切换至 "中华医学电子期刊资源库"
高级检索
中华腔镜泌尿外科杂志(电子版)

中华腔镜泌尿外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (05) : 549 -555. doi: 10.3877/cma.j.issn.1674-3253.2026.05.009

临床研究

前列腺增生手术患者基础代谢指标与膀胱内前列腺突入程度的相关性分析
代鑫亮1, 李威1, 柳子瑜1, 杨玙豪1, 方灿1, 庞俊2, 江东根2,†()   
  1. 1518107　深圳，中山大学医学院
    2518107　深圳，中山大学附属第七医院泌尿外科
  • 收稿日期:2025-09-30 出版日期:2026-10-01
  • 通信作者: 江东根
  • 基金资助:
    国家自然科学基金项目(81902613); 深圳市科创委面上项目(JCYJ20240813150255051)

Correlation analysis between basal metabolic indexes and the degree of intravesical prostatic protrusion in patients undergoing benign prostatic hyperplasia surgery

Xinliang Dai1, Wei Li1, Ziyu Liu1, Yuhao Yang1, Can Fang1, Jun Pang2, Donggen Jiang2,†()   

  1. 1School of Medicine, Sun Yat sen University; Shenzhen 518107, China
    2Department of Urology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China
  • Received:2025-09-30 Published:2026-10-01
  • Corresponding author: Donggen Jiang
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

代鑫亮, 李威, 柳子瑜, 杨玙豪, 方灿, 庞俊, 江东根. 前列腺增生手术患者基础代谢指标与膀胱内前列腺突入程度的相关性分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2026, 20(05): 549-555.

Xinliang Dai, Wei Li, Ziyu Liu, Yuhao Yang, Can Fang, Jun Pang, Donggen Jiang. Correlation analysis between basal metabolic indexes and the degree of intravesical prostatic protrusion in patients undergoing benign prostatic hyperplasia surgery[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(05): 549-555.

目的

探讨前列腺增生（BPH）手术患者基础代谢指标与膀胱内前列腺突入（IPP）程度的关系。

方法

回顾性收集2018年5月至2024年12月在中山大学附属第七医院泌尿外科手术治疗的649例BPH患者临床资料，通过经腹超声测量IPP，采用相关性分析、广义线性模型分析体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、空腹血糖、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）与IPP程度的关联，并进行年龄分层分析。

结果

全人群相关性分析显示，BMI（r=-0.182，P<0.001）、空腹血糖（r=-0.118，P<0.01）和TG（r=-0.128，P=0.012）与IPP程度均呈负相关，而HDL-C与IPP程度呈正相关（r=0.118，P=0.021）。年龄分层显示61～70岁（r=-0.209）及71～80岁（r=-0.226）组BMI与IPP程度呈明显负相关（均P<0.05）；>80岁组TG与IPP程度呈明显负相关（r=-0.399，P=0.012）；61～70岁组空腹血糖与IPP程度呈明显负相关（r=-0.143，P=0.032）。广义线性模型证实BMI（β=-0.040，P=0.001）是IPP程度的独立预测因子，其他代谢指标对IPP程度均无独立效应。

结论

BPH手术患者BMI、空腹血糖和TG均与IPP程度呈负相关，而HDL-C与IPP程度呈正相关；BMI是IPP程度的独立预测因子，两者之间的负向关联具有年龄特异性，61～80岁低BMI患者及>80岁低TG患者可能需加强IPP监测。

关键词: 前列腺增生, 膀胱内前列腺突入, 体重指数, 血糖, 血脂
Objective

To investigate the relationship between basal metabolic indexes and the degree of intravesical prostatic protrusion (IPP) in patients undergoing benign prostatic hyperplasia (BPH) surgery.

Methods

Clinical data of 649 BPH patients who underwent surgical treatment at the Department of Urology, the Seventh Affiliated Hospital of Sun Yat-sen University between May 2018 and December 2024 were retrospectively collected. IPP was measured via transabdominal ultrasound. Correlation analysis and generalized linear modeling were employed to examine the associations between IPP and various metabolic indicators, including body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). An age-stratified analysis was also performed.

Results

In the overall population, BMI (r=-0.182, P<0.001), fasting blood glucose (r=-0.118, P<0.01), and TG (r=-0.128, P=0.012) were negatively correlated with IPP, while HDL-C was positively correlated (r=0.118, P= 0.021). Age-stratified analysis revealed a significant negative correlation between BMI and IPP in the groups of 61-70 (r=-0.209) and 71-80 (r=-0.226) years (both P<0.05). A significant negative correlation between TG and IPP was observed in patients over 80 years (r=-0.399, P=0.012). Fasting blood glucose in the group of 61-70 years was significantly negatively correlated with IPP (r=-0.143, P=0.032). Generalized linear modeling confirmed that BMI (β=-0.040, P=0.001) was an independent predictor of IPP, whereas no other metabolic indicators showed independent association.

