中国中老年男性前列腺增生与慢性病的关联性分析：一项基于CHARLS的横断面研究

doi:10.3969/j.issn.1006-7795.2025.02.011

首都医科大学学报 ›› 2025, Vol. 46 ›› Issue (2): 252-262.doi: 10.3969/j.issn.1006-7795.2025.02.011

• 前列腺疾病诊疗技术与进展 • 上一篇下一篇

中国中老年男性前列腺增生与慢性病的关联性分析：一项基于CHARLS的横断面研究

明杰^1,2,靳松^1,2,刘占良^1,2,王宗伟³,牛亦农^1,2*

1.首都医科大学附属北京友谊医院泌尿外科，北京 100050; 2.北京市卫生健康委员会泌尿外科研究所，北京 100050; 3.哈佛大学医学院贝斯以色列女执事医疗中心泌尿外科，波士顿 02215

收稿日期:2025-01-13 出版日期:2025-04-21 发布日期:2025-04-14
通讯作者: 牛亦农 E-mail:niuyinong@mail.ccmu.edu.cn
基金资助:
国家自然科学基金项目（82170783），北京市临床重点专科项目（20240930）。

Relationship between chronic diseases and benign prostatic hyperplasia in middle-aged and older Chinese adults: A cross-sectional study based on CHARLS database

Ming Jie^1,2，Jin Song^1,2，Liu Zhanliang^1,2, Wang Zongwei³，Niu Yinong^1,2*

1.Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; 2.Institute of Urology, Beijing Municipal Health Commission, Beijing 100050, China; 3.Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston 02215, MA, USA

Received:2025-01-13 Online:2025-04-21 Published:2025-04-14
Supported by:
This study was supported by National Natural Science Foundation of China (82170783), Beijing Key Clinical Specialty Project (20240930).

摘要/Abstract

摘要： 目的探究中国中老年男性慢性病与前列腺增生（benign prostatic hyperplasia, BPH）风险的相关性。方法本研究使用了2013年中国健康与养老追踪调查（China Health and Retirement Longitudinal Study, CHARLS）数据库统计数据，共纳入了4 509名45岁以上的男性参与者。慢性病以及BPH诊断通过问卷调查获得。Logistic回归分析筛选BPH患病的独立危险因素，限制性立方样条（restricted cubic splines, RCS）分析计量资料与BPH患病的非线性关系，分层分析评估慢性病对不同亚组人群BPH患病的影响差异。结果 2013年CHARLS数据库中BPH的总体患病率约为9.8%。与非BPH患者相比，BPH患者合并慢性病的比例显著增加，包括高血压、糖尿病、慢性呼吸系统疾病、慢性心脏病、卒中、慢性肾脏病、慢性消化系统疾病、关节炎或风湿病、抑郁、记忆相关疾病等。多因素Logistic回归分析提示，10项流行病学研究中心抑郁量表（10-item Center for Epidemiological Studies Depression Scale, CESD-10）评分（OR = 1.043, 95%CI: 1.022~1.063, P < 0.001）、慢性呼吸系统疾病（OR = 1.518, 95%CI: 1.143~1.998, P = 0.003）、慢性心脏病（OR = 1.515, 95%CI: 1.143~1.998, P = 0.003）、慢性肾脏病（OR = 2.384, 95%CI: 1.799~3.137, P < 0.001）和慢性消化系统疾病（OR = 1.427, 95%CI: 1.129~1.796, P = 0.003）是BPH患病风险的独立危险因素。RCS分析表明，年龄、体质量指数（body mass index，BMI）、CESD-10评分与BPH不存在非线性关联，分层分析表明这些慢性病对不同分层人群BPH患病的影响效果基本稳定。结论 BPH常与多种慢性病并存，未来BPH的治疗应考虑与慢性病之间的共同病理机制，针对共享靶点进行综合干预。

