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目的探讨上海市中老年男性血清前列腺特异抗原(PSA)与体质指数(BMI)的关系,评价根据BMI水平制订不同的PSA界值的必要性。方法随机选取于2010年1-7月参加上海市科学技术委员会资助项目的 591名40岁及以上、无前列腺癌史的男性作为研究对象。通过问卷调查获取调查对象的一般人口学特征、患病及用药情况。采用国际前列腺症状分数(IPSS)判断男性排尿障碍程度。对调查对象进行体格检查和前列腺B超检查,采集清晨空腹静脉血检测PSA值。采用一般线性模型及偏相关分析,探讨BMI与PSA的关系。结果调查对象年龄40～77岁,平均(58.5±7.2)岁。调整年龄,是否使用阿司匹林、利尿剂及其他抗炎药,是否有糖尿病、IPSS评分及前列腺体积(连续性变量)等混杂因素后,BMI<24、24～、≥28kg/m2的男性PSA的几何均数分别为1.01ng/ml(95%CI:0.89～1.16ng/ml)、0.84ng/ml(95%CI:0.75～0.95ng/ml)和0.77ng/m(l95%CI:0.66～0.90ng/ml)。BMI与血清PSA水平呈负相关(r=-0.158,P<0.01)。结论采用PSA值评估前列腺癌患病风险时应当考虑BMI对PSA值的影响。
Objective To explore the relationship between serum PSA and BMI in middle-aged and elderly men in Shanghai and to evaluate the necessity of establishing different PSA thresholds based on BMI levels. METHODS: A total of 591 men aged 40 and over who did not have a history of prostate cancer who were enrolled in the Shanghai Science and Technology Commission from January to July 2010 were randomly selected as the study subjects. The general demographic characteristics, prevalence and medication status of the surveyed subjects were obtained through questionnaire survey. The International Prostate Symptom Score (IPSS) was used to determine the extent of urination disorder in men. Subjects were physical examination and prostate B ultrasound examination, fasting venous blood collected early detection of PSA value. The general linear model and partial correlation analysis were used to explore the relationship between BMI and PSA. Results The subjects were aged 40-77 years (mean, 58.5 ± 7.2) years. Adjusted the age, whether aspirin, diuretic and other anti-inflammatory drugs, whether there is diabetes, IPSS score and prostate volume (continuous variables) and other confounding factors, the BMI <24,24 ~, 28kg / m2 of male PSA geometry (95% CI: 0.89 to 1.16 ng / ml), 0.84 ng / ml (95% CI: 0.75 to 0.95 ng / ml) and 0.77 ng / ml (95% CI: 0.66 to 0.90 ng / ml). BMI was negatively correlated with serum PSA level (r = -0.158, P <0.01). Conclusions The impact of BMI on the PSA value should be considered when assessing the risk of prostate cancer using PSA values.