건강검진자에서 전립선 크기와 대사인자 및 Prostate-Specific Antigen과의 관계
Association of Metabolic Factors and Prostate-Specific Antigen Levels with Prostate Volume in Medical Check-ups
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
배경: 전립선비대증으로 진행하는 데는 전립선 크기가 관련이 있다. 전립선비대증과 대사증후군의 연관성에 대한 연구들이 보고 되고 있으나, 일치된 의견은 없다. 그러므로 본 연구에서는 전립선 크기가 정상인 경우에서 전립선 크기와 대사인자 및 PSA와의 연관성과, 전립선 증대의 경우 이와 관련이 있는 인자들을 알아보고자 하였다. 방법: 건강검진을 목적으로 전립선초음파검사를 받은, PSA<4 ng/mL인 40세 이상 남성 3,915명을 대상으로 하였고, 전립선 크기가 30 mL 미만인 경우(3,467명)와 30 mL 이상인 전립선증대의 경우(448명)로 구분하였다. 전립선 크기가 정상인 사람들에서 전립선 크기와 PSA 및 대사인자와의 연관성을 밝히기 위해 다중회귀분석을, 전립선증대와 PSA 및 대사인자와의 연관성을 밝히기 위해 로지스틱 회귀분석을 하였다. 결과: 전립선 크기와 관련 있는 인자는 PSA, 연령, 허리둘레였다. 전립선증대와 관련된 인자는 연령, 체질량지수, PSA였다. 연령과 대사인자들의 교란 효과를 통제하였을 때, 체질량지수가 23 kg/m2 미만에 비해 23-24.9 kg/m2인 경우에서는 1.580배(95% 신뢰구간; 1.171-2.131) (P=0.003), 체질량지수 25-29.9 kg/m2에서는 1.767배(95% 신뢰구간; 1.332-2.344) (P<0.001), 체질량지수 30 kg/m2 이상에서는 2.024배(95% 신뢰구간; 1.042-3.933) (P=0.038)의 전립선증대의 가능성이 더 높았다. 결론: 전립선 크기가 정상인 경우에서 전립선 크기와 관련된 대사인자는 복부비만이었고, 전립선증대와 관련 있는 대사인자는 비만이었다. PSA치 증가가 전립선 크기 증가와 연관이 있었다.
Abstract
Background: Baseline prostate volume (PV) is related with the progression of benign prostatic hyperplasia (BPH). Although recent studies have reported the relationship between BPH and metabolic syndrome, the findings are inconsistent. Thus, this study was performed to investigate the association of PV with metabolic factors and prostate-specific antigen (PSA) in individuals with normal PV and clarify the factors associated with benign prostate enlargement (BPE), including PSA. Methods: We selected 3,915 health examinees aged >40 yr with a PSA level <4 ng/mL who underwent ultrasonography of the prostate as part of a routine health check-up. These individuals were classified into two groups according to PV: normal PV (PV <30 mL) and BPE (PV ≥30 mL). We investigated the association of PV with metabolic factors and PSA using multiple linear regression analysis, and clarified the factors associated with BPE using logistic regression analysis. Results: The factors associated with PV were PSA, age, and waist circumference in individuals with normal PV. The factors associated with BPE were age, body mass index (BMI), and PSA. The logistic regression analysis adjusted for age and confounding factors showed that individuals with a BMI of 23-24.9 kg/m2, 25-29.9 kg/m2, and ≥30 kg/m2 had higher odds ratios of 1.580 (95% confidence interval, 1.171-2.131; P=0.003), 1.767 (1.332-2.344; P<0.001), and 2.024 (1.042-3.933; P=0.038), respectively, for BPE than individual with a BMI <23 kg/m2. Conclusions: Abdominal obesity was significantly associated with PV in individuals with normal PV, whereas obesity was an associated metabolic factor of BPE. PSA level was positively associated with PV.
