INFLUENCE OF AGE AND ENDOCRINE FACTORS ON THE VOLUME OF BENIGN PROSTATIC HYPERPLASIA
INFLUENCE OF AGE AND ENDOCRINE FACTORS ON THE VOLUME OF BENIGN PROSTATIC HYPERPLASIA
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DOI：
10.1016/s0022-5347(17)38353-2
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发表时间：
1991-02-01
影响因子：
6.6
通讯作者：
WALSH, PC
中科院分区：
文献类型：
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作者：
PARTIN, AW;OESTERLING, JE;WALSH, PC
为探讨内分泌因素对良性前列腺增生症(BPH)体积的影响，测定了42~71岁男性低体积前列腺癌患者血清中23种激素水平，并与其前列腺癌根治术标本中良性增生性组织的体积进行了相关分析。随着年龄的增长，前列腺增生症的体积明显增加。血清游离睾酮、雄烯二酮、脱氢表雄酮、脱氢表雄酮、硫酸脱氢表雄酮、β-5-雄烯二醇和17-羟孕烯醇酮水平随增龄而显著降低，性激素结合球蛋白、黄体生成素和卵泡刺激素水平显著升高。在对BPH体积和激素水平进行年龄校正后，BPH体积与游离睾酮、雌二醇和雌三醇呈正相关。这些数据表明，随着年龄的增长，BPH体积较大的患者血清雄激素和雌激素水平较高，提示血清雄激素和雌激素水平可能是BPH随年龄增长而持续刺激的因素。如果是这样的话，降低血浆睾酮水平、降低雌激素水平或通过其他机制阻断雄激素刺激的治疗尝试可能会干扰BPH随年龄的发展。相反，雄激素的产生随着年龄的增长逐渐下降的事实可以解释为什么只有20%到30%的活到80岁的男性需要治疗BPH引起的尿路梗阻。
To determine whether endocrine factors influence the volume of benign prostatic hyperplasia (BPH), 23 hormonal factors were measured in the serum of 64 men ages 42 to 71 years with low volume prostatic cancer and these levels were correlated with the volume of benign hyperplastic tissue in their radical prostatectomy specimens. With age there was a significant increase in the volume of BPH. Also with age there was a significant decrease in the serum levels of free testosterone, androstenedione, dehydroepiandronsterone (DHA), dehydroepiandronsterone sulphate (DHA-S), DELTA-5-androstenediol, and 17-hydroxypregnenolone, and a significant increase in sex hormone-binding globulin (SHBG), LH, and FSH. When BPH volume and hormone levels were corrected for age, BPH volume correlated positively with free testosterone, estradiol, and estriol.These data indicate that with age patients with larger volumes of BPH have higher serum androgen and estrogen levels suggesting that serum androgen and estrogen levels may be factors in the persistent stimulation of BPH with age. If so, therapeutic attempts at lowering plasma testosterone levels, reducing estrogen levels, or blocking androgenic stimulation through other mechanisms may interfere with the progression of BPH with age. Conversely, the fact that androgen production declines gradually with age may explain the observation that only 20 to 30% of men who live to age 80 require treatment of urinary obstruction from BPH.