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 middleaged and older Chinese adults:A cross-sectional study based on CHARLS database

作　　者：明杰 靳松 刘占良 王宗伟 牛亦农 Ming Jie;Jin Song;Liu Zhanliang;Wang Zongwei;Niu Yinong(Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Institute of Urology,Beijing Municipal Health Commission,Beijing 100050,China;Division of Urologic Surgery,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston 02215,MA,USA)

机构地区：[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

出　　处：《首都医科大学学报》2025年第2期252-262,共11页Journal of Capital Medical University

基　　金：国家自然科学基金项目(82170783);北京市临床重点专科项目(20240930)。

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4509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。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 4509 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.

关 键 词：CHARLS 数据库 前列腺增生 慢性病 关联性 

分 类 号：R697.3[医药卫生—泌尿科学]