| Part1:The Correlation of Serum High-SensitivityC-reactive pro-tein and Prostatitis-like Symptoms in Fangchenggang Area MaleObjective:The objective of current studies were to explore the relationship between serum High sensitivity C-reactive protein (Hs-CRP)and prostatitis-like symptoms(PLS)of GuangXi Fangchenggang Area, baced on the Fangchenggang Area Male Health and Examination Survey (FAMHES).Methods:Data were collected from 4303 medical examinationp atients aged between 17 to 88 years old volunteered for the male’s health and Examination Survey,which was carried out in Guangxi Fangchenggang Area, China.we adopted a highly sensitive detection method to detect serum c-reactive protein of the male healthy con- trol and applied a rating scale using National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) to assume prostatitis-like symptoms(PLS). Personal basic information,lifestyle habits such as height, weight, education level, smoking, drinking and exercise, and history of illness and medication history such as diabetes, coronary heart disease,high cholesterol,hypertension and cancer were also gathered by the same time.By formulating strict inclusion and exclusion criteria,1536 cases of male healthy controls in line with our study.Results:According NIH-CPSI total score, moderate to severe prostatitis-like symptoms in patients with a prevalence of 6.2%. Ac-cording to tertiles of serum concentrations HsCRP, the study popula tion was divided into three groups, By using the first percentile co-horts as a reference group, in an uncorrected condition, The risk of illness with prostatitis-like symptoms total score≥16 point or voiding symptoms risk≥3 point increased with serum HsCRP concentration gradually elevating. And the risk of the third percentile group was significantly higher than the first percentile group (CPSI total score: OR=2.00,95% CI=1.18-3.38; voiding symptoms score:OR=1.97,95 %CI=1.21-3.21.After correcting the relevant confounders (age,alcohol consumption, body mass index, exercise, smoking, education,diabetes, hypertension and dyslipidemia), risk of voiding symptoms still in- creased with HsCRP serum concentration evaluating,but the relations hip between CPSI total score and serum HsCRP weakened,becomin no statistical difference. However, the risk of moderate to severe prostatitis-like symptoms are significantly increased with increasing BMI, The results still have statistically significant (OR=2.26,95%CI= 1.15-4.44) after correcting the relevant confounderson the contrary, risk of moderate to severe prostatitis-like symptoms associated nega-tive with the level of education (OR=0.46,95%CI=0.23-0.87).On the other hand, in the age factor,only the 40-49 age group was hig her than the risk in the age group 18-29 for urinary symptoms, the results still have statistically significant (OR=1.78,95%CI=1.05-3.20) after correcting the relevant confounders. Risk of patients with dys-lipidemia was higher than those without dyslipidemia before correcti on, but the relationship weakened, becoming no sta-tistical differenc e after correcting the relevant confounders (OR= 1.48,95%CI=0.97-2.27)Conclusions:In the male population in Fangcheng area, risk of moderate to severe prostatitis-like symptoms and serum high sensi-tivity C-reactive protein levels may be a positive correlation.In void ing symptoms,40-49 year-olds has higher risk of urinary symp-tom s than 18-29 year-olds. Obesity and junior high school education or less people are more prone to have moderate to severe prostatitis-like symptoms. More definitive conclusion requires furtherthe large sample cohort studies to confirm.Part 2:The Correlation of Metabolic Syndrome and Prostatitis-like Symptoms in Fangchenggang Area MaleObjective:Current epidemiological and clinical evidence show that there exists potential link between metabolic syndrome and prostate disease. Insulin resistance and secondary hyperinsulinemia excite sympathetic nervous system and increase the α- adrenergic receptor on prostate and bladder neck. Insulin resistance and fat cells metabolic disorders lead to a elevated levels of inflammatory markers factors and pro-inflammatory cells. Patients with metabolic syndrome often associate with chronic low-grade inflammation state in local tissue. On the other hand, Testosterone,a androgen-dependent hormone, acts on the α-adrenergic receptors and affects the function of smooth muscle. According to the literature,by high and low testosterone levels of testosterone were more prone to metabolic syndrome.People with low levels of testosterone are more likely to occur metabolic syndrome than those with high levels. In addition, there is a large degree of overlap between the non-infectious risk factors of CP/CPPS and pathophysiology of metabolic syndrome, such as urine reflux in prostate, elevate levels of cytokines and inflammation, imbalance between androgen and estrogen, bladder voiding dysfunction. However, domestic and foreign study more focused on benign prostatic hyperplasia and lower urinary tract symptoms syndrome. So far there is no theory directly supports for the mechanism which metabolic syndrome affects CP/CPPS. So we attempt to research relationship between the severity of prostatitis-like symptoms and the metabolic syndrome with its 5 components of diagnostic criteria by using a method of large-scale epidemiological cross-sectional survey.Methods:Data were collected from urban males of Fangchenggang areas by the way of questionnaire and physical examination. In this study, all projects are completed in Fangchenggang City First People’s Hospital Medical Center. A total of 4303 males aged 17 years to 88 years complete the physical examination. