胰岛素抵抗对良性前列腺增生患者前列腺生长影响的初步研究

目的初步探讨胰岛素抵抗对前列腺体积增长速度的影响。方法对139例良性前列腺增生住院患者进行病史回顾,记录血压、身高、体重、空腹血糖、空腹胰岛素、高密度脂蛋白、甘油三酯、前列腺特异性抗原等测量结果,通过B超测量的前列腺三径长度计算得前列腺体积及其增长速度。将研究对象按有无胰岛素抵抗、有无代谢综合征和血胰岛素水平的高低分别分组并进行比较,采用t检验、方差分析等进行统计分析。结果胰岛素抵抗组患者的前列腺体积增长速度、空腹血糖和空腹胰岛素较非胰岛素抵抗组高,其中前列腺体积增长速度增高0.29 mL/年（P〈0.05）。而年龄、体重指数、收缩压、舒张压、甘油三酯、高密度脂蛋白、前列腺体积以及前列腺特异性抗原等两组无显著差异。代谢综合征组的前列腺体积增长速度与非代谢综合征组相比无显著差异。血胰岛素水平较高（空腹胰岛素〉4.22 mmol/L）的患者,其前列腺体积增长速度更快。结论胰岛素抵抗患者的前列腺体积增长速度较非胰岛素抵抗患者更快,提示胰岛素抵抗可能是导致良性前列腺增生的病因之一。因此,改变生活、饮食方式以及应用药物治疗胰岛素抵抗可能起到预防良性前列腺增生的作用,但尚需进一步研究证实。

A preliminary study of the impact of insulin resistance on the growth of the prostate in patients with benign prostatic hyperplasia

Objective To investigate the impact of insulin resistance on the prostate growth rate in patients with benign prostatic hyperplasia（BPH）.Methods There were 139 BPH patients included in this preliminary study.The blood pressure,body weight and height were measured.Biochemical analyses including serum glucose,insulin,triglycerides,high-density lipoprotein cholesterol（HDL-C） and prostate-specific antigen（PSA） were performed.The prostate volume was measured by transrectal ultrasound and then annual prostatic growth rate was calculated.The patients were divided into two groups according to whether they were diagnosised to have insulin resistance.They were also divided into different groups in terms of metabolic syndrome and hyperinsulinemia,respectively.The data were analyzed by t test and analysis of variance.Results BPH patients with insulin resistance had significantly higher serum glucose,inlulin and annual prostate growth rate compared with those without insulin resistance.The median annual prostate growth rate was 0.29mL/year（P0.05）.However,age,body mass index,systolic pressure,diastolic pressure,triglyceride,HDL-C,prostate volume and PSA levels had no significant difference between these two groups.Moreover,those with a higher serum insunlin level（serum insunlin 4.22mmol/L） had a higher prostate growth rate.In contrast,there was no significant difference in prostate growth rate between the patients with or without metabolic syndrome.Conclusions The present study demonstrates a further increase of prostate volume in BPH patients with insulin resistance.Thus,insulin resistance may contribute to development of BPH.It seems that BPH could be prevented by change of life style and medication for insulin resistance.Future studies are needed to confirm our results and to explain underlying mechanisms.