ENERGY BALANCE AND RISK OF BPH-RELATED OUTCOMES AND LUTS: A PROSPECTIVE STUDY

能量平衡以及 BPH 相关结果和 LUTS 的风险：一项前瞻性研究

• 批准号: 8189741
• 负责人: Siobhan Sutcliffe
• 金额: $ 22.8万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8189741
• 关键词: Acute; Address; Adult; Age; Benign; Benign Prostatic Hypertrophy; Body Size; Body Weight decreased; Body mass index; Cessation of life; Colorectal Cancer; Data Analyses; Data Collection; Development; Elderly; Etiology; Fatty acid glycerol esters; Health; Hip region structure; Histologic; Hyperplasia; Incidence; Intervention; Investigation; Joints; Knowledge; Life; Maintenance; Malignant neoplasm of lung; Malignant neoplasm of prostate; Measures; Nature; Nodule; Obesity; Outcome; Overweight; Physical activity; Prevention strategy; Preventive; Preventive Intervention; Primary Prevention; Prospective Studies; Prostate; Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial; Public Health; Quality of life; Questionnaires; Reporting; Research; Risk; Risk Factors; Screening for Ovarian Cancer; Stress; Time; Treatment Cost; Urinary Retention; Weight; Weight Gain; aged; base; common treatment; cost; energy balance; health economics; innovation; lower urinary tract symptoms; man; men; modifiable risk; novel; older men; prospective; symptom management

DESCRIPTION (provided by applicant): Benign prostatic hyperplasia (BPH) is a benign prostate condition characterized histologically by hyperplastic nodules in the periurethral region and transition zone of the prostate, and clinically by an enlarged prostate and lower urinary tract symptoms (LUTS). BPH-related outcomes and LUTS, which we refer to as BPH/LUTS, are extremely common among older men, leading to considerable bother and decreased quality of life, as well as severe complications, such as acute urinary retention and, in the most severe cases, death. Costs associated with management and treatment of this common condition are tremendous. In the year 2000 alone, BPH/LUTS management and treatment cost over $1.1 billion in the U.S. Therefore, given the considerable costs and negative impact of BPH/LUTS on older men's quality of life, identification of modifiable risk factors for BPH/LUTS development and their timing of action is crucial to inform effective primary prevention strategies. Energy balance, measured as body size and physical activity (PA), shows promise as a modifiable cause of BPH/LUTS. Several studies of later-life body size and PA have observed positive associations for body size, and inverse associations for PA with BPH/ LUTS, suggesting that energy balance may contribute to BPH/LUTS. However, most of these studies were limited to prevalent BPH/LUTS, making their findings susceptible to reverse causation and recall bias. Very few studies have investigated body size and/or PA in relation to incident BPH/LUTS and, of these few studies, most have observed null associations, drawing into question prevalent findings. Other unanswered questions include the possible timing of influence of body size and PA on BPH/LUTS development and the joint influence of these two factors. Therefore, to address these important research gaps, we propose to investigate body size and PA at baseline, as well as earlier in life, across adulthood, and jointly in relation to incident BPH/LUTS in the large Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. The proposed analyses are innovative because they will be one of only a few studies to investigate body size and PA in relation to incident BPH/LUTS; one of only a few to examine body size and PA earlier in life and across adulthood in relation to BPH/LUTS, and the first, to our knowledge, to investigate the joint influence of body size and PA on BPH/LUTS risk. The proposed analyses are significant because they hold the promise to inform novel, effective and tailored primary prevention strategies for BPH/LUTS development, including both the nature of possible interventions, e.g., whether PA maintenance or body size reduction is more important to stress in a "fat and fit" man; as well as the necessary timing of interventions, i.e., whether body size reduction and/or increase in PA need to be stressed earlier in life, or whether changes in body size and PA later in life may still reduce BPH/LUTS risk. Novel prevention strategies for BPH/LUTS are critical to reduce the incidence of this extremely common and bothersome condition, and ease its substantial economic and health burden. PUBLIC HEALTH RELEVANCE: The proposed secondary data analyses are relevant to public health because they will determine whether large body size (e.g., overweight and obesity) and lesser physical activity contribute to the development of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) in middle- and older-aged men. If our findings are promising, these could guide the development of novel, effective, and tailored primary prevention strategies for BPH/LUTS based on reduction or maintenance of body size and increase or maintenance of physical activity in men. Novel primary prevention strategies for BPH/LUTS are crucial to reduce the incidence of this extremely common and bothersome condition, and ease its tremendous financial and health toll.

