Epidemiology Program, College of Health Sciences, University of Delaware, 100 Discovery Blvd., 7th floor, Newark, DE, 19713, USA.
Coeus Health, 222 W Merchandise Mart Plaza, Chicago, IL, 60654, USA.
BMC Urol. 2021 Mar 27;21(1):47. doi: 10.1186/s12894-021-00816-5.
Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes.
Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation.
Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11-1.40; p-trend < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RR: 1.13, 95% CI 1.07-1.21; RR: 1.10, 95% CI 1.02-1.19; p-trend = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RR: 1.09, 95% CI 0.98-1.22; RR: 1.28, 95% CI 1.10-1.47) and a prostate volume ≥ 30 cc (RR: 1.12, 95% CI 1.05-1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia.
We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.
现有证据表明，体型与普遍存在的良性前列腺增生（BPH）相关结局和夜尿症之间存在关联。然而，关于整个生命周期中体型与 BPH 相关结局的发生之间的关联，证据有限。
我们的研究人群包括前列腺、肺、结直肠和卵巢癌筛查试验（PLCO）干预组中没有前列腺癌、BPH 相关结局或夜尿症病史的男性（n=4710）。使用泊松回归和稳健方差估计，检查早期（20 岁）、中期（50 岁）和晚期（年龄≥55 岁，平均年龄 60.7 岁）生命体型以及体重变化与 BPH 相关结局（包括自我报告的夜尿症和 BPH 医生诊断、直肠指检估计前列腺体积≥30 cc 和前列腺特异性抗原 [PSA] 浓度>1.4ng/mL）的关联。
晚期肥胖的男性发生夜尿症的可能性增加 25%（相对风险（RR）：1.25，95%置信区间（CI）：1.11-1.40；p<0.0001），晚期超重或肥胖的男性发生前列腺体积≥30 cc 的可能性也更高（RR：1.13，95%CI 1.07-1.21；RR：1.10，95%CI 1.02-1.19；p<0.0001）。与体重正常的男性相比。20 岁和 50 岁时的肥胖同样与夜尿症和前列腺体积≥30 cc 相关。考虑到体型轨迹，20 岁时体重正常但后来进入中老年时超重或肥胖的男性发生夜尿症（RR：1.09，95%CI 0.98-1.22；RR：1.28，95%CI 1.10-1.47）和前列腺体积≥30 cc 的风险增加（RR：1.12，95%CI 1.05-1.20）。在生命早期肥胖的男性太少，无法检查早期体型的独立影响。中老年体型改变了体力活动与夜尿症之间的关联。
我们发现，体型与生命早期体型无关，与 BPH 不良结局相关，这表明即使在生命晚期采取措施减少体型也可能会降低 BPH 相关结局和夜尿症的负担。
