血脂代谢异常和肥胖患者发生高危前列腺癌的风险可能更高
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Effects of dyslipidemia and obesity on high-risk prostate cancer
ABSTRACT：Objective To explore the effects of dyslipidemia and obesity on high-risk prostate cancer，so as to provide reference for the prevention and treatment of prostate cancer.Methods The clinical data of 175 patients with prostate cancer admitted to our hospital during Jun.2016 and Jun.2022 were retrospectively analyzed，including 122 high-risk prostate cancer and 53 non-high-risk prostate cancer.The logistic regression analysis were conducted to identify independent risk factors affecting the occurrence of high-risk prostate cancer.Evaluate the predictive value and optimal cutoff value of risk factors such as age，cholesterol，body mass index （BMI），and prostate-specific antigen （PSA） for the occurrence of high-risk prostate cancer through receiver operating characteristic （ROC） curves.Spearman analysis was used to investigate the correlation between Gleason scores and different risk factors.Results The age，BMI，cholesterol，PSA，incidence of obesity （BIM≥25） and high cholesterol in the high-risk prostate cancer group were all higher than those in the non-high-risk prostate cancer group （P<0.05）.Multivariate logistic regression showed that age （OR=1.097，95%CI：1.005-1.198，P=0.039），obesity （OR=4.459，95%CI：1.305-15.239，P=0.017），PSA （OR=1.170，95%CI：1.069-1.280，P=0.001），and cholesterol （OR=5.544，95%CI：1.304-23.577，P=0.020） were risk factors for high-risk prostate cancer.The ROC curve showed that the optimal cutoff values for age，cholesterol，BMI，and PSA were 74.50 years （AUC：0.748，95%CI：0.678-0.818），3.70 mmol/L （AUC：0.800，95%CI：0.731-0.870），24.97 （AUC：0.621，95%CI：0.532-0.711），and 18.67 ng/mL （AUC：0.864，95%CI：0.813-0.916），respectively，and the combined prediction value of age，cholesterol，BMI，and PSA for high-risk prostate cancer was the highest （AUC：0.931，95%CI：0.895-0.967）.The age （r=0.464，P<0.001），BMI （r=0.222，P=0.003），cholesterol （r=0.501，P<0.001），and PSA （r=0.473，P<0.001） were positively correlated with Gleason by Spearman analysis.Conclusion Obesity，age，PSA，and cholesterol level are independent risk factors for high-risk prostate cancer.When the age is ≥74.50 years，cholesterol level is ≥3.70 mmol/L，BMI is ≥24.97，PSA level is ≥18.67 ng/mL，the possibility of developing high-risk prostate cancer is high.
KEY WORDS：prostate cancer; obesity; cholesterol; lipid metabolism disorder
摘要：目的 探讨血脂代谢异常和肥胖因素是否影响高危前列腺癌的发生，旨在为前列腺癌的防治提供参考。（剩余10885字）
