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Cannavo A. Molecular Mechanisms Underlying Chronic and Degenerative Diseases. Int J Mol Sci 2023; 24:12507. [PMID: 37569882 PMCID: PMC10420070 DOI: 10.3390/ijms241512507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
The Special Issue entitled "Molecular Mechanisms Underlying Chronic and Degenerative Diseases" contains eight articles: six original studies and two reviews [...].
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Affiliation(s)
- Alessandro Cannavo
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
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2
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Simvastatin inhibits prostatic hyperplasia in rats with metabolic syndrome. Int Urol Nephrol 2022; 54:2125-2131. [PMID: 35691993 DOI: 10.1007/s11255-022-03227-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
OBJECTS To evaluate the influence of metabolic syndrome (MetS) induced by high fat diet (HFD) on prostate tissue and local inflammatory factors in rats model, and the protective efficacy of statins against pathological changes of prostate. METHODS 40 Sprague-Dawley rats were divided into 4 subgroups of normal diet (ND), HFD blank, HFD + saline and HFD + simvastatin. After the establishment of models, all subjects were killed to obtain body weight serum lipid, FBG level, FINS and HOMA-IR level. Hyperplasia level of prostate, as well as expression level of interleukin 6 (IL-6), insulin-like growth factor 1 (IGF-1), interleukin 10 (IL-10) and tumor necrosis factor alpha (TNF-α) were also measured. RESULTS Models have been successfully established. Level of serum lipid, prostatic weight, hyperplasia as well as expressions of IL-6, TNF-α and IGF-1 in the blank and saline subgroups of HFD group were higher than that of ND group (P < 0.05). While simvastatin has significantly resisted the former effects of HFD on serum lipid and prostate (P < 0.05). No significant difference in serum FBG level was found between groups and subunits. FINS levels of ND group was lower than other groups (P < 0.05). In addition, There is no significant difference in FPG and HOMA-IR levels in blank control subunit, saline control subunit, simvastatin subunit (P > 0.05). CONCLUSIONS MetS induced by HFD is an important factor in the induction of BPH. Simvastatin can alleviate the hyperplasia of prostate through the relief of local inflammation in prostatic tissue.
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Nian L, Shukang G, Shasha W, Xiangyun L. Aerobic exercises ameliorate benign prostatic hyperplasia via IGF-1/IGF-1R/ERK/AKT signalling pathway in prostate tissue of high-fat-diet-fed mice with insulin resistance. Steroids 2021; 175:108910. [PMID: 34461103 DOI: 10.1016/j.steroids.2021.108910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 08/02/2021] [Accepted: 08/21/2021] [Indexed: 12/15/2022]
Abstract
This study investigated the changes in the prostate of high-fat diet (HFD)-fed mice with insulin resistance (IR) and explored the possible mechanisms of the effects of 8-week treadmill aerobic exercise on prostatic hyperplasia in insulin-resistant mice through the IGF-1/IGF-1R/ERK/AKT signalling pathway. Results showed IR in mice caused an increase in prostate-related indicators, such as prostate weight (PW) and prostate volume (PV), resulting in prostatic hyperplasia. The area of the glandular lumen and the height of the glandular epithelium in mice with IR were increased, which indicating that it caused prostatic hyperplasia through epithelial cell proliferation. In addition, the level of IGF-1 in serum and the expression of IGF-1R, ERK and AKT in prostate tissue of high-fat diet induced IR mice increased significantly, which might be related to the proliferation of prostate cells. However, aerobic exercise lowered the blood sugar, serum insulin and IGF-1; inhibited the combination of IGF-1 and IGF-1R on the prostate; down-regulated the expression of IGF-1R, ERK and AKT proteins; and then suppressed the expression of downstream proliferation genes, thereby achieving the purpose of inhibiting the proliferation of prostate epithelial cells. In conclusion. Eight weeks of aerobic exercise might improve the prostate hyperplasia in mice via down-regulating the serum insulin and IGF-1, thus enhancing the insulin sensitivity of insulin-resistant mice and regulating the IGF-1/IGF-1R/ERK/AKT signalling pathway by inhibiting the expression of IGF-1R, ERK and AKT in the prostate tissue. However, this exercise had no significant effect on PV, PW and prostate index (PI).
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Affiliation(s)
- Liu Nian
- Shanghai Key Lab of Human Performance, Shanghai University of Sport, Shanghai 200438, China
| | - Gui Shukang
- Shanghai Key Lab of Human Performance, Shanghai University of Sport, Shanghai 200438, China
| | - Wang Shasha
- Shanghai Key Lab of Human Performance, Shanghai University of Sport, Shanghai 200438, China
| | - Liu Xiangyun
- Shanghai Key Lab of Human Performance, Shanghai University of Sport, Shanghai 200438, China.
