中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2010年
11期
896-898
,共3页
刘颖%屈晓冰%董莉妮%沈芳
劉穎%屈曉冰%董莉妮%瀋芳
류영%굴효빙%동리니%침방
前列腺增生%胰岛素抗体%胰岛素
前列腺增生%胰島素抗體%胰島素
전렬선증생%이도소항체%이도소
Prostatic hyperplasia%Insulin antibodies%Insulines
目的 观察胰岛素抵抗和空腹胰岛素(FINS)水平与老年良性前列腺增生(BPH)的关系. 方法 以2008年2月在湘雅二医院老年病科门诊就诊的BPH患者68例为观察对象,分析FINS、血清前列腺特异性抗原(PSA)、糖化血红蛋白、空腹血糖、餐后2 h血糖,计算胰岛素抵抗指数(HOMA-IR).测量血压、体质量、身高、腹围,计算体质指数.测定前列腺体积,评估下尿路症状(LUTS),并询问LUTS出现的时间. 结果 (1)按照HOMA-IR＞2.8为胰岛素抵抗,将患者分为敏感组48例和抗组20例,结果显示抵抗组患者的前列腺体积高于敏感组,分别为(61.1±32.9)ml和(40.4±16.5)ml,差异有统计学意义(P＜0.05);两组PSA分别为(3.3±2.3)μg/L与(2.9±1.3)μg/L,差异无统计学意义(P＞0.05);LUTS出现时间(13.4±6.6)年和(8.7±6.0)年,差异无统计学意义(P＞0.05);国际前列腺症状评分(IPSS)分别为(16.4±6.7)分和(13.3±7.1)分,差异无统计学意义(P＞0.05).(2)以前列腺症状药物治疗(MTOPS)研究的进展性评价指标为标准,将患者分为低进展组与高进展组,分别为30例和38例,两组FINS、HOMA-IR比较,差异有统计学意义(均P＜0.01).(3)前列腺体积与HOMA-IR、FINS呈正相关(r值分别为0.431和0.492,均P＜0.01).结论老年BPH患者存在胰岛素抵抗,胰岛素抵抗程度、高FINS水平与前列腺体积的增大及疾病进展有关.
目的 觀察胰島素牴抗和空腹胰島素(FINS)水平與老年良性前列腺增生(BPH)的關繫. 方法 以2008年2月在湘雅二醫院老年病科門診就診的BPH患者68例為觀察對象,分析FINS、血清前列腺特異性抗原(PSA)、糖化血紅蛋白、空腹血糖、餐後2 h血糖,計算胰島素牴抗指數(HOMA-IR).測量血壓、體質量、身高、腹圍,計算體質指數.測定前列腺體積,評估下尿路癥狀(LUTS),併詢問LUTS齣現的時間. 結果 (1)按照HOMA-IR＞2.8為胰島素牴抗,將患者分為敏感組48例和抗組20例,結果顯示牴抗組患者的前列腺體積高于敏感組,分彆為(61.1±32.9)ml和(40.4±16.5)ml,差異有統計學意義(P＜0.05);兩組PSA分彆為(3.3±2.3)μg/L與(2.9±1.3)μg/L,差異無統計學意義(P＞0.05);LUTS齣現時間(13.4±6.6)年和(8.7±6.0)年,差異無統計學意義(P＞0.05);國際前列腺癥狀評分(IPSS)分彆為(16.4±6.7)分和(13.3±7.1)分,差異無統計學意義(P＞0.05).(2)以前列腺癥狀藥物治療(MTOPS)研究的進展性評價指標為標準,將患者分為低進展組與高進展組,分彆為30例和38例,兩組FINS、HOMA-IR比較,差異有統計學意義(均P＜0.01).(3)前列腺體積與HOMA-IR、FINS呈正相關(r值分彆為0.431和0.492,均P＜0.01).結論老年BPH患者存在胰島素牴抗,胰島素牴抗程度、高FINS水平與前列腺體積的增大及疾病進展有關.
목적 관찰이도소저항화공복이도소(FINS)수평여노년량성전렬선증생(BPH)적관계. 방법 이2008년2월재상아이의원노년병과문진취진적BPH환자68례위관찰대상,분석FINS、혈청전렬선특이성항원(PSA)、당화혈홍단백、공복혈당、찬후2 h혈당,계산이도소저항지수(HOMA-IR).측량혈압、체질량、신고、복위,계산체질지수.측정전렬선체적,평고하뇨로증상(LUTS),병순문LUTS출현적시간. 결과 (1)안조HOMA-IR＞2.8위이도소저항,장환자분위민감조48례화항조20례,결과현시저항조환자적전렬선체적고우민감조,분별위(61.1±32.9)ml화(40.4±16.5)ml,차이유통계학의의(P＜0.05);량조PSA분별위(3.3±2.3)μg/L여(2.9±1.3)μg/L,차이무통계학의의(P＞0.05);LUTS출현시간(13.4±6.6)년화(8.7±6.0)년,차이무통계학의의(P＞0.05);국제전렬선증상평분(IPSS)분별위(16.4±6.7)분화(13.3±7.1)분,차이무통계학의의(P＞0.05).(2)이전렬선증상약물치료(MTOPS)연구적진전성평개지표위표준,장환자분위저진전조여고진전조,분별위30례화38례,량조FINS、HOMA-IR비교,차이유통계학의의(균P＜0.01).(3)전렬선체적여HOMA-IR、FINS정정상관(r치분별위0.431화0.492,균P＜0.01).결론노년BPH환자존재이도소저항,이도소저항정도、고FINS수평여전렬선체적적증대급질병진전유관.
Objective To explore the relationship between insulin resistance (IR) and benign prostatic hyperplasia (BPH) in elderly men. Methods All BPH outpatients in Geriatric department of the second Xiang Ya Hospital in Feb 2008 were recruited in this study. Bioche assays including insulin (FINS), prostate specific antigen (PSA), HbAlc, fasting plasma glucose, 2 hours postprandial blood glucose were performed and HOMA-IR were calculated. The blood pressure, body weight, height and waist circumference were measured, and the body mass index (BMI) was calculated. Prostate volume (PV) was measured by abdominal ultrasound, lower urinary tract symptoms (LUTS) was evaluated by International Prostate Symptom Score (IPSS) and inquired about the history of LUTS in detail. Results (1) HOMA-IR＞ 2.8 was diagnosed as insulin resistance (IR). The patients were divided into two groups: insulin sensitivity (IS) group (n=48) and IR group (n=20). The PV level was higher in IR group than in IS group [(61.1-32. 9) ml vs. (40.4±16.5)ml, P＜0. 05], there were no statistical differences in PSA [(3.3±2.3) μg/L vs. (2.91±1.3) μg/L, P＞0.05], the history of LUTS [(13.4±6.6)years vs. (8.7±6.0)years, P＞0.05], IPSS [(16.42±6.67)scores vs. (13. 29±7.09)scores, P＞0. 05] between the two groups. (2)According to BPH progressivity evaluation provided by MTOPS study (age≥62 years, PSA≥1. 6 μg/L, PV≥31 ml), the patients were divided into two groups: low progressive risk group (n= 30) and high progressive risk group (n= 38). The FINS and HOMA-IR levels were significantly higher in highprogressive risk group than in low progressive risk group (all P＜0. 01). (3)The PV was positively correlated with HOMA-IR level and FINS level (r= 0. 431, 0. 492, P＜0. 01). Conclusions IR exists in majority of elderly BPH patients, the degree of IR and relative high level of FINS are related to the enlargement of PV and the development of BPH.