Conclusion

In BPH patients undergoing surgery, BMI, fasting blood glucose, and TG were negatively correlated with IPP, whereas HDL-C was positively correlated. BMI was an independent predictor of IPP, with age-specific negative associations. Enhanced monitoring of IPP may be warranted in patients aged 61-80 years with low BMI and those over 80 years with decreased TG levels.

Key words: Benign prostatic hyperplasia, Intravesical prostatic protrusion, Body mass index, Blood glucose, Blood lipids
图1 超声测量前列腺突入膀胱（IPP）示意图
表1 前列腺增生（BPH）患者一般资料特征
变量 数值 Kolmogorov-Smirnov检验
年龄[岁，M(Q)] 68 (62，75) D=0.057，P<0.001
BMI [kg/m2，(±s)] 24.06±3.09 D=0.025，P=0.200
SBP [mmHg，M(Q)] 132 (121，144) D=0.036，P=0.045
DBP [mmHg，M(Q)] 80 (73，87） D=0.036，P=0.041
TC [mmol/L，(±s)] 4.65±1.08 D=0.041，P=0.064
TG [mmol/L，M(Q)] 1.22 (0.88，1.74) D=0.220，P<0.001
LDL-C [mmol/L，M(Q)] 2.73 (2.12，3.25) D=0.059，P=0.001
HDL-C [mmol/L，M(Q)] 1.10 (0.94，1.32) D=0.079，P<0.001
空腹血糖[mmol/L，M(Q)] 5.54 (5.03，6.65) D=0.154，P<0.001
IPP [mm，M(Q)] 8.75 (4.70，14.00) D=0.099，P<0.001
图2 BPH患者基础代谢指标与IPP相关性分析注：图中数值为相关系数，***P<0.001，**P<0.01，*P<0.05
表2 BPH患者不同年龄组与IPP的相关性分析
  ≤60岁 61～70岁 71～80岁 >80岁
例数(n) 相关系数(r) P值 例数(n) 相关系数(r) P值 例数(n) 相关系数(r) P值 例数(n) 相关系数(r) P值
BMI (kg/m2) 107 -0.099 0.311 236 -0.209 0.001 131 -0.226 0.010 51 -0.108 0.449
空腹血糖(mmol/L) 97 -0.134 0.192 227 -0.143 0.032 124 -0.104 0.250 51 0.039 0.784
TG (mmol/L) 70 0.075 0.539 169 -0.143 0.064 105 -0.179 0.068 39 -0.399 0.012
HDL-C(mmol/L) 70 0.081 0.504 169 0.097 0.211 105 0.189 0.053 39 0.186 0.258
表3 BPH患者代谢相关指标广义线性模型分析
变量 系数(β) 标准误(Sx) 95%CI Exp (β) P值
截距 3.207 0.494 (2.238，4.175) 24.693 <0.001
年龄（岁） -0.000 0.004 (-0.008，0.008) 1.000 0.996
BMI(kg/m2) -0.040 0.012 (-0.063，-0.016) 0.961 0.001
空腹血糖(mmol/L) -0.034 0.023 (-0.080，0.012) 0.967 0.145
TG(mmol/L) 0.038 0.022 (-0.005，0.081) 1.039 0.086
HDL-C(mmol/L) 0.198 0.120 (-0.037，0.433) 1.219 0.098
[1]
Awedew AF, Han H, Abbasi B, et al. The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet Heal Longev, 2022, 3(11): e754-e776. DOI: 10.1016/S2666-7568(22)00213-6.
[2]
Launer BM, McVary KT, Ricke WA, et al. The rising worldwide impact of benign prostatic hyperplasia[J]. BJU Int, 2021, 127(6): 722-728. DOI: 10.1111/bju.15286.
[3]
Song Z, Cheng ZJ, Yuan H, et al. Correlation between benign prostatic hyperplasia and comorbidities: a systematic analysis integrating global burden of disease and Mendelian randomization study[J]. J Transl Med, 2024, 22(1): 1035. DOI: 10.1186/s12967-024-05604-x.
[4]
Wei H, Zhu C, Huang Q, et al. Global, regional, and national burden of benign prostatic hyperplasia from 1990 to 2021 and projection to 2035[J]. BMC Urol, 2025, 25(1): 34. DOI: 10.1186/s12894-025-01715-9.