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score sheet was used to assess prostatitis-like symptoms. Qualified professionals involved in the investigation went through uniform training. Investigation included basic personal information, such as height, weight, hip circumference, waist circumference, blood pressure, and other aspects such as marital status, family history, medical history, medication history, education level, smoking, exercise, alcohol consumption, physical activity and diet structure. Hematological indicators included triglycerides, High-Density Lipoprotein cholesterol, (HDL-c) and Fasting Blood Glucose(FBG), etc. Blood samples were venous blood collected after fasting for 8 hours. After making strict inclusion and exclusion criteria, the final study included 2542 qualified person.Results:The overall prevalence rate of prostatitis-like symptoms is 12.23% (311/2542)and the overall prevalence rate of the metabolic syndrome is 13.93%(354/2542). Patients with severe prostatitis-like symptoms with a median age of 43 years old was significantly higher than patients with no prostatitis-like symptoms with a median age of 35 years old. The difference was statistically significant (P=0.037). Males with metabolic syndrome in the absence, mild, moderate, and severe of prostatitis-like symptoms, accounting for 14.3%,8.82%,19.4% and 14.29% respectively. This difference of distribution was statistically significant (P=0.045). The prevalence of patients with CPSI total score moderate to severe symptoms gradually increased from 4.21% to 10,07% with increasing age. The prevalence of patients with Pain scores moderate to severe symptoms increased from 2.04%,group less than 29, to 7.91%,group more than 60. The prevalence of metabolic syndrome is also gradually increased with increasing age. Based on CPSI total score,the risk that male group 50-59 and male group more than 60 have moderate to severe prostatitis-like symptoms is 1.98 times and 2.55 times more than that male group less than 29 respectly. If baced on the pain score, the risk that male group more than 60 have moderate to severe prostatitis-like symptoms is 4.74 times more than that male group less than 29.Also baced on the pain score, the risk that people with waist circumference more than 90CM occur moderate to severe prostatitis-like symptoms is 2.07 times more than that people with normal waist circumference. Single component of the metabolic syndrome abnormal, such as high fasting blood sugar, high cholesterol, low high-density lipoprotein,unclearly affects prostatitis-like symptoms. With the increasing of the number of abnormal components of metabolic syndrome,3 or more abnormalities in men,prevalence of moderate to severe increases gradually while the prevalence of mild decreases gradually, but trend test finds the changes of prevalence not statistically significant. (P> 0.05). The risk of men with metabolic syndrome having moderate to severe prostatitis-like symptoms is significantly higher than that of man without metabolic syndrome (OR =2.41,95% CI:1.16-5.02). After adjusting for age, The risk of men with metabolic syndrome having moderate to severe prostatitis-like symptoms is 2.21 times more than that having mild prostatitis-like symptoms. Further adjusting for education, smoking, alcohol consumption, exercise,the results suggest a higher risk (OR= 2.53,95% CI:1.14-5.66).Conlusions:(1) Prevalence of moderate to severe prostatitis-like symptoms and metabolic syndrome increases gradually with the increasing age. (2) There exists a association between the metabolic syndrome and moderate to severe prostatitis-like symptoms.Part 3:The Correlation of Lifestyle and Prostatitis-like Symptoms in Fangchenggang Area MaleObjective:The chronic prostatitis patient is large, low cure rate, and recurrence rate is high in them, the clinicians and patients are not satisfied the effect of treatment of it, the main reason are the etiology and pathogenesis of chronic prostatitis are not clear, have a wide range of controversy. It has been reported that chronic prostatitis may be several causes also play a role, one or several key plays a major role, or many different kinds of disease, but with the same or similar clinical manifestations. It has been reported that the development of certain foods can affect prostate disease, such as soy have a protective effect in preventing prostate disease. It is confirmed that lycopene can significantly inhibit the growth of normal prostate cells, and showed a dose-response relationship in vitro. For the relationship between behavior and prostatitis, it has been reported physical activity can reduce the risk of prostatitis, but in terms of TV time to measure the sedentary time, found that sedentary not