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4
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Erbay G, Ceyhun G. Association between hyperlipidemia and prostatic enlargement: A case-control study. Urologia 2021; 89:58-63. [PMID: 33749403 DOI: 10.1177/03915603211003401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A high-fat diet is associated with the development of benign prostatic enlargement (BPE), but whether hyperlipidemia is associated with BPE remains unclear. This study aimed to evaluate whether hyperlipidemia is a risk factor for the development of BPE. MATERIAL AND METHODS This study included 265 BPE patients with lower urinary tract symptoms (LUTS) and 248 age-matched healthy individuals without LUTS. The patient and control groups included in the study were compared in terms of fasting serum glucose, serum lipid values, prostate specific antigen (PSA), and prostate size measured by abdominal ultrasonography. RESULTS The prostate sizes of the patient and healthy control group were 59.4 ± 12.6 and 41.8 ± 11.1 ml, respectively (p = 0.007). It was observed that the mean PSA value of the patient group (2.33 ± 1.69) was statistically higher than that of the control group (1.21 ± 1.05) (p = 0.002). Total cholesterol and LDL-cholesterol were significantly higher and HDL-cholesterol was significantly lower among the patients compared to the controls. Prostate size had a negative correlation with HDL-cholesterol and a positive correlation with LDL-cholesterol and total cholesterol. Additionally, LDL-cholesterol and total cholesterol were independent risk factors for prostate enlargement. CONCLUSION This study indicates that increased levels of LDL-cholesterol and total cholesterol are significantly associated with the enlargement of the prostate. Hyperlipidemia may be one of the risk factors in the processes of prostatic growth and progression.
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Affiliation(s)
- Güven Erbay
- Urology Clinic, Faculty of Medicine, Karamanoglu Mehmetbey University, Karaman, Turkey
| | - Gökhan Ceyhun
- Department of Cardiology Clinic, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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Omran A, Leca BM, Oštarijaš E, Graham N, Da Silva AS, Zaïr ZM, Miras AD, le Roux CW, Vincent RP, Cardozo L, Dimitriadis GK. Metabolic syndrome is associated with prostate enlargement: a systematic review, meta-analysis, and meta-regression on patients with lower urinary tract symptom factors. Ther Adv Endocrinol Metab 2021; 12:20420188211066210. [PMID: 34900218 PMCID: PMC8664322 DOI: 10.1177/20420188211066210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is defined by at least three of the following five criteria: blood pressure ⩾130/85 mmHg, fasting blood glucose ⩾5.6 mmol/l, triglycerides concentration ⩾1.7 mmol/l, waist circumference ⩾102 cm (for men), and high-density lipoprotein cholesterol concentration <1.03 mmol/l (for men). MetS has been associated with worse lower urinary tract symptoms (LUTS) and higher International Prostate Symptom questionnaire scores. MATERIALS AND METHODS MEDLINE, Cochrane, ClinicalTrials.gov, and SCOPUS were critically appraised for all peer-reviewed manuscripts that suitably fulfilled our protocol's inclusion criteria established a priori. Meta-analytical and meta-regression calculations were performed in R using the Sidik-Jonkman and Hartung-Knapp random effects model and predefined covariates. RESULTS A total of 70 studies (n = 90,206) were included in qualitative synthesis. From these, 60 studies focused on MetS and LUTS: 44 reported positive correlations, 5 reported negative correlations, 11 reported no association, and 10 studies focused on MetS and total prostate volume (TPV). MetS positively correlated with moderate LUTS [odds ratio (OR) = 1.56, 95% confidence interval (CI) = 1.35-1.80], severe LUTS (OR = 2.35, 95% CI = 1.82-3.03), overactive bladder (OAB; OR = 3.2, 95% CI = 1.6-5.8), and nocturia severity (OR = 2.509, 95% CI = 1.571-4.007) at multivariate analysis. A total of 30 studies (n = 22,206) were included in meta-analysis; MetS was significantly associated with higher TPV (mean differences = 4.4450 ml, 95% CI = 2.0177-6.8723), but no significant predictive factors for effect sizes were discovered. CONCLUSION Our meta-analysis demonstrates a significant association between the aggravating effects of MetS, which commonly coexists with obesity and benign prostate enlargement.