关键词: CHARLS, 数据库, 前列腺增生, 慢性病, 关联性

Abstract: Objective To explore the correlation between chronic diseases and the risk of benign prostatic hyperplasia (BPH) in middle-aged and older Chinese man.Methods Data from the 2013 China Health and Retirement Longitudinal Study (CHARLS) were used, including 4 509 male participants aged 45 years and older. Chronic diseases and BPH diagnoses were obtained through a questionnaire survey. Logistic regression analysis was performed to identify independent risk factors for BPH. Restricted cubic splines (RCS) were used to explore the nonlinear relationship between variables and BPH prevalence, while stratified analyses were conducted to assess the differential impact of chronic diseases on BPH prevalence in different subgroups.Results Compared to patients without BPH, those with BPH had a significantly higher prevalence of comorbid chronic diseases, including hypertension, diabetes, chronic respiratory diseases, chronic heart disease, stroke, chronic kidney disease, chronic digestive diseases, arthritis or rheumatism, depression, and memory-related disorders. Multivariable Logistic regression analysis indicated that factors such as the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) scores (OR = 1.043, 95% CI: 1.022－1.063, P < 0.001), chronic respiratory disease (OR = 1.518, 95% CI: 1.143－1.998, P = 0.003), chronic heart disease (OR = 1.515, 95% CI: 1.143－1.998, P = 0.003), chronic kidney disease (OR = 2.384, 95% CI: 1.799－3.137, P < 0.001), and chronic digestive disease (OR=1.427， 95%CI：1.129-1.796,P=0.003) were independently associated with the occurrence of BPH. RCS analysis demonstrated no non-linear association between age, BMI, and CESD-10 scores and BPH. Stratified analysis revealed that the influence of these chronic conditions on BPH remained constantly stable across different subgroups.Conclusion BPH is commonly comorbid with various chronic diseases. Future treatment strategies for BPH should consider the shared pathological mechanisms between BPH and these chronic conditions, with a focus on integrated interventions targeting common pathways.

Key words: CHARLS, Database, benign prostatic hyperplasia, chronic disease, correlation

中图分类号:

R697+.3

明杰, 靳松, 刘占良, 王宗伟, 牛亦农. 中国中老年男性前列腺增生与慢性病的关联性分析：一项基于CHARLS的横断面研究[J]. 首都医科大学学报, 2025, 46(2): 252-262.

Ming Jie, Jin Song, Liu Zhanliang, Wang Zongwei, Niu Yinong. Relationship between chronic diseases and benign prostatic hyperplasia in middle-aged and older Chinese adults: A cross-sectional study based on CHARLS database[J]. Journal of Capital Medical University, 2025, 46(2): 252-262.