increase the risk of prostatitis.There are literature reported that increased sexual activity and frequency physical activity can reduce the prevalence rate of chronic prostatitis, the pressure of life, emotional state, physical condition and social support level are related with the prevalence of prostatitis but smoking, drinking, age at first sex, number of sexual partners are not related to the prevalence of prostatitis. Another literatures found that the walking with vigorous exercise has the same effect in reducing the risk of prostatitis. The relationship between lifestyle behaviors and prostatitis is not consistent, different ethnic and regional groups have quite different lifestyle might be one of the reasons. At present, large-scale epidemiological survey of the relationship between lifestyle and prostatitis in China Southern male population is rarely reported, therefore, this study intends to investigate the male population of Fangchengang region, to explore the correlation of life behavior and male prostatitis-like symptoms in Fangchenggang region of Guangxi.Methods:Our research group carried out a large-scale cross-sectional survey basedon demographic information in the Fangchenggang of Guangxi. The survey collected a total of 4303 research object data. Respondents aged between 17 to 88, and them accepted professional training before the survey. Survey content including the demographic information, occupation, education level, marital status, mode of transport, physical activity, exercise and the frequency, type and frequency of drinking, eating eggs, milk, sweet, salty and the frequency of greasy foods and types of edible oil and other related with lifestyle. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score scale was used to assess the prostatitis like symptoms, it includes nine problems:the problem of 1-4 scoring table for pain or discomfort symptom score, is used to evaluate the pain of location, frequency and the degree of pain. Pain scores more than 4 cent considered prostatitis-like symptoms(prostatitis-like symptoms, PLS). Statistical software SPSS17.0 was used to process and analyze the data. The multivariate logistic regression model was used to analyze the correlation of life behavior and prostatitis like symptoms.Results:This study included 2768 subjects, age range 17-84 years old. the total prevalence rate of prostatitis-like symptoms was 12.9% (356/2768). Prostatitis-like symptoms group age (39.34±11.90), no prostatitis like symptoms group age(37.84±11.81) years, the age difference of two groups was significant (P=0.026). Compared with the symptomatic group, no symptomatic group receiving high school and higher education, and are more prone to alcohol in beer, less intake of sweets and fats. Compared with the no symptomatic group, symptomatic group more inclined to have sex. The two groups have no significant difference in the frequency of exercise, exercise time per week, occupational physical strength, occupational physical activity, drinking frequency, mode of transport, eat eggs frequency, eat milk frequency, salty food frequency, types of edible oil. A statistically significant correlation between age, sex, education level, sweets and greasy food frequency and frequency of prostatitis-like symptoms (p<0.05). The education level and prostatitis-like symptoms were negatively correlated (r=-0.041). Age, sex, sweets, greasy food frequency and prostatitis like symptoms were positively correlated (r=0.047,0.061,0.058,0.056). The correlation of occupational physical strength, occupational physical activity forms, drinking frequency, modes of transportation, exercise time per week, exercise frequency and eat eggs frequency, eat milk frequency, types of edible oil and prostatitis-like symptoms had no statistical significance (P> 0.05). Without the correction of other related factors, the prostatitis-like symptoms risk of population which eat sweets 3-4 times a week, receiving education of primary school or below, was higher than other populations(OR=1.636,95%CI:1.179-2.270),(OR= 2.227,95% CI 1.207-4.110). Compared with the edible oils and fats food every week less than2 times group, the prostatitis-like symptoms risk of edible oils and fats food frequency every week 3-4 times and 5-7 times group was higher(OR=1.403,95%CI:1.037-1.898), (OR=1.474,95% CI:1.058-2.053). Drank beer and wine compared with other classes such as rice wine may decreases the risk of prostatitis-like symptoms(OR= 0.379,95%CI:0.174-0.825).After correction of other related risk factors, the correlation between oil edible food frequency, level of education, drank and prostatitis-like symptoms abated, had no statistical significance. The risk of people which eat sweets 3-4 times a week suffering from prostatitis like symptoms is 1.561 times than 2 times a week, and risk of the sexual life of people suffering from prostatitis-like symptoms is 1.765 times than the asexual life people.Conclusions:Eating sweets 3-4 times a week and sexual life people are more likely to suffer prostatitis-like symptoms. Because of the limitations of cross-sectional studies, this view need more samples cohort studies to confirm. |
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