Study On The Correlation Between Metabolic Syndrome And Urodynamic Characteristics In Patients With Benign Prostatic Hyperplasia

Objective:To study the clinical data and urodynamic parameters of benign prostatic hyperplasia(BPH)combined with metabolic syndrome(MS),and to compare differences in the urinary fluid dynamics of patients with BPH with or without MS and different MS conditions.Methods:Clinical data were retrospectively collected and analyzed from January 2020 to January 2022 in patients with BPH diagnosed at Nanchang University Hospital No.1with urinary fluid dynamics.According to relevant standards,232 patients with BPH were finally included in this study and divided into BPH + MS group(119 cases)and BPH group(113 cases).Both groups completed digital rectal examination(DRE),urinary color Doppler ultrasound and related laboratory examination,urodynamic examination,and collected clinical data of the patients,such as age,height,weight,detailed medical history,etc.Furthermore,patients with BPH complicated with MS need to further improve the records of medical history inquiry and blood glucose,blood pressure monitoring,and the use of therapeutic drugs.By classifying and comparing the clinical data of all patients and the differences in urine kinetics index,we analyzed the characteristics of MS and its components on the corresponding urinary fluid dynamics results of BPH patients,which can provide some theoretical basis for the clinical diagnosis and treatment of BPH.Results:1.After independent sample t-test,single-factor ANOVA test and chi-square test for the clinical data of the two groups(taking whether combined with MS as the independent variable and the clinical data as the dependent variable respectively),it was found that,compared with the simple BPH group,there were significant differences in the BPH + MS group with higher body weight(WT: 69.0 ± 8.8 vs 63.1± 10.8),systolic blood pressure(SBP: 151.1 ± 15.2 vs 135.0 ± 18.5),diastolic blood pressure(DP: 83.8 ± 11.1 vs 79.6 ± 11.0)and fasting blood glucose(FBG: 13.6 ± 5.2vs 5.30 ± 1.87),and lower high-density lipoprotein cholesterol(HDL-C: 1.13 ± 0.32 vs 1.40 ± 0.95)and cholesterol(TC: 4.07 ± 0.90 vs 4.44 ± 0.81)(P<0.01).What’s more,the BPH + MS group had lower low density lipoprotein cholesterol(LDL-C:2.44 ± 0.77 vs 2.66 ± 0.71)and triglyceride(TG: 1.48 ± 1.26 vs 1.15 ± 0.59)than the simple BPH group(P<0.05).There was no significant difference in other indexes(height,BMI,waistline,age,smoking,drinking,and blood uric acid)between the two groups(P>0.05).2.After independent sample t-test,single-factor ANOVA test and chi-square test for the clinical data of the two groups(taking whether combined with MS as the independent variable and the urodynamic data as the dependent variable respectively),it was found that,compared with the simple BPH group,there were significant differences in the BPH + MS group with lower systolic force value of the naturalized detrusor contractility(38.4 ± 32.4 vs 51.5 ± 34.2)(P<0.01).Furthermore,The maximum detrusor pressure(Pdet-max)in BPH + MS group was lower than that in the simple BPH group(96.3 ± 35.0 vs 107.9 ± 41.4)(P<0.05).There was no significant difference between the two groups in bladder initial urine volume(FDV),bladder strong urine volume(UDV),bladder residual urine volume(PVR),URA,OBI,bladder compliance(BC),bladder stability(BC),Linear passive urethral resistance relation Schafer nomogram(Lin PURR)and detrusor systolic rating(P>0.05).3.After data sorting and classification(taking whether a component of MS is abnormal as the independent variable and the urodynamic data as the dependent variable respectively),independent sample t-test,single-factor ANOVA and chi-square test showed that the maximum urinary flow rate and normalized detrusor pressure of BPH patients with elevated blood pressure were higher than those without elevated blood pressure with significant statistical significance(P<0.01).The maximal detrusor contractility in BPH patients with elevated blood pressure was higher than that in patients without elevated blood pressure with statistical significance(P<0.05).The normalized detrusor pressure in BPH patients with elevated blood glucose was higher than that in those without elevated blood glucose with statistical significance(P<0.05).The normalized detrusor pressure in BPH patients with reduced HDL cholesterol was lower than that in those without reduced HDL cholesterol with significant statistical significance(P<0.01).The maximum detrusor contractility,maximum urinary flow rate,detrusor contractility,and bladder stability in BPH patients with reduced HDL cholesterol were lower than those without reduced HDL cholesterol with statistical significance(P<0.05).The normalized detrusor pressure of BPH patients with widened waist circumference was higher than that of BPH patients without widened waist circumference with significant statistical significance(P<0.01).The maximum detrusor contractility,maximum urinary flow rate and detrusor contractility in BPH patients with widened waist circumference were higher than those without widened waist circumference with statistical significance(P<0.05).The maximum detrusor contractility of BPH patients with elevated triglyceride was lower than that of those without elevated triglyceride with statistical significance(P<0.05).The normalized detrusor pressure of BPH patients with increased BMI was higher than that of BPH patients without increased BMI with significant statistical significance(P<0.01).The maximal detrusor contractility in BPH patients with increased BMI were higher than those without increased BMI with statistical significance(P<0.05).The normalized detrusor pressure and maximal detrusor contractility of BPH patients with elevated blood uric acid were lower than those without elevated blood uric acid with statistical significance(P<0.05).There was no statistically significant difference in prostate clinical indexes among BPH patients with abnormal MS diagnostic indexes(P>0.05).4.Multiple linear regression analysis and multiple logical regression analysis were conducted using the diagnostic indexes of each component of metabolic syndrome as the independent variables and a certain index of urodynamic data as dependent variables.BMI had significant effects on maximum detrusor contractility(Pdet-max),naturalized detrusor contractility,Linear passive urethral resistance relation Schafer nomogram(Lin PURR)and detrusor systolic rating in BPH patients,fasting blood glucose(FBG)had significant effects on OBI in BPH patients,and systolic blood pressure(SBP)had significant effects on naturalized detrusor contractility in BPH patients(all P<0.01).Meanwhile,BMI affected bladder compliance in BPH patients,fasting blood glucose(FBG)also affected Linear passive urethral resistance relation Schafer nomogram(Lin PURR)and the contractility of naturalized detrusor muscle in BPH patients(all P<0.05).There was no statistically significant correlation between other urinary fluid dynamics indexes and MS-related indexes(P>0.05).Conclusion:1.BPH combined with MS is more common in BPH patients.Univariate analysis showed that the status of detrusor muscle in the BPH+MS group was significantly different from that in the simple BPH group.Multivariate analysis showed that abnormal BMI,fasting blood glucose and blood pressure might be related to abnormal urodynamics indexes in BPH patients.2.Urodynamic examination can objectively and accurately analyze bladder and detrusor muscle function in patients with BPH,and evaluate the curative effect after operation,and provide a theoretical basis for personalized diagnosis and treatment of BPH.3.MS exacerbates urinary tract decline in patients with BPH,but the mechanism of action remains to be further investigated.