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Affiliation(s)
| | | | - Eduard Oštarijaš
- Institute for Translational Medicine, University of Pecs Medical School, Pecs, Hungary
| | - Natasha Graham
- Department of Obstetrics & Gynaecology, Queen Elizabeth Hospital, London, UK
| | - Ana Sofia Da Silva
- Department of Urogynaecology, King’s College Hospital NHS Foundation Trust, London, UK
| | | | - Alexander D. Miras
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Carel W. le Roux
- Diabetes Complication Research Centre, School of Medicine and Medical Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Royce P. Vincent
- Faculty of Life Sciences and Medicine, School of Life Course Sciences, King’s College London, London, UKDepartment of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, London, UK
| | - Linda Cardozo
- Department of Urogynaecology, King’s College Hospital NHS Foundation Trust, London, UK
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Hermoso DAM, Bizerra PFV, Constantin RP, Ishii-Iwamoto EL, Gilglioni EH. Association between metabolic syndrome, hepatic steatosis, and testosterone deficiency: evidences from studies with men and rodents. Aging Male 2020; 23:1296-1315. [PMID: 32406295 DOI: 10.1080/13685538.2020.1764927] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Testosterone is the predominant androgen in men and the lack of it can be a trigger to the development of the metabolic syndrome. Here we review the relationship between testosterone deficiency, metabolic syndrome, and hepatic steatosis reported by studies with men and rodents. The prevalence of metabolic syndrome and testosterone deficiency is higher among older subjects. Low total and free testosterone levels were positively associated with disturbs on energy metabolism, changes in body fat distribution, and body composition. Studies reported visceral fat accumulation in men with hypogonadism and castrated rats. Despite some contradictions, the association between higher adiposity, low testosterone, and metabolic syndrome was a common point among the studies. Few studies evaluated the hepatic steatosis and found an association with hypogonadism. Most of the studies with rodents combined the castration with a high-fat diet to study metabolic disturbs. The importance of proper levels of testosterone for energy metabolism homeostasis in men was also underlined by studies that investigated the metabolic effects of testosterone replacement therapy and androgen deprivation therapy.
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Affiliation(s)
- Danielle Aparecida Munhos Hermoso
- Departament of Biochemistry, Laboratory of Biological Oxidation and Laboratory of Experimental Steatosis, State University of Maringá, Maringá, Brazil
| | - Paulo Francisco Veiga Bizerra
- Departament of Biochemistry, Laboratory of Biological Oxidation and Laboratory of Experimental Steatosis, State University of Maringá, Maringá, Brazil
| | - Rodrigo Polimeni Constantin
- Departament of Biochemistry, Laboratory of Biological Oxidation and Laboratory of Experimental Steatosis, State University of Maringá, Maringá, Brazil
| | - Emy Luiza Ishii-Iwamoto
- Departament of Biochemistry, Laboratory of Biological Oxidation and Laboratory of Experimental Steatosis, State University of Maringá, Maringá, Brazil
| | - Eduardo Hideo Gilglioni
- Departament of Biochemistry, Laboratory of Biological Oxidation and Laboratory of Experimental Steatosis, State University of Maringá, Maringá, Brazil
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Cakir SS, Ozcan L, Polat EC, Besiroglu H, Kocaaslan R, Ötunctemur A, Ozbek E. Statins are effective in the treatment of benign prostatic hyperplasia with metabolic syndrome. Aging Male 2020; 23:538-543. [PMID: 30463466 DOI: 10.1080/13685538.2018.1541979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To compare the efficacy of statins and ɑ blockers drug therapies for benign prostatic hyperplasia (BPH) in patients with metabolic syndrome (MetS). MATERIALS AND METHOD A total of three hundred patients were randomly distributed into three groups of one hundred patients each. Group 1 received only ɑ-adrenoceptor antagonist (ɑ-blocker, AB) (Tamsulosin), group 2 received only statin (atorvastatin), and group 3 received AB plus statin (Tamsulosin + Atorvastatin). The efficacy measurement was assessed by analyzing the changes from baseline in the total International Prostate Symptom Score (IPSS), disease-specific QoL question score and maximum urinary flow rate at the end of 6 months in each group and between the three groups. RESULTS Pre-treatment and post-treatment value of triglycerides (TG), high-density lipoprotein (HDL), and prostate volüme (PV) were not significantly different in AB group, while TG and PV were significantly lower in patients taking statin and combined therapy. The significant decrease was demonstrated in maximum urinary flow rate (Qmax) in three groups. However, the most significant decrease was observed in the combination therapy group. IPSS, postvoid residual urine volüme (PVR), and Quality of Life score (QoL) significantly changed in three groups. CONCLUSION We recommend of the use of statins in those men with BPH accompanied by MetS in which AB is ineffective alone.
