Clinical effects of statins on benign prostatic hyperplasia complicating metabolic syndrome in elderly patients / 中华老年医学杂志

Objective To evaluate the effect of simvastatin and atorvastatin on clinical progression of benign prostatic hyperplasia (BPH) in elderly patients with metabolic syndrome (MS).Methods A total of 135 patients with BPH and MS aged 60 years and over were divided into three groups:simvastatin group (n=45,40 mg/d),atorvastatin group (n=45,20 mg/d) and control group (n=45).BMI,waist circumference,blood pressure,levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL C),high sensitivity C-reactive protein (hs-CRP),interleukin 6 (IL-6),testosterone,estradiol,prostate specific antigen (PSA) and international prognostic scoring system (IPSS) and prostate volume were detected before and 12 months after treatment.Results Compared with control group,patients receiving simvastatin or atorvastatin for 12 months showed that the levels of serum TC,TG,LDL-C,hs-CRP,IL-6,IPSS were decreased(all P＜0.05),the level of serum HDL-C level were increased (all P＜0.05),and prostate volume was reduced(P＜0.05).The decrease in prostate volume was more in patients receiving simvastatin than receiving atorvastatin [(10.86±5.65) ml vs.(5.91 ± 3.03)ml,P＜0.05].Multiple stepwise regression analysis showed that the reduction of prostate volume was positively related to the decreases of serum TC and IL-6 levels,and to the increase of serum HDL-C level.Conclusions Simvastatin and atorvastatin have the efficacy reducing prostate volume and improving obstruction symptoms of lower urinary tract,and slowing the clinical progression of BPH and simvastatin is more effective than atorvastatin on reducing prostate volume.The efficacies of statins might be through lowering cholesterol level and antiinflammatory effect.

Reduced expression and secretion of apolipoprotein M in fat-fed, streptozotocin-diabetic rats is partially reversed by an artificial ligand of PPARγ / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of administration of rosiglitazone, an artificial ligand of PPARγ, on the expression and secretion of apolipoprotein (apoM) in fat-fed, streptozotocin-treated rats, an animal model for type 2-like diabetes.@*METHODS@#Healthy male SD rats were divided into 4 groups: a control group (n=7), a high-fat chow group (HF group, n=8), a diabetes mellitus group (DM group, n=7), and a diabetes mellitus group with rosiglitazone intervention group (RSG group, n=7). Fasting blood glucose (FBG), fasting insulin (FINS), triglyceride (TG) and total cholesterol (TC) were measured at the beginning of the study. The diabetic rats model was established by feeding high fat chow and intraperitoneal injection of streprozotocin. Then the randomly selected treatment group was given rosiglitazone by daily gavage for 8 weeks. All the rats were killed at the fifteenth week, at which time blood and tissues (liver, kidney, adipose) were collected and prepared. The levels of FBG, FINS, TG and TC were assayed. The level of apoM in serum was measured by enzyme-linked immunosorbent assay (ELISA). Reverse transcription polymerase chain reaction (RT-PCR) was used to determine apoM mRNA expression in liver, kidney, and adipose tissues.@*RESULTS@#Compared with either control group or HF group, serum apoM concentration in the DM group was reduced significantly (P<0.05); compared with the DM group, however, serum apoM concentrations in RSG group were increased (P<0.05). The expression of apoM mRNA in liver was highest, in kidney medium, and in adipose tissue extremely low (P<0.05). ApoM mRNA expression in liver and kidney was decreased in both DM and HF groups compared to control group (P<0.05). But, as with serum apoM concentration, apoM mRNA in the liver, kidney and adipose tissues of the RSG group were all increased markedly (P<0.05). The level of serum apoM in SD rats correlated negatively with TG (r=-0.466, P=0.011), TC (r=-0.568, P= 0.001), FBS (r =-0.371, P<0.001), and FINS(r=-0.768, P= 0.048 ).@*CONCLUSION@#These results suggest that apoM may participate in the glucose and lipid metabolism by the regulation of PPARγ.

The association of fasting insuline and insuline resistance with benign prostatic hyperplasia / 中国综合临床

