Platz E A, Kawachi I, Rimm E B, Colditz G A, Stampfer M J, Willett W C, Giovannucci E
Department of Epidemiology, Harvard School of Public Health, Boston, Mass 02115, USA.
Arch Intern Med. 1998 Nov 23;158(21):2349-56. doi: 10.1001/archinte.158.21.2349.
Benign prostatic hyperplasia (BPH) leading to prostatic enlargement and lower urinary tract symptoms is highly prevalent among older men. Sympathetic nervous system activity, which is decreased by physical activity, is associated with increased prostatic smooth-muscle tone and prostatic symptoms. Therefore, we assessed whether physical activity leads to fewer lower urinary tract symptoms in the Health Professionals Follow-up Study.
We observed men who were aged 40 to 75 years at baseline in 1986 for subsequent incidence of surgery for BPH. The men were free of diagnosed cancer, including prostate cancer at baseline and during follow-up, had not had a radical prostatectomy, and provided data on physical activity. Cases were men who under-went BPH surgery between 1986 and 1994 (n = 1890) or, among those who did not have surgery, who scored 15 or more points of 35 (n = 1853) on 7 questions about lower urinary tract symptoms modified from the American Urological Association Symptom Index. Noncases were men who scored 7 points or less (n = 21745). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from multiple logistic regression models.
After controlling for age, race or ethnicity, alcohol consumption, and smoking, physical activity was inversely related with total BPH (extreme quintiles: OR, 0.75; 95% CI, 0.67-0.85; P for trend, <.001), surgery for BPH (OR, 0.76; 95% CI, 0.64-0.90; P for trend, <.001), and symptomatic BPH (OR, 0.75; 95% CI, 0.64-0.87; P for trend, <.001). Walking, the most prevalent activity, was inversely related to BPH risk; men who walked 2 to 3 h/wk had a 25% lower risk of total BPH.
Our results indicate that more physically active men have a lower frequency of lower urinary tract symptoms.
良性前列腺增生（BPH）导致前列腺肿大和下尿路症状，在老年男性中极为普遍。身体活动会降低交感神经系统活性，而交感神经系统活性与前列腺平滑肌张力增加及前列腺症状相关。因此，我们在健康专业人员随访研究中评估了身体活动是否会减少下尿路症状。
我们观察了1986年基线年龄在40至75岁的男性，以了解其后续BPH手术的发生率。这些男性在基线和随访期间均未被诊断患有癌症，包括前列腺癌，未接受过根治性前列腺切除术，并提供了身体活动数据。病例为1986年至1994年间接受BPH手术的男性（n = 1890），或在未接受手术的男性中，根据从美国泌尿外科学会症状指数修改而来的7个关于下尿路症状的问题，得分在35分中达到15分或更高的男性（n = 1853）。非病例为得分7分或更低的男性（n = 21745）。通过多元逻辑回归模型计算比值比（OR）和95%置信区间（CI）。
在控制年龄、种族或族裔、饮酒和吸烟因素后，身体活动与总体BPH呈负相关（极端五分位数：OR，0.75；95% CI，0.67 - 0.85；趋势P值，<.001），与BPH手术呈负相关（OR，0.76；95% CI，0.64 - 0.90；趋势P值，<.001），与有症状的BPH呈负相关（OR，0.75；95% CI，0.64 - 0.87；趋势P值，<.001）。步行是最常见的活动，与BPH风险呈负相关；每周步行2至3小时的男性患总体BPH的风险降低25%。
我们的结果表明，身体活动较多的男性下尿路症状的发生频率较低。