참고문헌 (30)
- Berry SJ, "The development of human benign prostatic hyperplasia with age", J Urol, 132, pp.474~479 (1984)
- Emberton M, "Benign prostatic hyperplasia : A progressive disease of aging men", Urology, 61, pp.267~273 (2003)
- Marberger MJ, "Prostate volume and serum prostate-specific antigen as predictors of acute urinary retention", Eur Urol, 38, pp.563~568 (2000)
- Lieber MM, "Prostate volume and prostate-specific antigen in the absence prostate cancer : a review of the relationship and prediction of long-term outcomes", Prostate, 49, pp.208~212 (2001)
- Lee C, "Etiology of benign prostatic hyperplasia", Urol Clin North Am, 22, pp.237~246 (1995)
- Yeon Won Park, "Relationship between Lower Urinary Tract Symptoms", Benign Prostatic Hyperplasia and Metabolic Syndrome in Korean Men, 2012, pp.30(3), 183~188[DOI]
- Kwon H, "Relationship between predictors of the risk of clinical progression of benign prostatic hyperplasia and metabolic syndrome in men with moderate to severe lower urinary tract symptoms", Urology, 81, pp.1325~1329 (2013)
- Gupta A, "Anthropometric and metabolic factors and risk of benign prostatic hyperplasia : a prospective cohort study of Air Force veterans", Urology, 68, pp.1198~1205 (2006)
- Hammarsten J, "Hyperinsulinaemia as a risk factor for developing benign prostatic hyperplasia", Eur Urol, 39, pp.151~158 (2001)
- Polascik TJ, "Prostate specific antigen : a decade of discovery-what we have learned and where we are going", J Urol, 162, pp.293~306 (1999)
- Schröder FH, "Screening and prostate-cancer mortality in a randomized European study", N Engl J Med, 360, pp.1320~1328 (2009)
- Collins GN, "Relationship between prostate specific antigen, prostate volume and age in the benign prostate", Br J Urol, 71, pp.445~450 (1993)
- Roehrborn CG, "Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia. PROSCAR long-term efficacy and safety study", J Urol, 163, pp.13~20 (2000)
- Mochtar CA, "Prostate-specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia", Eur Urol, 44, pp.695~700 (2003)
- Baillargeon J, "The association of body mass index and prostate-specific antigen in a population-based study", Cancer, 103, pp.1092~1095 (2005)
- Han JH, "Relationship between serum prostate-specific antigen levels and components of metabolic syndrome in healthy men", Urology, 72, pp.749~754 (2008)
- Bosch JL, "Natural history of benign prostatic hyperplasia: appropriate case definition and estimation of its prevalence in the community", Urology, 46(S1), pp.34~40 (1995)
- Aarnink RG, "Formula-derived prostate volume determination", Eur Urol, 29, pp.399~402 (1996)
- Hyun Keun Byun, "Relationships between Prostate-Specific Antigen, Prostate Volume, and Components of Metabolic Syndrome in Healthy Korean Men", Investigative and Clinical Urology, 53(11), pp.774~778 (2012), 대한비뇨기과학회
- Giovannucci E, "Obesity and benign prostatic hyperplasia", Am J Epidemiol, 140, pp.989~1002 (1994)
- Becker S, "Obesity related hyperinsulinaemia and hyperglycemia and cancer development", Arch Physiol Biochem, 115, pp.86~96 (2009)
- Pasquali R, "Effect of obesity and body fat distribution on sex hormones and insulin in men", Metabolism, 40, pp.101~104 (1991)
- Giovannucci E, "Obesity and benign prostatic hyperplasia", Am J Epidemiol, 140, pp.989~1002 (1994)
- Parsons JK, "Obesity and benign prostatic hyperplasia: Clinical connections, emerging etiological paradigms and future directions", J Urol, 189(S1), pp.S102~S106 (2013)
- Greene KL, "Prostate specific antigen best practice statement: 2009 update", J Urol, 189(S1), pp.S2~S11 (2013)
- Jeong IG, "The association of metabolic syndrome and its components with serum prostate-specific antigen levels in a Korean-screened population", Cancer Epidemiol Biomarkers Prev, 19, pp.371~380 (2010)
- Werny DM, "Obesity is negatively associated with prostate-specific antigen in U.S. men, 2001-2004", Cancer Epidemiol Biomarkers Prev, 16, pp.70~76 (2007)
- Bohnen AM, "Serum prostate-specific antigen as a predictor of prostate volume in the community : The Krimpen study", Eur Urology, 51, pp.1645~1652 (2007)
- Mäkinen JI, "Endogenous testosterone and serum lipids in middle-aged men", Atherosclerosis, 197, pp.688~693 (2008)
- Bataille V, "Sex hormone-binding globulin is a major determinant of the lipid profile : the PRIME study", Atherosclerosis, 179, pp.369~373 (2005)