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Affiliation(s)
- Suleyman Sami Cakir
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Levent Ozcan
- Department of Urology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Emre Can Polat
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | | | - Ramazan Kocaaslan
- Department of Urology, Kafkas University School of Medicine, Kars, Turkey
| | - Alper Ötunctemur
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Emin Ozbek
- Department of Urology, Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey
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Li J, Peng L, Cao D, Gou H, Li Y, Wei Q. The association between metabolic syndrome and benign prostatic hyperplasia: a systematic review and meta-analysis. Aging Male 2020; 23:1388-1399. [PMID: 32482153 DOI: 10.1080/13685538.2020.1771552] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE We performed this meta-analysis to assess the association between metabolic syndrome (MetS) and benign prostatic hyperplasia (BPH). METHOD We conducted extensive searches on the PubMed, Science and Cochrane Library to identify all articles. Outcomes including annual prostate growth rate, prostate volume (PV), International Prostate Symptom Score (IPSS), IPSS sub-scores (voiding and storage), prostate- specific antigen (PSA), maximum urine flow rate (Qmax), post-void residual urine volume (PVR) and quality of life (QoL) were assessed. RESULTS 21 studies with 15,317 patients were included. Patients with MetS had higher annual prostate growth rate [weighted mean difference (WMD) = 0.79; p < .001], larger PV (WMD = 2.62; p < .001), lower Qmax (WMD = -0.48; p = .001) and more PVR (WMD = 8.28; p < .001). However, no significant differences were found between two groups in IPSS (WMD = 0.20; p = .37), IPSS-voiding (WMD = -0.05; p = .78), IPSS-storage (WMD = -0.22; p = .26), PSA (WMD = 0.04; p = .43), and QoL (WMD = -0.01; p = .70). CONCLUSIONS The study suggested that MetS may be one of the risk factors for the clinical progress of BPH. However, further study is warranted to support these results.
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Affiliation(s)
- Jinze Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Sichuan, China
| | - Lei Peng
- Department of Urology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Sichuan, China
| | - Dehong Cao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Haocheng Gou
- Department of Otolaryngology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Sichuan, China
| | - Yunxiang Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Sichuan, China
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
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Xia BW, Zhao SC, Chen ZP, Chen C, Liu TS, Yang F, Yan Y. The underlying mechanism of metabolic syndrome on benign prostatic hyperplasia and prostate volume. Prostate 2020; 80:481-490. [PMID: 32104919 DOI: 10.1002/pros.23962] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 02/04/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate the potential mechanism of the effect of metabolic syndrome (MetS) on prostate volume (PV) and the risk of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and the relationships of MetS and the major pathogenic factors of MetS with the clinical progression of BPH/LUTS in older Chinese men. SUBJECTS AND METHODS We analyzed clinical data obtained from 506 ostensibly healthy men who underwent routine health check-ups and recruited 415 subjects from a group of previously studied men after 4 years. We evaluated the associations of major pathological factors of MetS, including insulin resistance, subclinical inflammatory state, and sex hormone changes, with PV, the risk of BPH and the clinical progression of BPH/LUTS by using multiple linear regression and logistic regression. RESULTS After adjustment for age, insulin, HOMA (homeostatic model assessment) index, leptin, resistin, adiponectin, C-reactive protein, tumor necrosis factor-α (TNF-α), sex hormone-binding globulin, and testosterone levels were significantly associated with PV (all P < .05), and in the age-adjusted logistic regression model, positive associations of resistin and TNF-α with BPH/LUTS were found (OR, 1.662, P = .007 and OR, 1.044, P < .001, respectively). Predictors of BPH/LUTS clinical progression were significantly correlated with MetS and TNF-α. The group with higher TNF-α levels had a higher rate of newly diagnosed BPH (9.5% vs 19.1%, P = .006) and a greater increase in PV levels (0.61 ± 0.08 vs 1.09 ± 0.35 cm3 , P <.001) after 4 years. CONCLUSIONS MetS and its pathological factors were associated with an increased PV and an increased risk of BPH/LUTS that is more prone to clinical progression. TNF-α may serve as an early biological indicator to identify which patients with BPH/LUTS are at higher risk of unfavorable outcomes.
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Affiliation(s)
- Bo-Wen Xia
- Department of Urology, Capital Medical University, Beijing, China
| | - Si-Cong Zhao
- Department of Urology, Capital Medical University, Beijing, China
| | - Zong-Ping Chen
- Department of Urology, Capital Medical University, Beijing, China
| | - Chao Chen
- Department of Urology, Capital Medical University, Beijing, China
| | - Tian-Shu Liu
- Department of Urology, Capital Medical University, Beijing, China
| | - Fan Yang
- Department of Urology, Capital Medical University, Beijing, China
| | - Yong Yan
- Department of Urology, Capital Medical University, Beijing, China
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Wu S, He H, Wang Y, Xu R, Zhu B, Zhao X. Association between benign prostate hyperplasia and metabolic syndrome in men under 60 years old: a meta-analysis. J Int Med Res 2019; 47:5389-5399. [PMID: 31612766 PMCID: PMC6862896 DOI: 10.1177/0300060519876823] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Shuiqing Wu
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People's Republic of China