Objective To reveal the effect of fasting insuline(FINS) and insuline resistance(IR) in the process of benign prostatic hyperplasia(BPH). Methods One hundred and seventeen outpatients( ≥60 ys)with BPH from geriatric department were enrolled into the study. The patients were divided into groups according to their FINS and insulin resistance index (HOMA-IR). The indices of BPH, including volume of prostate ( PV ),prostate specific antigen( PSA ), international prostate symptom score (IPSS), course of BPH were analyzed in both groups. Results The PV ( [ 56. 46 ± 26. 88 ] ml vs [ 44. 84 ± 17.66 ] ml, P = 0. 017 ) and the course ( [ 18. 00 ± 6. 91 ] years vs [ 13.93 ± 7. 74 ] years, P = 0. 031 ) were significantly greater in BPH combined hyperinsulinemias(HINS) group than the BPH with normal FINS group;but we found no significant differences in the comparisons of serum PSA level or IPSS between two groups. The PV( [54. 17 ± 25.38 ] ml vs [42. 26 ±14. 15]ml,P =0. 004)and the course([ 16.58 ±7. 65] years vs [13.49 ±7. 59] years,P = 0. 036) were also significantly greater in BPH combined insuline resistance gruop than the insulin sensitivity group, again we found no significant differences in the comparisons of serum PSA level or IPSS between two groups. Conclusion FINS and IR are risk factors of progressed BPH and can promote the progress of BPH.

The effect of metabolic syndrome on pathogenesis of benign prostate hyperplasia / 中华老年医学杂志

ObjectiveTo explore the effect of metabolic syndrome (MS) on the occurrence and development of benign prostate hyperplasia (BPH).Methods 101 elderly BPH patients were divided into two groups:BPH (n = 45) and BPH with MS (n= 56)group.The effects of metabolic indexes,including body mass index (BMI),waist,high density lipoprotein cholesterol (HDL-C),fasting blood glucose (FBS) and insuline resistance index (H()MA-IR),on prostate volume(PV),prostate-specific antigen (PSA),international prostate symptom score (IPSS) and lower urinary tract symptoms (LUTS) were surveyed in BPH patients.Results BPH with MS group showed significantly higher values of PV (t = 3.22,P= 0.003)and longer course of LUTS (t= 2.02,P =0.046) than BPH group.The BPH patients with overweight and obesity had significantly higher levels of PV(49.44±26.83 ml and 51.7±22.2 ml,P=0.021 and 0.043) than BPH patients with normal weight (38.10 ± 10.64 ml).Additionally,BPH patients with abdominal obesity had significantly higher levels of PV than BPH patients without abdominal obesity(50.26±26.51 ml vs.38.99± 11.25ml,P=0.005).BPH patients with low HDL-C had significantly higher PV than BPH patients with normal HDL-C[(54.23±28.92)ml vs.(40.40± 14.87) ml,P=0.009].The values of PV,PSA in the BPH patients with elevated FBS were significantly higher than in BPH patients with normal FBS (t=3.17 and 2.4I,P= 0.035 and 0.013).BPH patients with insuline resistance (IR) had higher values of PV and longer courses of LUTS than BPH patients without IR (t= 3.43 and 3.58,P-0.001).The PV was positively correlated with BMI(r= 0.459.P= O.OOO),FINS (r= 0.42,P=O.OOI),HOMA-IR (r= 0.49,P= 0.003) and gatively correlated with HDL-C (r= 0.38,P-0.000)- Multiple linear stepwise regression analysis showed that PV was closely correlated with HOMA-IR.ConclusionsMS has evident effects on the occurrence and development of BPH.

Relationship between benign prostatic hyperplasia and insulin resistance in elderly men / 中华老年医学杂志

Objective To explore the relationship between insulin resistance (IR) and benign prostatic hyperplasia (BPH) in elderly men. Methods All BPH outpatients in Geriatric department of the second Xiang Ya Hospital in Feb 2008 were recruited in this study. Bioche assays including insulin (FINS), prostate specific antigen (PSA), HbAlc, fasting plasma glucose, 2 hours postprandial blood glucose were performed and HOMA-IR were calculated. The blood pressure, body weight, height and waist circumference were measured, and the body mass index (BMI) was calculated. Prostate volume (PV) was measured by abdominal ultrasound, lower urinary tract symptoms (LUTS) was evaluated by International Prostate Symptom Score (IPSS) and inquired about the history of LUTS in detail. Results (1) HOMA-IR＞ 2.8 was diagnosed as insulin resistance (IR). The patients were divided into two groups: insulin sensitivity (IS) group (n=48) and IR group (n=20). The PV level was higher in IR group than in IS group [(61.1-32. 9) ml vs. (40.4±16.5)ml, P＜0. 05], there were no statistical differences in PSA [(3.3±2.3) μg/L vs. (2.91±1.3) μg/L, P＞0.05], the history of LUTS [(13.4±6.6)years vs. (8.7±6.0)years, P＞0.05], IPSS [(16.42±6.67)scores vs. (13. 29±7.09)scores, P＞0. 05] between the two groups. (2)According to BPH progressivity evaluation provided by MTOPS study (age≥62 years, PSA≥1. 6 μg/L, PV≥31 ml), the patients were divided into two groups: low progressive risk group (n= 30) and high progressive risk group (n= 38). The FINS and HOMA-IR levels were significantly higher in highprogressive risk group than in low progressive risk group (all P＜0. 01). (3)The PV was positively correlated with HOMA-IR level and FINS level (r= 0. 431, 0. 492, P＜0. 01). Conclusions IR exists in majority of elderly BPH patients, the degree of IR and relative high level of FINS are related to the enlargement of PV and the development of BPH.

