。然而,年龄≥70 岁的患者之间没有显著差异。
在接受 TURP 的患者中,前列腺体积和生长速度受到不同血糖稳态状态的影响。高血糖可能在前列腺生长中起重要作用。