Body size and serum levels of insulin and leptin in relation to the risk of benign prostatic hyperplasia
Body size and serum levels of insulin and leptin in relation to the risk of benign prostatic hyperplasia
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DOI：
10.1016/s0022-5347(05)64687-3
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发表时间：
2002-08-01
影响因子：
6.6
通讯作者：
Hsing, AW
中科院分区：
文献类型：
--
作者：
Dahle, SE;Chokkalingam, AP;Hsing, AW
目的：由于肥胖对代谢和内分泌的影响，肥胖与良性和恶性前列腺增生的病因有关。因为肥胖是血清胰岛素和瘦素水平的重要决定因素（肥胖基因Ob的产物），我们研究肥胖和血清胰岛素和瘦素水平在良性前列腺增生（BPH）病因中的作用。材料和方法：空腹血清胰岛素和瘦素水平以及身体质量指数（衡量整体肥胖的指标）和腰臀比（腹部肥胖的指标），在200名新诊断的BPH住院手术的男性和302名随机选择的健康男性受试者从上海，China.Results：较高的腰臀比和较高的血清胰岛素与BPH的风险增加显着相关。相对于腰臀比最低四分位数（小于0.856）的男性，腰臀比最高四分位数（大于0.923）的男性风险为2.4倍（比值比2.42，95%置信区间[CI] 1.34至4.37，趋势检验p = 0.01）。同样相对于男性在最低四分位数的胰岛素（小于5.87 muU。每毫升）最高四分位数的那些（大于9.76 μ U）。每毫升）风险显著增加（比值比2.47，95% CI 1.35至4.54，趋势检验p = 0.009）。胰岛素对BPH风险的影响在腰臀比低和中三分位数的男性中更为明显（高胰岛素三分位数与低胰岛素三分位数的比值比分别为2.8和2.7），而在腰臀比最高的男性中，胰岛素与BPH风险无显著相关性。与此相反，我们没有发现比较瘦素最高和最低四分位数的显著优势比，（比值比0.62，95% CI 0.33 - 1.17）或体重指数（比值比1.64，95% CI 0.96至2.81）。我们的研究结果表明，腹部肥胖和血清胰岛素增加，可能是整体肥胖而不是血清瘦素与BPH的高风险相关。需要进一步的前瞻性和实验室研究来证实这些结果并阐明潜在的机制。
Purpose: Obesity has been implicated in the etiology of benign and malignant prostatic growth due to its influence on metabolic and endocrine changes. Because obesity is an important determinant of serum levels of insulin and leptin (the product of the obesity gene Ob), we investigated the role of obesity and serum levels of insulin and leptin in benign prostatic hyperplasia (BPH) etiology.Materials and Methods: Fasting serum levels of insulin and leptin as well as the body mass index, a measure of overall obesity, and waist-to-hip ratio, an indicator of abdominal obesity, were determined in 200 men newly diagnosed with BPH who were hospitalized for surgery and in 302 randomly selected healthy male subjects from the population in Shanghai, China.Results: A higher waist-to-hip ratio and higher serum insulin were significantly associated with an increased risk of BPH. Relative to men in the lowest waist-to-hip ratio quartile (less than 0.856) those in the highest quartile (greater than 0.923) were at 2.4-fold risk (odds ratio 2.42, 95% confidence interval [CI] 1.34 to 4.37, test for trend p = 0.01). Similarly relative to men in the lowest quartile of insulin (less than 5.87 muU. per ml.) those in the highest quartile (greater than 9.76 muU. per ml.) were at significantly increased risk (odds ratio 2.47, 95% CI 1.35 to 4.54, test for trend p = 0.009). The effect of insulin on BPH risk was more pronounced in men in low and middle tertiles of the waist-to-hip ratio (odds ratios comparing high to low insulin tertiles 2.8 and 2.7, respectively), while among men in the highest waist-to-hip ratio tertile insulin was not significantly associated with BPH risk. In contrast, we found no significant odds ratio comparing the highest to lowest quartiles of leptin (odds ratio 0.62, 95% CI 0.33 to 1.17) or body mass index (odds ratio 1.64, 95% CI 0.96 to 2.81).Conclusions: Our results suggest that abdominal obesity and increasing serum insulin, and possibly overall obesity but not serum leptin are associated with a higher risk of BPH. Further prospective and laboratory studies are needed to confirm these results and elucidate the underlying mechanisms.