| | - Haiqing He
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People's Republic of China
| | - Yinhuai Wang
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People's Republic of China
| | - Ran Xu
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People's Republic of China
| | - Bin Zhu
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People's Republic of China
| | - Xiaokun Zhao
- Department of Urology, The Second Xiangya Hospital, Central South University, Hunan Province, People's Republic of China
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Grzesiak K, Rył A, Baranowska-Bosiacka I, Rotter I, Dołęgowska B, Słojewski M, Sipak-Szmigiel O, Ratajczak W, Lubkowska A, Metryka E, Piasecka M, Laszczyńska M. Comparison between selected hormone and protein levels in serum and prostate tissue homogenates in men with benign prostatic hyperplasia and metabolic disorders. Clin Interv Aging 2018; 13:1375-1382. [PMID: 30122909 PMCID: PMC6080669 DOI: 10.2147/cia.s168146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose The purpose of the study was to assess the relationship between changes in the levels of selected hormones in serum and prostate tissue homogenate in regard to metabolic disorders in patients with diagnosed, surgically treated benign prostatic hyperplasia (BPH). Patients and methods The study involved a group of 154 men with a diagnosis of BPH with metabolic syndrome (MetS) and without MetS. The serum levels of the hormones – total testosterone, free testosterone, insulin, dehydroepiandrosterone sulfate, estradiol, luteinizing hormone, sex hormone binding globulin (SHBG), and insulin-like growth factor-1 (IGF-1) – were determined using the ELISA method. Prostate tissue sections obtained from the patients during transurethral resection of the prostate were frozen in liquid nitrogen. We determined the levels of the same hormones. Results There was a statistically significant difference between the groups in terms of serum SHBG levels, but not in the prostate tissue SHBG levels. A similar relationship was observed in regard to IGF-1, the serum levels of which were significantly higher in patients with MetS. MetS had an effect on the ratio of hormone levels in serum to their levels in the prostate tissue. Correlations between the levels of biochemical parameters and the levels of hormones in serum and the prostate tissue of BPH patients with and without MetS demonstrate that serum SHBG levels correlated weakly with waist size and triglyceride levels. Conclusion The occurrence of MetS in BPH patients was associated with changes in the levels of hormones and proteins. These changes, however, were not always equivalent to changes in the levels of these parameters in prostate tissue. It should also be mentioned that MetS in BPH patients had an influence on a quantitative balance between the levels of SHBG in serum and prostate tissue.
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Affiliation(s)
- Katarzyna Grzesiak
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin, Poland
| | - Aleksandra Rył
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland,
| | | | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland,
| | - Barbara Dołęgowska
- Department of Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Marcin Słojewski
- Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Olimpia Sipak-Szmigiel
- Department of Obstetrics and Pathology of Pregnancy, Pomeranian Medical University, Szczecin, Poland
| | - Weronika Ratajczak
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin, Poland
| | - Anna Lubkowska
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Emilia Metryka
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Małgorzata Piasecka
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin, Poland
| | - Maria Laszczyńska
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin, Poland
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Tan X, Zhang X, Li D, Chen X, Dai Y, Gu J, Chen M, Hu S, Bai Y, Ning Y. Transurethral vaporesection of prostate: diode laser or thulium laser? Lasers Med Sci 2018; 33:891-897. [PMID: 29633057 DOI: 10.1007/s10103-018-2499-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/27/2018] [Indexed: 12/29/2022]
Abstract
This study compared the safety and effectiveness of the diode laser and thulium laser during prostate transurethral vaporesection for treating benign prostate hyperplasia (BPH). We retrospectively analyzed 205 patients with BPH who underwent a diode laser or thulium laser technique for prostate transurethral vaporesection from June 2016 to June 2017 and who were followed up for 3 months. Baseline characteristics of the patients, perioperative data, postoperative outcomes, and complications were compared. We also assessed the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), average flow rate (AFR), and postvoid residual volume (PVR) at 1 and 3 months postoperatively to evaluate the functional improvement of each group. There were no significant differences between the diode laser and thulium laser groups related to age, prostate volume, operative time, postoperative hospital stays, hospitalization costs, or perioperative data. The catheterization time was 3.5 ± 0.8 days for the diode laser group and 4.7 ± 1.8 days for the thulium laser group (p < 0.05). Each group had dramatic improvements in IPSS, QoL, Qmax, AFR, and PVR compared with the preoperative values (p < 0.05), although there were no significant differences between the two groups. Use of both diode laser and thulium laser contributes to safe, effective transurethral vaporesection in patients with symptomatic BPH. Diode laser, however, is better than thulium laser for prostate transurethral vaporesection because of its shorter catheterization time. The choice of surgical approach is more important than the choice of laser types during clinical decision making for transurethral laser prostatectomy.