描述（由申请人提供）：良性前列腺增生（BPH）是一种良性前列腺疾病，其组织学特征为前列腺尿道周围区域和移行带的增生性结节，临床特征为前列腺肥大和下尿路症状（LUTS）。BPH相关的结果和LUTS，我们称之为BPH/LUTS，在老年男性中非常常见，导致相当大的麻烦和生活质量下降，以及严重的并发症，如急性尿潴留，在最严重的情况下，死亡。与这种常见疾病的管理和治疗相关的成本是巨大的。仅在2000年，BPH/LUTS管理和治疗费用超过11亿美元，在美国。因此，考虑到BPH/LUTS对老年男性生活质量的巨大成本和负面影响，识别BPH/LUTS发展的可改变风险因素及其行动时机对于有效的初级预防策略至关重要。能量平衡，测量身体大小和体力活动（PA），显示出作为BPH/LUTS的可改变原因的希望。一些关于晚年体型和PA的研究观察到体型的正相关性，以及PA与BPH/ LUTS的负相关性，表明能量平衡可能有助于BPH/LUTS。然而，这些研究中的大多数仅限于流行的BPH/LUTS，使他们的研究结果容易受到反向因果关系和回忆偏差的影响。很少有研究调查了身体大小和/或PA与BPH/LUTS事件的关系，在这几项研究中，大多数观察到无效关联，对普遍的发现提出了质疑。其他未回答的问题包括身体大小和PA对BPH/LUTS发展的影响的可能时间以及这两个因素的联合影响。因此，为了解决这些重要的研究空白，我们建议在大型前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验中研究基线时以及生命早期、成年期的体型和PA，并联合研究其与BPH/LUTS事件的关系。拟议的分析是创新的，因为它们将是仅有的几项研究之一，以调查身体大小和PA与事件BPH/LUTS;仅有的几项研究之一，以检查身体大小和PA在生命早期和整个成年期与BPH/LUTS的关系，以及第一个，据我们所知，调查身体大小和PA对BPH/LUTS风险的联合影响。拟议的分析是重要的，因为它们有望为BPH/LUTS发展提供新颖，有效和量身定制的一级预防策略，包括可能的干预措施的性质，例如，PA维持还是体型减小对“肥胖和健康”男性的压力更重要;以及干预的必要时机，即，是否需要在生命早期强调身体尺寸减小和/或PA增加，或者在生命后期身体尺寸和PA的变化是否仍然可以降低BPH/LUTS风险。BPH/LUTS的新预防策略对于降低这种极其常见和令人烦恼的疾病的发病率并减轻其巨大的经济和健康负担至关重要。 公共卫生相关性：拟定的次要数据分析与公共卫生相关，因为它们将确定大体型（例如，超重和肥胖）和较少的体力活动有助于中年和老年男性中良性前列腺增生（BPH）/下尿路症状（LUTS）的发展。如果我们的研究结果是有希望的，这些可以指导开发新的，有效的，量身定制的一级预防策略BPH/LUTS的基础上减少或维持身体大小和增加或维持体力活动的男性。BPH/LUTS的新型一级预防策略对于降低这种极其常见和令人烦恼的疾病的发病率，并减轻其巨大的经济和健康损失至关重要。