中年2型糖尿病患者合并前列腺增生的影响因素分析

发布时间：2018-05-31 00:20

  本文选题：2型糖尿病 + 男性　； 参考：《郑州大学》2017年硕士论文

【摘要】：背景前列腺增生是中老年男性常见病,严重的前列腺增生会引起男性尿频、尿急、尿不适等多种症状,降低其生活质量。有研究认为,2型糖尿病男性前列腺体积增大风险约为非糖尿病男性的2倍。然而,关于2型糖尿病与男性前列腺之间的关系目前说法不一。并且,2型糖尿病患者性激素与前列腺之间的关系的研究较少。目的分析中年男性2型糖尿病(type 2 diabetes,T2DM)患者合并前列腺增生(benign prostatic hyperplasia,BPH)的影响因素,为临床疾病防治提供依据。方法收集2015年10月至2016年10月郑州大学第一附属医院内分泌科住院T2DM男性患者100例,年龄40-60岁,平均年龄(49.21±5.73)岁,均符合1999年WHO糖尿病诊断标准。由超声医师行经腹超声检查,测量所有研究对象前列腺纵径(a)、横径(b)和前后径(c),通过公式计算前列腺体积(PV)=a(cm)×b(cm)×c(cm)×0.52,超过12.5 mL即为BPH。根据前列腺是否增生将患者分为T2DM无BPH组和T2DM合并BPH组。测定卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、总睾酮(TT)、泌乳素(PRL)、性激素结合球蛋白(SHBG)、血总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹C肽(FCP)。用空腹C肽代替空腹胰岛素评价胰岛素抵抗[Homa-IR(CP)]=1.5+空腹血糖(mmol/L)×空腹C肽(pmol/L)/2800,胰岛β细胞功能[HOMA-islet(CP)]=0.27×空腹C肽(pmol/L)/[空腹血糖(mmol/L)-3.5]。根据Vermeulen公式计算游离睾酮(FT)=(TT-23.43FT)/[SHBG-(TT-23.43FT)]×10-9mol/L,其中TT、FT、SHBG单位为nmol/L。应用SPSS17.0软件进行统计学分析,计量资料以x_±s表示,首先进行正态检验,两组间比较采用t检验;对前列腺增生的危险因素进行logistic回归分析。P0.05为差异有统计学意义。结果(1)两组间一般资料及糖脂代谢指标的比较:与T2DM无BPH组比较,T2DM合并BPH组的年龄较大[(50.33±4.46对47.53±6.94)岁,P0.05],HbA1c、HOMA-IR(CP)较高[(8.91±1.98对7.95±1.17)%,(3.26±0.82对2.86±0.61),均P0.05];而HOMA-islet(CP)、TC、LDL-C、TG、HDL-C及BMI在两组差异均无统计学意义(P0.05)。(2)两组间性激素指标的比较:与T2DM无BPH组比较,T2DM合并BPH组的TT、FT较低[(13.92±5.43对17.15±7.63)nmol/L,(0.31±0.12对0.40±0.16)nmol/L,P0.05],E2/FT较高[(106.55±58.22对72.52±33.82),P0.05];FSH、LH、E2、PRL呈升高趋势[(28.60±9.08对27.23±8.00)mIU/ml,(5.78±3.17对5.61±2.72)mIU/ml,(5.21±2.20对4.82±2.20)pg/ml,(15.61±9.92对15.31±8.25)ng/ml],但是差异无统计学意义(P0.05)。(3)以有无BPH为因变量,进行二分类logistic回归分析结果显示:年龄、FT、HbA1c、HOMA-IR(CP)是BPH的危险因素。结论增龄、FT降低、E2/FT升高、高血糖及胰岛素抵抗均可能促进中年男性T2DM患者BPH的发生发展。
[Abstract]:Background benign prostatic hyperplasia (BPH) is a common disease in middle-aged and aged men. Studies have suggested that men with type 2 diabetes are about twice as likely as non-diabetic men to increase their prostate volume. However, the relationship between type 2 diabetes and men's prostate is currently at odds. And the relationship between sex hormones and prostate in type 2 diabetes is less studied. Objective to analyze the influencing factors of benign prostatic hyperplasia (BPH) in middle-aged male patients with type 2 diabetes mellitus (T2DM) and to provide evidence for the prevention and treatment of clinical diseases. Methods from October 2015 to October 2016, 100 male patients with T2DM in Department of Endocrinology, first affiliated Hospital of Zhengzhou University, aged 40-60 years, with an average age of 49.21 卤5.73 years, were collected. All of them met the diagnostic criteria of WHO diabetes mellitus in 1999. Transabdominal ultrasound examination was performed to measure the longitudinal and transverse diameter of prostate and the anterior and posterior diameter of prostatic gland in all subjects studied. The volume of prostate was calculated by formula (PVN) 脳 BU (cm) 脳 cu (cm) 脳 0.52and more than 12.5 mL was BPH. Patients with benign prostatic hyperplasia were divided into T2DM without BPH group and T2DM with BPH group. Determination of follicle stimulating hormone (FSH), luteinizing hormone (LHN), estradiol (E 2), total testosterone (TTT), prolactin (PRL), sex hormone binding globulin (SHBG), serum total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), high density lipoprotein cholesterol (HDL-CU), fasting blood glucose (FG). FBGG, HbA1C, fasting C-peptide, FCPC. Using fasting C-peptide instead of fasting insulin to evaluate insulin resistance (Homa-IRN CPV) 1.5 fasting glucose mmol-L) 脳 fasting C-peptide pmol-L / L / 2800, islet 尾 cell function [HOMA-isletCPN] 0.27 脳 fasting C-peptide pmol-L / L / [fasting glucose mmol-L ~ (-1) -3.5]. The free testosterone FTT-23.43 FTT / [SHBG-TT-23.43 FTT] 脳 10 ~ (-9) mol / L was calculated according to the Vermeulen formula. The statistical analysis was carried out by SPSS17.0 software. The measurement data were expressed as x _ 卤s. First, the normal test was performed. T test was used to compare the two groups. The logistic regression analysis was used to analyze the risk factors of prostatic hyperplasia. There was significant difference between the two groups. Results 1) comparison of general data and glucose and lipid metabolism indexes between the two groups: compared with T2DM without BPH group, the age of T2DM combined with BPH group was older [50.33 卤4.46 vs 47.53 卤6.94 years old] HbA1cHoma IRCPP was higher [8.91 卤1.98 vs 7.95 卤1.17 + 0.26 卤0.82 vs 2.86 卤0.61, P 0.05], while HOMA-islet BPH group had no significant difference in TLDL-CG-HDL-C and BMI between the two groups. 缁勯棿鎬ф縺绱犳寚鏍囩殑姣旇緝:涓嶵2DM鏃燘PH缁勬瘮杈，

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