[5]
Wang YB, Yang L, Deng YQ, 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. DOI: 10.1186/s12967-022-03722-y.
[6]
Tong Y, Zhou RY. Review of the roles and interaction of androgen and inflammation in benign prostatic hyperplasia[J]. Mediators Inflamm, 2020, 2020: 7958316. DOI: 10.1155/2020/7958316.
[7]
Fu X, Wang Y, Lu Y, et al. Association between metabolic syndrome and benign prostatic hyperplasia: The underlying molecular connection[J]. Life Sci, 2024, 358: 123192. DOI: 10.1016/j.lfs.2024.123192.
[8]
Eze BU, Ani CO, Mbaeri TU. Is intravesical prostatic protrusion associated with more complications in benign prostatic hyperplasia patients?[J]. Low Urin Tract Symptoms, 2021, 13(4): 468-474. DOI: 10.1111/luts.12394.
[9]
Lu CH, Wu HHH, Lin TP, et al. Is intravesical prostatic protrusion a risk factor for hydronephrosis and renal insufficiency in benign prostate hyperplasia patients?[J]. J Chin Med Assoc, 2019, 82(5): 381-384. DOI: 10.1097/JCMA.0000000000000088.
[10]
黄健, 张旭. 中国泌尿外科和男科疾病诊断治疗指南:2022版[M]. 北京: 科学出版社, 2022: 475-522.
[11]
Cannarella R, Condorelli RA, Barbagallo F, et al. Endocrinology of the aging prostate: current concepts[J]. Front Endocrinol, 2021, 12: 554078. DOI: 10.3389/fendo.2021.554078.
[12]
Huang J, Chan CK, Yee S, et al. Global burden and temporal trends of lower urinary tract symptoms: a systematic review and meta-analysis[J]. Prostate Cancer Prostatic Dis, 2023, 26(2): 421-428. DOI: 10.1038/s41391-022-00610-w.
[13]
Hennenberg M, Hu S, Tamalunas A, et al. Genetic predisposition to benign prostatic hyperplasia: where do we stand?[J]. Eur Urol Open Sci, 2024, 70: 154-157. DOI: 10.1016/j.euros.2024.10.012.
[14]
王姊娟, 杜依青, 张建, 等. 代谢综合征及其诊断指标与重度良性前列腺增生症的相关性研究[J]. 协和医学杂志, 2020, 11(6): 703-709. DOI: 10.3969/j.issn.1674-9081.2020.06.012.
[15]
Sandhu JS, Bixler BR, Dahm P, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline amendment 2023[J]. J Urol, 2024, 211(1): 11-19. DOI: 10.1097/ju.0000000000003698.
[16]
Kristal AR, Arnold KB, Schenk JM, et al. Race/ethnicity, obesity, health related behaviors and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial[J]. J Urol, 2007, 177(4): 1395-1400. DOI: 10.1016/j.juro.2006.11.065.
[17]
吴玥, 朱文, 王庆伟, 等. 基于盆底MRI评估年龄与前列腺癌根治术对男性盆底解剖结构及尿控的影响[J]. 临床泌尿外科杂志, 2021, 36(10): 769-775. DOI: 10.13201/j.issn.1001-1420.2021.10.003.
[18]
相晓波, 周童, 李世亮, 等. 良性前列腺增生患者糖脂等指标与前列腺体积的相关性研究[J]. 中华预防医学杂志, 2024, 58(9): 1384-1387. DOI: 10.3760/cma.j.cn112150-20240521-00411.
[19]
桑培培, 程昱璇, 彭薇, 等. 良性前列腺增生患者血清激素水平与前列腺体积的关系[J]. 标记免疫分析与临床, 2022, 29(10): 1638-1642. DOI: 10.11748/bjmy.issn.1006-1703.2022.10.004.
[20]