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Affiliation(s)
- Xinji Tan
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaobo Zhang
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China. .,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China. .,Urolithiasis Institute of Central South University, Xiangya Hospital, Central South University, Changsha, Hunan, China. .,The Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Dongjie Li
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China
| | - Xiong Chen
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China
| | - Yuanqing Dai
- The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Gu
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mingquan Chen
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sheng Hu
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yao Bai
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.,The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,The Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yu Ning
- The Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
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13
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Plata M, Caicedo JI, Trujillo CG, Mariño-Alvarez ÁM, Fernandez N, Gutierrez A, Godoy F, Cabrera M, Cataño-Cataño JG, Robledo D. Prevalence of metabolic syndrome and its association with lower urinary tract symptoms and sexual function. Actas Urol Esp 2017; 41:522-528. [PMID: 28390836 DOI: 10.1016/j.acuro.2016.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/12/2016] [Accepted: 12/13/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To estimate the frequency of metabolic syndrome (MetS) in a daily urology practice and to determine its association with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). MATERIAL AND METHODS A retrospective study was conducted. Data from all male patients aged ≥40 years who attended our outpatient urology clinic from 2010 to 2011 was collected. Prevalence of MetS was determined, and LUTS and ED were assessed. A logistic model was used to determine possible associations, controlling for confounders and interaction factors. RESULTS A total of 616 patients were included. MetS was observed in 43.8% (95% CI 39.6-48.3). The bivariate model showed an association between MetS and LUTS (p<0.01), but not between MetS and ED. The logistic model showed an association between MetS and the International Prostate Symptom Score (IPSS), while controlling for other variables. Patients exhibiting moderate LUTS had a greater risk for MetS than patients with mild LUTS (OR 1.83, 95% CI 1.14-2.94). After analyzing for individual components of MetS, positive associations were found between diabetes and severe LUTS (OR 1.3, 95% CI 1.24-7.1), and between diabetes and ED (OR 2.57, 95% CI 1.12-5.8). CONCLUSION This study was able to confirm an association between MetS and LUTS, but not for ED. Specific components such as diabetes were associated to both. Geographical differences previously reported in the literature might account for these findings. Given that MetS is frequent among urological patients, it is advisable that urologists actively screen for it.
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Affiliation(s)
- M Plata
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia.
| | - J I Caicedo
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia
| | - C G Trujillo
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia
| | - Á M Mariño-Alvarez
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia
| | - N Fernandez
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - A Gutierrez
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - F Godoy
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - M Cabrera
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - J G Cataño-Cataño
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - D Robledo
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia
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14
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Ngai HY, Yuen KKS, Ng CM, Cheng CH, Chu SKP. Metabolic syndrome and benign prostatic hyperplasia: An update. Asian J Urol 2017; 4:164-173. [PMID: 29264226 PMCID: PMC5717972 DOI: 10.1016/j.ajur.2017.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/12/2016] [Accepted: 12/15/2016] [Indexed: 01/21/2023] Open
Abstract
Metabolic syndrome (MetS) is a cluster of metabolic abnormalities related to central adiposity and insulin resistance. Its importance is increasingly recognized as it associates with increased risks of metabolic and cardiovascular diseases. These metabolic aberrations of MetS may lead to development of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) in men. A 26.5%-55.6% prevalence of MetS in men with LUTS was reported in worldwide studies. Although the exact biological pathway is not clear yet, insulin resistance, increased visceral adiposity, sex hormone alterations and cellular inflammatory reactions played significant roles in the related pathophysiological processes. Clinician should recognize the cardiovascular and metabolic impacts of MetS in men with LUTS, early risk factors optimization and use of appropriate medical therapy may possibly alter or slower the progression of LUTS/BPH, and potentially avoid unnecessary morbidities and mortalities from cardiovascular and metabolic diseases for those men.
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Affiliation(s)
- Ho-Yin Ngai
- Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Hong Kong, China
| | - Kar-Kei Steffi Yuen
- Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Hong Kong, China
| | - Chi-Man Ng
- Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Hong Kong, China
| | - Cheung-Hing Cheng
- Division of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong, China
| | - Sau-Kwan Peggy Chu
- Division of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong, China
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15
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Fu Y, Zhou Z, Yang B, Zhang K, He L, Zhang X. The Relationship between the Clinical Progression of Benign Prostatic Hyperplasia and Metabolic Syndrome: A Prospective Study. Urol Int 2016; 97:330-335. [PMID: 27509202 DOI: 10.1159/000448484] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 07/18/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate whether metabolic syndrome (MetS) may be associated with the clinical progression of benign prostatic hyperplasia (BPH). METHODS A total of 525 community-dwelling men (aged 45-78) with lower urinary tract symptoms (LUTS) who had complete data at 3-year follow-up were included in this prospective study. International Prostate Symptom Score (IPSS) questionnaire, prostate ultrasonography for prostate volume (PV), maximum urine flow rate (Qmax) and biological parameters were recorded. Participants were divided into a BPH with the MetS group and a BPH without the MetS group, and all received a 3-year follow-up to monitor possible correlations between LUTS/BPH clinical progression and MetS. RESULTS The results showed that MetS was associated with IPSS, Qmax and PV (p < 0.05) after 3-year follow-up. The mean change of IPSS, PV and Qmax were positively and negatively correlated with time in the BPH with MetS group during the 3-year follow-up. In addition, the BPH clinical progression rate was significantly higher in the BPH with MetS group, compared with the BPH without MetS group (p < 0.05). Diabetes mellitus (DM) and hypertension were related to increased risk of BPH clinical progression. CONCLUSIONS The present results suggest that MetS, in particular, DM and hypertension, may accelerate the clinical progression of BPH in community-dwelling middle-aged and older men.
