| Objective Obstructive Sleep Apnea-Hypopnea Syndrome(OSAHS)is a common disease characterized by sleep disruption,recurrent apnea,and intermittent hypoxia during sleep,which leads to a series of target organ damage including hypertension,myocardial infarction,diabetes,cerebrovascular disease,etc.The cause of benign prostatic hyperplasia(BPH)is controversial,and local hypoxia and inflammation are the two main theories of benign prostatic hyperplasia.However,it is not clear whether OSAHS-related hypoxia causes BPH.The objective of this study was to evaluate the effects of OSAHS-related repeated apnea and hypoxia on prostate hyperplasia.MethodsMale patients who had undergone polysomnography and full abdominal color Doppler ultrasound from January 2016 to December 2020 in our Sleep Center were included.The height,weight,neck circumference,and waist circumference were measured on admission.Before monitoring,patients’ age,Epworth narcolepsy scale score and whether they had basic diseases were recorded in detail through questionnaire survey.PSG examination was performed on the same evening,and the patients’ fasting venous blood were collected from the next morning to detect relevant serological indicators,and full-abdominal color ultrasound examination was conducted.Logistics regression was used to analyze independent risk factors for prostate hyperplasia and then all patients were classified into young men by age group(age ≤ 40 years old)and older group(age> 40 years old)for further stratified analysis.ResultsA total of 467 patients were enrolled in this study,including 435 patients finally diagnosed with OSAHS and 32 patients with simple snoring.According to AHI,they were divided into control group,mild OSAHS group,moderate OSAHS group and severe OSAHS group.The incidence of BPH in each group was 37.5%,55.0%,62.9%,and 47.7%,and the difference were not statistically significant(p=0.075).The general conditions,sleep parameters,and biochemical indicators of each OSAHS grouping were compared,and the binary variables were assigned.Finally,logistics regression analysis was performed and found that age and the severity of OSAHS were risk factors for prostate hyperplasia(the p-values are 0.000,0.016).Then a stratified analysis was carried out according to whether the age was greater than 40 years old,and it was found that the incidence of BPH in men aged ≤ 40 years in the OSAHS groups were 0.0%,13.0%,33.3%,and 43.9%(p=0.006).The incidence of BPH among different OSAHS groups in men older than 40 years were52.2%,71.9%,71.1%,and 56.3%(p=0.038).Then,Bonferroni method was used to conduct multiple comparisons,and it was found that there were differences in the prevalence of BPH among different OSAHS groups in young men,while there was no difference in the prevalence of BPH among different groups in men older than40 years old.Spearman correlation analysis showed that the young male group including age,AHI,ODI,minimum blood oxygen at night,mean blood oxygen at night,and Ts90% are significantly related to prostate hyperplasia(p<0.05).In older men,age,AHI,mean blood oxygen,GGT,history of anti-diabetics,uric acid,triglycerides,VLDL,uric acid,and ODI are all significantly related to prostate hyperplasia(p<0.05).Finally,the multivariate logistics regression results suggest that in the young male group,age and AHI were independent risk factors for prostate hyperplasia(OR-values were 0.125,0.024,p-values were 0.009,0.041),while in men older than 40 years old,only age was a risk factor for prostate hyperplasia(OR= 0.071,p=0.000).Conclusions1 In the population grouped according to AHI,with the increase of AHI,patients’ BMI gradually increased,but their age gradually decreased,and there was no difference in the prevalence of BPH.2 After age stratification,the incidence of BPH in different OSAHS groups in young men gradually increased with the increase of AHI,and there were significant differences in the incidence of BPH in men aged over 40.Age was always an independent risk factor for prostate hyperplasia.In young men(age ≤40 years old),AHI was also an independent risk factor for prostate hyperplasia,suggesting that OSAHS might affect the occurrence of prostate hyperplasia in young men. |
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