Kim JH, Han IH, Shin SJ, et al. Signaling role of adipocyte leptin in prostate cell proliferation induced by Trichomonas vaginalis[J]. Korean J Parasitol, 2021, 59(3): 235-249. DOI: 10.3347/kjp.2021.59.3.235.
[21]
Kosmacek EA, Oberley-Deegan RE. Adipocytes protect fibroblasts from radiation-induced damage by adiponectin secretion[J]. Sci Rep, 2020, 10(1): 12616. DOI: 10.1038/s41598-020-69352-w.
[22]
Gharbieh S, Reeves F, Challacombe B. The prostatic middle lobe: clinical significance, presentation and management[J]. Nat Rev Urol, 2023, 20(11): 645-653. DOI: 10.1038/s41585-023-00774-7.
[23]
Zorn KC, Bidair M, Trainer A, et al. Aquablation therapy in large prostates (80-150 cc) for lower urinary tract symptoms due to benign prostatic hyperplasia: WATER II 3-year trial results[J]. BJUI Compass, 2022, 3(2): 130-138. DOI: 10.1002/bco2.121.
[24]
Eure G, Rukstalis D, Roehrborn C. Prostatic urethral lift for obstructive Median lobes: consistent results across controlled trial and real-world settings[J]. J Endourol, 2023, 37(1): 50-59. DOI: 10.1089/end.2022.0324.
[1] 张宗明, 刘立民, 张翀. 减重手术新术式与新进展：从术式创新到策略融合[J/OL]. 中华普通外科学文献(电子版), 2026, 20(04): 217-224.
[2] 刘洵, 毕亮, 郎韧, 吴安石. 同种异体原位肝移植术后早期死亡的危险因素分析[J/OL]. 中华普通外科学文献(电子版), 2026, 20(03): 150-156.
[3] 林英立, 靳孟丽, 胡建东, 颜廷晖. 2型糖尿病患者前列腺增生组织中HIF-1α/VEGF的表达及意义[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2026, 20(04): 407-412.
[4] 熊星, 段启林, 曾静, 王舟怡, 戴平, 黄桂晓. 6点尿道瓣后离断技术在经尿道等离子前列腺剜除术中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2026, 20(02): 185-190.
[5] 董雯, 张小春, 金黑鹰, 金超. 结直肠息肉生长速率预测模型建立及其在结直肠腺瘤性息肉筛查中的应用价值[J/OL]. 中华结直肠疾病电子杂志, 2026, 15(04): 331-339.
[6] 马博, 李涛, 董扬帆, 商少华, 马华, 王俊, 纪文静. 减重代谢手术改善2型糖尿病肥胖患者胃肠肽及血糖的前瞻性研究[J/OL]. 中华消化病与影像杂志(电子版), 2026, 16(01): 53-60.
[7] 叶茂, 王晓兰, 黄何, 吕苏奇, 李晨, 李跃伟, 吕定超. 45岁及以上人群中载脂蛋白B与冠状动脉狭窄严重程度的相关性分析[J/OL]. 中华临床医师杂志(电子版), 2026, 20(03): 202-209.
[8] 温欢, 苏博, 刘金波, 王宏宇. 血糖水平与冠状动脉钙化及轻度认知障碍的相关性研究[J/OL]. 中华临床医师杂志(电子版), 2026, 20(01): 19-27.
[9] 赵灵芝, 石光英. 熊去氧胆酸联合瑞舒伐他汀治疗脂肪肝合并高脂血症患者的临床疗效研究[J/OL]. 中华临床医师杂志(电子版), 2025, 19(08): 589-593.
[10] 于洋, 贾珂珂, 乔蕊, 宋涵超, 陈薇薇, 范雯怡. 基于风险导向抽样的血糖POCT协同质量管理体系构建[J/OL]. 中华临床实验室管理电子杂志, 2026, 14(01): 58-65.
[11] 杜泽宇, 郭恒, 张向辉, 何佳, 木拉提别克·克尔曼, 马儒林, 郭淑霞. 新疆兵团农村居民血脂指标与心血管疾病发病关联的队列研究[J/OL]. 中华心脏与心律电子杂志, 2026, 14(01): 28-35.
[12] 侯莉明, 王晓明. 老年人群血脂异常的管理策略[J/OL]. 中华老年病研究电子杂志, 2026, 13(01): 1-6.
[13] 李转霞, 张梅, 周沁, 李林娟. 连续葡萄糖监测指标与阻塞性睡眠呼吸暂停严重程度相关性研究[J/OL]. 中华肥胖与代谢病电子杂志, 2026, 12(01): 16-22.
[14] 余志鹏, 林世文, 张嘉娜, 韩世华. 黄连素用于辅助治疗2型糖尿病的降糖疗效及安全性Meta分析[J/OL]. 中华肥胖与代谢病电子杂志, 2026, 12(01): 62-71.
[15] 胡琼丹, 侯善兵, 陈霞, 王教媛, 戴晓熹. 应激性血糖升高比值预测急性缺血性脑卒中静脉溶栓预后的价值[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 396-402.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号

AI
小
编
AI小编
你好！我是《中华医学电子期刊资源库》AI小编，有什么可以帮您的吗？