参考文献

［1］Wang W Y, Guo Y W, Zhang D X, et al. The prevalence of benign prostatic hyperplasia in mainland China: evidence from epidemiological surveys［J］. Sci Rep, 2015, 5: 13546.
［2］Liu D W, Li C, Li Y Y, et al. Benign prostatic hyperplasia burden comparison between China and United States based on the Global Burden of Disease Study 2019［J］. World J Urol, 2023, 41(12): 3629－3634.
［3］Djavan B, Margreiter M, Dianat S S. An algorithm for medical management in male lower urinary tract symptoms［J］. Curr Opin Urol, 2011, 21(1): 5－12.
［4］Zi H, Liu M Y, Luo L S, et al. Global burden of benign prostatic hyperplasia, urinary tract infections, urolithiasis, bladder cancer, kidney cancer, and prostate cancer from 1990 to 2021［J］. Mil Med Res, 2024, 11(1): 64.
［5］Park S, Ryu J M, Lee M. Quality of life in older adults with benign prostatic hyperplasia［J］. Healthcare (Basel), 2020, 8(2): 158.
［6］Hacker K. The burden of chronic disease［J］. Mayo Clin Proc Innov Qual Outcomes, 2024, 8(1): 112－119.
［7］Suarez Arbelaez M C, Nackeeran S, Shah K, et al. Association between body mass index, metabolic syndrome and common urologic conditions: a cross-sectional study using a large multi-institutional database from the United States［J］. Ann Med, 2023, 55(1): 2197293.
［8］Suzuki Y, Kaneko H, Okada A, et al. Benign prostatic hyperplasia and incident cardiovascular disease［J］. Circ J, 2024, 88(3): 408－416.
［9］Sarma A V, Kellogg Parsons J. Diabetes and benign prostatic hyperplasia: emerging clinical connections［J］. Curr Urol Rep, 2009, 10(4): 267－275.
［10］Zhao Y H, Hu Y S, Smith J P, et al. Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS)［J］. Int J Epidemiol, 2014, 43(1): 61－68.
［11］Zhang W, Cao G, Sun Y, et al. Depressive symptoms in individuals diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia(LUTS/BPH)in middle-aged and older Chinese individuals: results from the China Health and Retirement Longitudinal Study［J］. J Affect Disord, 2022, 296: 660－666.
［12］Hsieh F Y, Bloch D A, Larsen M D. A simple method of sample size calculation for linear and logistic regression［J］. Stat Med, 1998, 17(14): 1623－1634.
［13］Lambert P C, Abrams K R, Jones D R, et al. Analysis of ambulatory blood pressure monitor data using a hierarchical model incorporating restricted cubic splines and heterogeneous within-subject variances［J］. Stat Med, 2001, 20(24): 3789－3805.
［14］Schauer I G, Rowley D R. The functional role of reactive stroma in benign prostatic hyperplasia［J］. Differentiation, 2011, 82(4/5): 200－210.
［15］Wu F C W, Tajar A, Pye S R, et al. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study［J］. J Clin Endocrinol Metab, 2008, 93(7): 2737－2745.
［16］Rastrelli G, Vignozzi L, Corona G, et al. Testosterone and benign prostatic hyperplasia［J］. Sex Med Rev, 2019, 7(2): 259－271.
［17］Hata J, Harigane Y, Matsuoka K, et al. Mechanism of androgen-independent stromal proliferation in benign prostatic hyperplasia［J］. Int J Mol Sci, 2023, 24(14): 37511400.
［18］Cunha G R. Epithelio-mesenchymal interactions in primordial gland structures which become responsive to androgenic stimulation［J］. Anat Rec, 1972, 172(2): 179－195.
［19］Gacci M, Corona G, Sebastianelli A, et al. Male lower urinary tract symptoms and cardiovascular events: a systematic review and meta-analysis［J］. Eur Urol, 2016, 70(5): 788－796.
［20］Peng Y H, Huang C W, Liao W C, et al. Association between chronic obstructive pulmonary disease and increased risk of benign prostatic hyperplasia: a retrospective nationwide cohort study［J］. BMJ Open, 2017, 7(6): 28645971.
［21］Kim H J, Park J W, Cho Y S, et al. Pathogenic role of HIF-1α in prostate hyperplasia in the presence of chronic inflammation［J］. Biochim Biophys Acta Mol Basis Dis, 2013, 1832(1): 183－194.
［22］Henein M Y, Vancheri S, Longo G, et al. The role of inflammation in cardiovascular disease［J］. Int J Mol Sci, 2022, 23(21): 12906.
［23］Zitzmann M. Testosterone deficiency and chronic kidney disease［J］. J Clin Transl Endocrinol, 2024, 37: 100365.
［24］Wang Q, Zhang B, Li B, et al. Correlation between benign prostatic hyperplasia/lower urinary tract symptoms and renal function in elderly men aged 80 years and older［J］. Clin Interv Aging, 2023, 18: 61－69.
［25］Black M, Slade A, Caras R J, et al. Evaluation of renal function recovery after Holmium laser enucleation of the prostate in patients with chronic kidney disease［J］. J Endourol, 2023, 37(7): 817－822.
［26］Rule A D, Lieber M M, Jacobsen S J.Is benign prostatic hyperplasia a risk factor for chronic renal failure?［J］.J Urol, 2005,173(3):691－696.
［27］Chen J, Chen B, Lin B, et al. The role of gut microbiota in prostate inflammation and benign prostatic hyperplasia and its therapeutic implications［J］. Heliyon, 2024, 10(19): e38302.
［28］Asare G A, Sule D S, Oblitey J N, et al. High degree of prostate related LUTS in a prospective cross-sectional community study in Ghana (Mamprobi)［J］. Heliyon, 2021, 7(11): e08391.
［29］Wang Y B, Yang L, Deng Y Q, et al. Causal relationship between obesity, lifestyle factors and risk of benign prostatic hyperplasia: a univariable and multivariable Mendelian randomization study［J］. J Transl Med, 2022, 20(1): 495.
［30］Xu X L, Sun M Q, Ye J F, et al. The effect of aromatase on the reproductive function of obese males［J］. Horm Metab Res, 2017, 49(8): 572－579.
［31］Xiong Y, Zhang Y C, Jin T, et al. Depressive males have higher odds of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a retrospective cohort study based on propensity score matching［J］. Asian J Androl, 2021, 23(6): 633－639.
［32］Yang L, Chen X, Liu Z, et al. The impact of illness perceptions on depressive symptoms among benign prostatic hyperplasia patients with lower urinary tract symptom［J］. Int J Gen Med, 2021, 14: 9297－9306.
［33］Xie Z L, Liu X B, Hu Z G, et al. Longitudinal association between the dynamic nature of depression with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH)［J］. BMC Public Health, 2024, 24(1): 1121.
［34］Ohira T. Lower urinary tract symptoms secondary to benign prostatic hyperplasia and cardiovascular diseases in Japan-what is the next step?［J］. Circ J, 2021, 85(11): 2100－2101.
［35］Butt A K, Patel J, Shirwany H, et al. Beneficial extracardiac effects of cardiovascular medications［J］. Curr Cardiol Rev, 2022, 18(2): e151021197270.
［36］Pushpakom S, Iorio F, Eyers P A, et al. Drug repurposing: progress, challenges and recommendations［J］. Nat Rev Drug Discov, 2019, 18(1): 41－58.

中国中老年男性前列腺增生与慢性病的关联性分析：一项基于CHARLS的横断面研究

Relationship between chronic diseases and benign prostatic hyperplasia in middle-aged and older Chinese adults: A cross-sectional study based on CHARLS database

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 1

编辑推荐

Metrics

本文评价