目的 观察前列腺增生患者血清脂代谢指标及脂肪因子水平变化，探讨其与病情严重程度的关系。方法 2022年3月-2023年7月张家口市第一医院诊治前列腺增生患者103例为增生组，其中国际前列腺症状评分0～19分者71例为轻中度组，20～35分者32例为重度组;健康体检男性50例为对照组。比较增生组与对照组、重度组与轻中度组体质量指数(BMI)及肥胖、高血压、糖尿病、吸烟、饮酒史等临床资料，血清脂代谢指标[三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白(apo)A、apoB]及脂肪因子(瘦素、抵抗素、脂联素、降脂蛋白、趋化素)水平。采用多因素logistic回归分析前列腺增生患者病情严重的影响因素。结果 增生组BMI[(24。78±2。63)kg/m2]及血清三酰甘油、总胆固醇、apoB、瘦素水平[(1。05±0。17)mmol/L、(3。95±0。51)mmol/L、(0。78±0。10)g/L、(12。86±3。03)μg/L]均高于对照组[(23。97±1。77)kg/m2、(0。95±0。17)mmol/L、(3。26±0。57)mmol/L、(0。71±0。12)g/L、(9。92±2。57)μg/L](P＜0。05)，apo A 水平[(1。26±0。31)g/L]低于对照组[(1。44±0。40)g/L](t=3。011，P=0。003)，肥胖、高血压、糖尿病、吸烟、饮酒比率及血清低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、抵抗素、脂联素、降脂蛋白、趋化素水平与对照组比较差异均无统计学意义(P＞0。05)。重度组BMI[(25。71±2。44)kg/m2]、肥胖比率(46。88％)、糖尿病比率(62。50％)及血清三酰甘油[(1。14±0。16)mmol/L]、总胆固醇[(4。11±0。60)mmol/L]、apoB[(0。85±0。10)g/L]、瘦素[(15。09±2。62)μg/L]水平均高于轻中度组[(24。36±2。62)kg/m2、25。35％、40。85％、(1。01±0。15)mmol/L、(3。88±0。45)mmol/L、(0。75±0。09)g/L、(11。85±2。66)μg/L](P＜0。05)，apoA[(1。13±0。37)g/L]、降脂蛋白[(0。64±0。28)ng/L]水平均低于轻中度组[(1。33±0。26)g/L、(0。88±0。22)ng/L](P＜0。05)，症状持续时间，高血压、吸烟、饮酒比率及血清低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、抵抗素、脂联素、趋化素水平与轻中度组比较差异均无统计学意义(P＞0。05)。血清 apoA(OR=0。023，95％CI:0。001～0。395，P=0。009)、瘦素(OR=1。697，95％CI:1。221～2。359，P=0。002)、降脂蛋白(OR=0。004，95％CI:0。001～0。120，P=0。002)是前列腺增生患者病情严重的影响因素。结论 前列腺增生患者血清瘦素水平升高，apoA、降脂蛋白水平降低提示病情严重。
Correlation of lipid metabolism indicators and adipokines with severity of prostatic hyperplasia
Objective To observe the changes of lipid metabolism indicators and adipokines in patients with prostatic hyperplasia(PH),and to investigate their correlations with the disease severity.Methods Totally 103 patients with PH were diagnosed and treated in the First Hospital of Zhangjiakou from March,2022 to July,2023,and were divided into 71 patients with International Prostate Symptom Score(IPSS)0-9(mild to moderate PH group)and 32 patients with IPSS 20-35(severe PH group),and another 50 healthy male volunteers receiving physical examination were as controls(control group).The clinical data[body mass index(BMI),obesity,hypertension,diabetes,smoking habits,alcohol consumptions],serum lipid metabolism indicators[triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),apolipoprotein(apo)A,apoB]and serum adipokines[leptin,resistin,adiponectin,adipsin,chemokine]were compared among three groups.Multivariate logistic regression analysis was done to evaluate the influencing factors of aggravation of PH.Results The BMI,TG,TC,apoB and leptin were higher in PH group[(24.78±2.63)kg/m2,(1.05±0.17)mmol/L,(3.95±0.51)mmol/L,(0.78±0.10)g/L,(12.86±3.03)μg/L]than those in control group[(23.97±1.77)kg/m2,(0.95±0.17)mmol/L,(3.26±0.57)mmol/L,(0.71±0.12)g/L,(9.92±2.57)μg/L](P＜0.05),the apoA level was lower in PH group[(1.26±0.31)g/L]than that in control group[(1.44±0.40)g/L](t=3.011,P=0.003),and there were no significant differences in the proportions of obesity,hypertension,diabetes,smoking habits and alcohol consumptions,and the levels of LDL-C,HDL-C,resistin,adiponectin,adipsin and chemokine between two groups(P＞0.05).The BMI,proportion of obesity,proportion of diabetes,and levels of TG,TC,apoB and leptin were higher in severe PH group[(25.71±2.44)kg/m2,46.88％,62.50％,(1.14±0.16)mmol/L,(4.11±0.60)mmol/L,(0.85±0.10)g/L,(15.09±2.62)μg/L]than those in mild to moderate PH group[(24.36±2.62)kg/m2,25.35％,40.85％,(1.01±0.15)mmol/L,(3.88±0.45)mmol/L,(0.75 士 0.09)g/L,(11.85±2.66)μg/L](P＜0.05),the apoA and adipsin levels were lower in severe PH group[(1.13±0.37)g/L,(0.64±0.28)ng/L]than those in mild to moderate PH group[(1.33±0.26)g/L,(0.88±0.22)ng/L](P＜0.05),and there were no significant differences in the duration of symptoms,proportions of hypertension,smoking habits and alcohol consumptions,and levels of LDL-C,HDL-C,resistin,adiponectin and chemokine between two groups(P＞0.05).The apoA(OR=0.023,95％CI:0.001-0.395,P=0.009),leptin(OR=1.697,95％CI:1.221-2.359,P=0.002)and adipsin(OR=0.004,95％CI:0.001-0.120,P=0.002)were the influencing factors of the aggravation of PH.Conclusion The leptin level increases and the levels of apoA and adipsin decrease in patients with PH,which indicates the aggravation of PH.
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