良性攝護腺肥大導致腰椎骨質密度增加與骨小樑指數骨骼強度關係之研究分析

背景：本篇研究進一步要瞭解良性攝護腺肥大（benign prostatic hyperplasia, BPH）與腰椎骨質密度（bone mineral density, BMD）增加是否與骨小樑增加有關。方法：本篇研究利用回溯性研究方式進行分析，收集來自臺灣南部某區域教學醫院，受檢者於本院預防醫學中心接受健康檢查受檢者，收集時間從2014年6月至2020年12月，收集年齡區間為50～98歲男性，排除癌症患者、實驗室數據資料不完整、BMD有任何一個區域部位無法量測，我們即排除不納入本研究。最終收集4,697位受檢者納入本篇研究，利用彩色Doppler超音波影像判斷，分成正常組與BPH組。結果：共計收集4,697位個案，年齡50～98歲間受檢者，平均年齡61.73± 7.59 years，身高166.38 ± 5.80 cm，體重68.73 ± 9.94 kg，身體質量指數24.80 ± 3.13 kg/m^2，平均骨小樑指數（trabecular bone score, TBS）1.374± 0.088。平均腰椎BMD為0.983 ± 0.156 g/cm^2，平均右側股骨頸BMD為0.712 ± 0.113 g/cm^2，平均右側全髖BMD為0.884 ± 0.126 g/cm^2，平均左側股骨頸BMD為0.719 ± 0.113 g/cm^2，平均左側全髖BMD為0.854 ± 0.126g/cm^2，TBS為1.374 ± 0.088。最後發現，腰椎BMD區域，BPH組為正常組的1.068倍，有顯著（p = 0.038），但腰椎TBS，BPH組為正常組的1.033倍，但無顯著（p = 0.324）。結論：本篇新發現腰椎BMD增加，並不是由於骨小樑增加，是否因乃增加皮質骨還要進一步研究，針對BPH疾病對於BMD影響也可以利用TBS來做另類評估。

關鍵字

良性攝護腺肥大；腰椎骨質密度；骨小樑指數

並列摘要

Purpose: This study aims to find and understand whether benign prostatic hyperplasia (BPH) and increased lumbar spine bone mineral density (BMD) were associated with increased trabecular bone strength. Methods: This is a retrospective study, analyzing, and collecting the subjects receiving health examinations at the preventive medical center (from a regional teaching hospital in southern Taiwan) from June 2014 to December 2020. We include male patients in the age range of 50-98 years and excluded cancer patients, incomplete laboratory data, and any region of BMD that could not be measured. Finally, 4,697 subjects were collected and included in this study, and we divided them to normal group and BPH group by color Doppler sonography. Results: A total of 4,697 cases were collected, aged 50-98 years, with an average age of 61.73 ± 7.59 years, height of 166.38 ± 5.80 cm, weight of 68.73 ± 9.94 kg, body mass index of 24.80 ± 3.13 kg/m^2, and trabecular bone score (TBS) of 1.374 ± 0.088. Mean lumbar spine BMD was 0.983 ± 0.156 g/cm^2, mean right femoral neck BMD was 0.712 ± 0.113 g/cm^2, mean right total hip BMD was 0.884 ± 0.126 g/cm^2, mean left femoral neck BMD was 0.719 ± 0.113 g/ cm^2, The mean left total hip BMD was 0.854 ± 0.126 g/cm^2, mean TBS was 1.374 ± 0.088. Finally, it was found that the BMD of the lumbar spine was 1.068 times that of the normal group in the BPH group (p = 0.038), but the TBS of the lumbar spine in the BPH group was 1.033 times that of the normal group (p = 0.324). Conclusions: The new findings in this study are that the increase in lumbar spine BMD is not due to the increase in trabecular bone strength. Whether it is due to the increase in cortical bone should be further studied. TBS can also be used in conjunction to assess the impact of BPH disease on BMD.

並列關鍵字

benign prostatic hyperplasia ； lumbar spine bone mineral density ； trabecular bone score

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