The analysis of pharmacotherapy for benign prostatic hyperplastic in outpatients in geriatrics department of three hospitals in Changsha / 中华老年医学杂志

Objective To understand the elementary information and pharmacotherapy for benign prostatic hyperplasia (BPH) in outpatients in geriatrics department of three hospitals. Methods The outpatients diagnosed as BPH were investigated by daily BPH diagnosis report form, BPH medical-care requirement questionnaire, international prostate symptom score (IPSS) questionnaire and BPH quality of life scale (BPHQLS) in odd months. Results There were 657 outpatients in the three hospitals, including 456 males and 201 females. 289 patients were diagnosed as BPH, accounting for 44% of all outpatients and 63.4% of male patients. The average age of BPH patients was (77.2±5.7)years, the mean volume of prostate was (41.44 ± 21.00)ml, the median value of prostate specific antigen (PSA) was 2.24 μg/L, the mean maximum flow rate was (12. 65± 5.74)ml/s, and the average of IPSS and BPHQLS were 14.8±8. 11, 2. 56±1.36, respectively. The percentage of pharmacotherapy was 66.21% (96/145), and the rates of a-receptor blocker monotherapy and 5α-reduetase inhibitor monotherapy were 6.90% and 8. 97%, respectively. The percentage of drug combination was 26.90%. Conclusions BPH outpatients in geriatrics department of the three hospitals are at high risk, and most of them receive drug therapy. The drug choice is reasonable.

Association of lipoprotein-associated phospholipase A2 levels with coronary artery disease, extent of angiographic coronary artery lesions and risk factors in the elderly / 中华老年医学杂志

Objective To observe the correlation between lipoprotein-associated phospholipase A2(Lp-PLA2) levels and coronary artery disease (CAD), extent of angiographic coronary artery lesions and risk factors of CAD in the elderly. Methods Plasma levels of Lp-PLA2, triglyceride (TG), total cholesterol(TC), low density lipoprotein(LDL-C), high density lipoprotein cholesterol (HDL-C) and high sensitivity C-reactive protein(hs-CRP) were measured in 67 elderly patients with angiographic CAD meanwhile in 23 normal controls without angiographic coronary artery lesions. The extent of coronary artery lesions was evaluated according to the number of vessel lesions (divided into single, double and triple-vessel lesions) and Gensini scoring system. Then the relationship between Lp-PLA2 and CAD was assessed. Results The plasma levels of Lp-PLA2 were significantly higher in the CAD group than in the controls [(352.7 ± 129.0) vs. (204.0 ± 59. 7) μg/L, P < 0. 01]. Lp-PLA2 levels increased with the number of coronary artery lesions and Gensini score, then were positively correlated with age(r= 0. 25, P<0. 05) ,TC(r=0. 33, P<0. 01) ,LDL-C(r=0.27, P< 0. 05),apoB(r=0. 36, P<0. 01). The levels of LP-PLA2 and LP(a) were associated with CAD by using stepwise regression analysis. Conclusions In the eldly, the levels of LP-PLA2 are much higher in angiographic CAD, and these may reflect the severity of CAD. LP-PLA2 is a risk factor for CAD.

Effects of curcumin on secretion of adiponectin and interleukin-6 in human adipose tissues: an in vitro study / 中西医结合学报

OBJECTIVE: To investigate the effects of different concentrations of curcumin on secretion of adiponectin (APN) and interleukin-6 (IL-6) in human adipose tissues cultivated in vitro. METHODS: Seven male patients with kidney stones were admitted. Abdominal subcutaneous adipose tissue and perirenal adipose tissue were collected from the operating-patients, and were cultivated with different concentrations of curcumin (10 and 100 microg/ml) in vitro. The contents of APN and IL-6 in the culture medium of adipose tissue cells were measured by enzyme-linked immunosorbent assay (ELISA) after they were cultured for 6 and 24 hours. RESULTS: Compared with the blank control group, the content of APN in the adipose tissue culture medium was increased by 100 microg/ml curcumin (P<0.05) after 6-hour culture, and the content of IL-6 was significantly decreased by 100 microg/ml curcumin after 6- and 24-hour culture (P<0.05). CONCLUSION: 100 microg/ml curcumin can increase APN secretion and decrease IL-6 secretion in human adipose tissues cultivated in vitro.