고혈압과 당뇨병, 비만이 없는 중년 남성에서의 인슐린저항성과 전립선 비대증과의 연관성
Association between Insulin Resistance and Benign Prostatic Hyperplasia in Healthy Middle-aged Korean Men
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연구배경: 고혈압과 당뇨병, 비만이 없는 중년 남성에서 인슐린저항성을 평가하는 도구인 homeostatic model assessmentinsulin resistance (HOMA-IR)를 이용하여 HOMA-I와 전립선 비대증과의 연관성을 확인하고자 하였다. 방법: 2011년 한 해 동안 일개 종합병원 종합건강검진센터를 내원하여 종합건강검진을 받은 40세 이상 59세 남성 대상자 중 설문지에 모두 대답하고 경직장 초음파를 시행 받은 4,907명 중 신체계측에 결측이 있는 자와 기타 관련 질환 및 약물 복용력이 있는 대상자를 제외하여 최종1,727명을 대상으로 연구를 진행하였다. 계산식을 이용하여HOMA-IR을 계산하였고, 3분위수로 나누어 HOMA-IR과전립선 비대증과의 연관성을 로지스틱 회귀분석방법을 이용하여 구명하였다. 결과: 전립선 비대증의 전체 유병률은 24.4% (1,727명 중421명)였다. HOMA-IR이 가장 낮은 군에 비해 HOMA-IR 의 높은 군에서 전립선 비대증과의 비차비가 증가하였고, 이러한 용량-반응 경향은 비보정 모델, 연령보정 모델에서유의하였다. 연령, 체질량지수, 중성지방, 고밀도 콜레스테롤, 저밀도 콜레스테롤, 음주, 흡연, 운동, 육류섭취 습관을보정한 다변량 보정의 모델에서도 HOMA-IR이 가장 낮은군에 비해 제2분위수에서 비차비가 1.76 (95% 신뢰구간, 1.31-2.35), 제3삼분위군에서 1.83 (95% 신뢰구간, 1.34-2.48) 으로 나왔다. 결론: 본 연구를 통하여 건강한 중년 남성에서 인슐린저항성과 전립선 비대증과의 연관성을 확인하였다. 인슐린저항성의 개선이 전립선 비대증에 예방 효과가 있을지에대해서는 추후 전향적 연구가 필요하다.
Abstract
Background: We examined the association between insulin resistance assessed by homeostatic model assessment- insulin resistance (HOMA-IR) and benign prostatic hyperplasia (BPH) in healthy middle-aged male subjects. Methods: A cross-sectional study included 1,727 male subjects, aged 40-59 year, free of medication history for BPH who received a transrectal ultrasonography and completed a structured questionnaire in 2011. Multiple logistic regression analysis was performed to evaluate the relationships of HOMA-IR with BPH across the tertile of HOMA-IR. Results: The prevalence of BPH was 24.4% (421 out of 1,727). It was increased across HOMA-IR tertiles in crude and age-adjusted models. In a multivariable-adjusted model after adjusting potential confounders such as age, body mass index (BMI), triglyceride, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), alcohol consumption, smoking, exercise and meat consumption, odds ratios (95% confidence intervals, CIs) of BPH for 2nd tertile and 3rd tertile compared to 1st tertile were 1.76 (1.31-2.35), and 1.83 (1.34-2.48), respectively. Conclusions: In middle-aged, healthy men, higher HOMA-IR was significantly associated with higher prevalence of BPH, supporting insulin resistance as an independent risk factor for BPH.
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