南方医科大学学报

南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (12): 1721-.

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肥胖相关血液稀释与前列腺特异性抗原浓度的关系

李方龙，殷小涛，李德维，殷昭阳，齐思勇，石怀银，高江平，张旭   

  • 出版日期:2015-12-20 发布日期:2015-12-20

Association between obesity-related plasma hemodilution and the concentration of
prostate specific antigen

  • Online:2015-12-20 Published:2015-12-20

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摘要： 目的探索肥胖因素对前列腺增生（BPH）患者血清前列腺特异性抗原（PSA）浓度的影响，建立能够消除该影响的新PSA
变数。方法回顾性分析我院2005年7月~2014年8月，经病理确诊为前列腺增生的患者的临床资料，纳入身高、体质量、前列腺
体积等数据完整的患者共706例。分别计算PSA质量（PSA浓度与血容量的乘积）和PSA质量比（PSA质量与前列腺体积的比
值）2个指标，分析体质量指数（BMI）与PSA、PSA质量和PSA质量比的关系。结果BMI和血容量以及前列腺体积均呈正相关
（P<0.05）。线性回归分析显示BMI对血容量的影响大于对前列腺体积的影响（决定系数：0.569 vs 0.027）。PSA与前列腺体积
呈正相关，与BMI和血容量呈负相关（P<0.05）；PSA质量与前列腺体积呈正相关（P<0.05），但是与BMI和血容量均无相关性
（P>0.05）；PSA质量比与BMI和血容量均呈负相关（P<0.05），与前列腺体积无相关性（P>0.05）。将BMI分成正常组（BMI<23
kg/m2）、超重组（BMI 23~24.9 kg/m2）和肥胖组（BMI>25 kg/m2）进行亚组分析，结果表明血容量和前列腺体积在各组之间差异明
显（P<0.05），并且BMI增高伴随着血容量增多以及前列腺体积增大；PSA质量在各组之间的差异无统计学意义（P>0.05），而
PSA和PSA质量比在各组之间存在明显差异（P<0.05）。结论在前列腺增生患者中，高BMI可能会造成高血容量，从而对真实
PSA水平产生稀释效应；本研究建立的PSA质量能够较好的消除肥胖对PSA水平的影响。

Abstract: Objective To determine the effect of obesity on prostate specific antigen (PSA) in men with benign prostatic
hyperplasia (BPH) and develop a PSA-related parameter that can eliminate the effect of obesity. Methods We reviewed the
clinical data of 706 patients with BPH. Two PSA-related parameters, namely PSA mass (total circulating PSA protein) and PSA
mass ratio (total circulation PSA protein per prostate volume), were calculated for all the patients and the association of BMI
with PSA, PSA mass, and PSA mass ratio was assessed. Results A higher BMI was significantly associated with a greater
plasma volume and prostate volume (P<0.05). Linear regression analysis revealed a greater adjusted R2 of BMI versus plasma
volume than of BMI PSA (0.569 vs 0.027). PSA was positively associated with the prostate volume and negatively with BMI and
plasma volume (P<0.05). PSA mass was positively associated with prostate volume (P<0.05) but was not associated with BMI or
plasma volume (P>0.05). PSA mass ratio was not associated with prostate volume (P>0.05) but negatively associated with BMI
and plasma volume. Plasma volume and prostate volume, PSA, and PSA mass ratio (P<0.05), but not PSA mass (P>0.05),
differed significantly among normal-weight, overweight, and obese patients. Conclusion A higher BMI is associated with a
greater plasma volume in BPH patients. In obese patients with BPH, a lower PSA concentration may result from hemodilution
caused by a greater plasma volume, and PSA mass can eliminate the effect of obesity on PSA.