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Affiliation(s)
- Yongqiang Fu
- Department of Urology, Peking University Shougang Hospital, Beijing, China
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16
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Bavendam TG, Norton JM, Kirkali Z, Mullins C, Kusek JW, Star RA, Rodgers GP. Advancing a Comprehensive Approach to the Study of Lower Urinary Tract Symptoms. J Urol 2016; 196:1342-1349. [PMID: 27341750 DOI: 10.1016/j.juro.2016.05.117] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE Lower urinary tract symptoms are common in the United States population, leading to significant economic, quality of life and public health issues. The burden will increase as the population ages, and risk factors for lower urinary tract symptoms, including diabetes and obesity, remain highly prevalent. Improving clinical management and establishing the knowledge base to prevent lower urinary tract symptoms will require a comprehensive research approach that examines factors beyond the lower urinary tract. While the study of extra-lower urinary tract factors has increased recently, current urological research does not systematically account for the broad set of potential contributing factors spanning biological, behavioral, psychological/executive function and sociocultural factors. A comprehensive assessment of potential contributors to risk, treatment response and progression is necessary to reduce the burden of this condition in the United States. MATERIALS AND METHODS We considered challenges to continuing the predominantly lower urinary tract dysfunction centric approach that has dominated previous research of lower urinary tract symptoms. RESULTS We developed a new, comprehensive framework for urology research that includes a broader set of potential factors contributing to lower urinary tract symptoms. This framework aims to broaden research to consider a comprehensive set of potential contributing factors and to engage a broad range of researchers in the investigation of as many extra-lower urinary tract factors as possible, with the goal of improving clinical care and prevention. CONCLUSIONS We propose a new framework for future urology research, which should help to reduce the medical and economic burden of lower urinary tract symptoms in the United States population.
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Affiliation(s)
- Tamara G Bavendam
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Jenna M Norton
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Ziya Kirkali
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Chris Mullins
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - John W Kusek
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Robert A Star
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Griffin P Rodgers
- Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
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17
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An association between diet, metabolic syndrome and lower urinary tract symptoms. AFRICAN JOURNAL OF UROLOGY 2016. [DOI: 10.1016/j.afju.2015.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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18
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Wang JY, Fu YY, Kang DY. The Association Between Metabolic Syndrome and Characteristics of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2016; 95:e3243. [PMID: 27175628 PMCID: PMC4902470 DOI: 10.1097/md.0000000000003243] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The purpose of this systematic review was to examine the association of metabolic syndrome (MS) with measures of benign prostatic hyperplasia (BPH) including prostate growth rate, prostate volume, International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA) level, and maximal flow rate.Medline, Cochrane CENTRAL, EMBASE, CBM, and Google Scholar databases were searched until March 23, 2015 using combinations of the keywords benign prostate hyperplasia/BPH, metabolic syndrome, total prostate volume, prostate growth rate, prostate specific antigen, International Prostate Symptom Score/IPSS, maximal flow rate. Cohort or case-control studies of patients with BPH and MS that reported quantitative outcomes were included. The pooled mean differences of the outcome measures were compared between patients with and without MS.A total of 158 potentially relevant studies were identified, and 8 were included in the meta-analysis. The 8 studies included in the meta-analysis contained a total of 3093 BPH patients, wherein 1241 had MS and 1852 did not have MS. BPH patients with MS had a significantly higher prostate growth rate (pooled mean difference = 0.67 mL/y, P < 0.001) and larger prostate volume (pooled mean difference = 6.8 mL, P = 0.010) than the BPH patients without MS. There was no significant difference in IPSS score (pooled mean difference = 1.58, P = 0.202) or maximal flow rate (pooled mean difference = -1.41 mL/s, P = .345) between BPH patients with and without MS. A borderline nonsignificant difference in PSA (pooled mean difference = 0.24 ng/mL, P = 0.056) was noted between BPH patients with and without MS.The results of this meta-analysis are consistent with literature indicating that BPH patients with MS have a higher prostate growth rate and larger prostate volume than those without MS; however, further study is necessary to determine the association of BPH and metabolic disorder elements and the potential risk of disease progression in BPH patients with MS.
