The Observation Of Correlations Between Type-2Diabetes Mellitus And Benign Prostatic Hyperplasia By Transrectal Ultrasound

Objective1. To explore the correlations between type2diabetes mellitus(T2DM) and benign prostatic hyperplasia(BPH), in order to definite the etiology and mechanism of BPH under the influence of T2DM-related abnormal metabolic index.2. To discuss the differences of ultrasonic characteristics of the prostate transition zone tissue between non-diabetic BPH patients and diabetic BPH by transrectal real-time elasticity imaging.Methods1. Transtrectal ultrasound and related serological examination was performed on42non-diabetic BPH patients (group A) and38diabetic BPH patients (group B).1.1Data on body height and weight were collected and body mass index (BMI) were calculated.1.2Blood samples were drawn from fasting patients to determine cholesterol(Ch), triglycerides(TG)、LDL and HDL-cholesterol (LDL-C, HDL-C), fasting blood glucose(FBG), hemoglobin A1C (HbA1c).1.3Transrectal ultrasound was performed on all the80patients and the prostate was measured and then the total prostate volume(TPV)、transitional zone volume(TZV) and transitional zone index(TZI) were calculated. After that the systolic peak velocity(PSV), mean glow velocity(VM) and resistant index(RI) of the artery near the surgical capsule of prostate was monitoring by color Doppler flow imaging(CDFI).Perform statistics on the data, comparative analysis the correlation and difference between non-diabetic BPH and diabetic BPH.2. Finally TRTE examination was performed on all the80BPH patients, and the elastography of transitional zone was observed. The relationship of the elastic ultrasonographic characteristics between two groups was analyzed.Results1. Compare with group A and group B, BMI、CHOL、TC、LDL-C、FBG、HbA1c、TPV、 T2V、TZI and RI was significantly higher in diabetic patients than in non-diabetic BPH men (P<0.05), whereas the HDL-C、PSV and VM in diabetic patients was significantly lower than in non-diabetic BPH patients (P<0.05). The Levene test demonstrate that TZI (P=0.024) and RI (P=0.011) between two groups are significantly different.2. TZI is related with BMI、TC、FBG and HbA1c on0.01level (double side), the correlation was more significant than the results of TPV and TZV with BMI、TC、FBG and HbA1C. r is equal to0.344、0.585、0.626、0.532separately.3. RI is related with BMI、TC、LDL-C、FBG、HbA1c、TZV and TZI on0.01level (double side), and r is equal to0.296、0.600、0.303、0.662、0.619、0.304.0.470separately; and RI is related with CHOL、HDL-C、VM on0.01level (double side), r is equal to0.251、-2.48、-2.79separately.4. Elasticity imaging techniques depending on the different elastic coefficient between different organizations, transfer the echo of the tissue movement before and after pressure to real-time colorized imaing, thus the tissue hardness among different zone of the prostate can be showed clearly. TRTE was performed on all the80BPH patients, and there are no significant difference on the tissue hardness of the prostate transition zone between non-diabetic BPH patients and diabetic BPH patients.Conclusions1. There was correlation between BPH and T2DM related biochemical indexes, the process of BPH would be much more rapidly combine with T2DM. The significantly higher Rl values of the transitional zone in diabetic patients compared with patients with non-diabetic BPH indicate considerable vascular damage in the transitional zone of these patients. Diabetic vascular damage may cause hypoxia and may contribute to the pathogenesis of BPH.3. TRTE can evaluate the tissue hardness effectively, we found no significant different tissue hardness on the prostate transition zone between patients with non-diabetic BPH and diabetic BPH men.