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The Effect on Bone Mineral Density of Benign Prostatic Hyperplasia Combined With High Prostate Specific Antigen

良性攝護腺增生結合高攝護腺特異性抗原對骨礦物質密度之影響

摘要


Background: According to the previous studies, we have separately explored the effects of benign prostate hypertrophy (BPH) and prostate specific antigens (PSA) on bone mineral density (BMD). Therefore, this study will further analyze the combination of BPH and PSA, and divide subjects into. BPH with PSA greater than 4 ng/mL (disease group) and no BPH with normal PSA (less than 4 ng/mL) (normal group). We compare the two variables at the same time to find whether the factors have a comprehensive impact on BMD. Methods: Total of 5,605 males who were examined in the preventive medical center of our hospital were collected for evaluation. Total hip replacement surgery, internal fixation in the lumbar spine or hip, lumbar vertebroplasty, or incomplete data were excluded. In the study, clinicians used ultrasound to confirm the diagnosis of BPH. The serum by chemiluminescence immunoassay is also used to determine whether the value of the PSA level is normal or not. PSA level greater than 4 ng/mL is considered abnormal. A dual-energy X-ray absorptiometer was used to measure the BMD of three parts (lumbar spine and bilateral hips). Results: Of the 5,605 males, 5,323 (95%) were in the normal group and 282 (5%) in the disease group. The mean age of patients was 53.85 ± 12.10 years in the normal group and 68.46 ± 7.72 years in the disease group (p < 0.001), with a significant difference. The diseased group having significantly increased BMD at the lumbar spine area, but significantly decreased BMD in the bilateral hips, as compared with the normal group. Conclusions: In conclusion, the disease group had high lumbar spine BMD but lower BMD in the bilateral hips. These findings suggest that men diagnosed with BPH or high PSA should be considered at risk for hip fractures and need the evaluation for BMD.

並列摘要


背景:根據先前研究已各別探討攝良性護腺肥大與攝護腺特異性抗原對於骨質密度是有影響,因此本篇研究進一步分析良性攝護腺肥大與攝護腺特異性抗原合併探討,分成良性攝護腺肥大與攝護腺特異性抗原增高> 4 ng/mL(疾病組)與無良性攝護腺肥大且攝護腺特異性抗原正常< 4 ng/mL(正常組),同時比較這二者因素對於骨質密度是否為全面性之影響。方法:共收集5,605名於本院健檢中心受檢的男性進行了評估。人工髖關節置換手術、腰椎與髖部有任一部位執行鋼釘內固定手術、腰椎椎體成型術或資料不完整者排除於本研究中。研究中臨床醫師使用超音波掃描確認診斷有無良性攝護腺增生之狀況。也使用化學發光免疫測定的血清確定攝護腺特異性抗原水平之數值正常與否。攝護腺特異性抗原水平> 4 μg/L被認為是異常。利用雙能量X光吸收測量儀量測三個部位(腰椎和雙側髖部)骨礦物質密度之數值。結果:在評估的5605名男性中,正常組為5,323名(95%),疾病組為282名(5%)。正常組平均年齡為53.85 ± 12.10歲,疾病組平均年齡為68.46 ±7.72歲(p < 0.001),差異有統計學意義。與正常組相比,疾病組的骨礦物質密度有顯著差異,患病組的腰椎骨礦物質密度明顯升高,而雙側髖部骨礦物質密度明顯降低。結論:疾病組的腰椎骨礦物質密度升高,但雙側髖部骨礦物質密度降低。這些發現表明,被診斷為良性攝護腺增生或前列腺特異抗原高的男性應被視為有髖部骨折的風險,並進行骨礦物質密度評估。

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