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Affiliation(s)
- Jian-Ye Wang
- From the Department of Urology, Beijing Hospital, Ministry of Health (J-YW); MSD China, Medical Affairs Department, Beijing Office, Beijing (Y-YF); and Department of Evidence Based Medicine and Clinical Epidemiology (D-YK); West China Hospital, Sichuan University, Chengdu China (D-Y K)
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19
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Choi JD, Kim JH, Ahn SH. Transitional Zone Index as a Predictor of the Efficacy of α-Blocker and 5α-Reductase Inhibitor Combination Therapy in Korean Patients with Benign Prostatic Hyperplasia. Urol Int 2016; 96:406-12. [DOI: 10.1159/000442995] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/01/2015] [Indexed: 11/19/2022]
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20
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Zhao S, Tang J, Shao S, Yan Y. The Relationship between Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Mean Platelet Volume: The Role of Metabolic Syndrome. Urol Int 2016; 96:449-58. [DOI: 10.1159/000443313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/10/2015] [Indexed: 11/19/2022]
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21
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DiBello JR, Ioannou C, Rees J, Challacombe B, Maskell J, Choudhury N, Kastner C, Kirby M. Prevalence of metabolic syndrome and its components among men with and without clinical benign prostatic hyperplasia: a large, cross-sectional, UK epidemiological study. BJU Int 2015; 117:801-8. [PMID: 26392030 DOI: 10.1111/bju.13334] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Jonathan Rees
- Backwell and Nailsea Medical Group; North Somerset UK
| | - Ben Challacombe
- Department of Urology; Guy's and St Thomas' Hospital; London UK
| | | | | | | | - Mike Kirby
- Faculty of Health and Human Sciences; University of Hertfordshire; Hatfield UK
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22
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Russo GI, Castelli T, Urzì D, Privitera S, La Vignera S, Condorelli RA, Calogero AE, Favilla V, Cimino S, Morgia G. Emerging links between non-neurogenic lower urinary tract symptoms secondary to benign prostatic obstruction, metabolic syndrome and its components: A systematic review. Int J Urol 2015; 22:982-90. [DOI: 10.1111/iju.12877] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/16/2015] [Indexed: 01/20/2023]
Affiliation(s)
| | | | - Daniele Urzì
- Department of Urology; University of Catania; Catania Italy
| | | | - Sandro La Vignera
- Department of Clinical and Experimental Medicine; University of Catania; Catania Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine; University of Catania; Catania Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine; University of Catania; Catania Italy
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23
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Meta-analysis of metabolic syndrome and benign prostatic hyperplasia in Chinese patients. World J Urol 2015; 34:281-9. [PMID: 26119349 DOI: 10.1007/s00345-015-1626-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 06/15/2015] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To investigate the impact of metabolic syndrome (MetS) on benign prostatic hyperplasia (BPH), focusing on MetS and its relationship with prostate volume and prostate-specific antigen (PSA) in Chinese patients by performing a meta-analysis. METHODS We systematically searched the PubMed, Embase, China National Knowledge Infrastructure, Wanfang, and VIP databases from inception to November 2014. All studies investigating the impact of MetS on prostate volume and PSA among BPH patients were included. Pooled mean difference (WMD) and 95% confidence interval (CI) were used to analyze the difference between patients with MetS and those without MetS. RESULTS Sixteen studies enrolled 1895 BPH patients, of whom 2224 had MetS. Compared with those without MetS, BHP patients with MetS had significantly higher total prostate volume (WMD 10.15 ml; 95% CI 7.37-12.93) and serum PSA level (WMD 0.53 ng/ml; 95% CI 0.17-0.88), respectively. In addition, annual prostate growth rate in patients with MetS was higher (WMD 0.49 ml/year; 95% CI 0.24-0.73) than in those without MetS. CONCLUSIONS This meta-analysis supports that the presence of MetS increases total prostate volume and annual prostate growth rate in Chinese BPH patients. Future studies are needed to explain the detailed underlying mechanisms.
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24
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Yu Z, Li J, Li Z, Hou R. Photoselective Vaporization of the Prostate and Simultaneous Suprapubic Cystostomy for the Treatment of Benign Prostatic Hyperplasia in Patients with Mild to Severe Detrusor Underactivity. Urol Int 2015; 95:269-75. [DOI: 10.1159/000434688] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 06/01/2015] [Indexed: 11/19/2022]
Abstract
Introduction: This study investigated the clinical efficacy and safety of photoselective vaporization of the prostate (PVP) and simultaneous suprapubic cystostomy for benign prostatic hyperplasia (BPH) in patients with mild to severe detrusor underactivity (DU). Subjects and Methods: Seventy-eight patients with BPH were divided into 3 groups according to the severity of DU: mild DU group, moderate DU group and severe DU group. The preoperative and postoperative data, including the detrusor pressure at maximum flow (Pdetmax), bladder compliance, maximum urinary flow (Qmax), postvoid residual urine (PVR) values, International Prostate Symptom Score (IPSS) and quality of life (QoL) were evaluated. Results: The therapeutic effectiveness including cure and improvement in mild and moderate DU group was significantly higher than that of the severe group. Compared to the preoperative values, Pdetmax, bladder compliance, Qmax, PVR, IPSS and QoL scores at 12 months postoperatively had significantly improved. In addition, the above parameters at 12 months postoperatively in the mild or moderate DU group had significant difference compared to the severe DU group. Conclusion: PVP and simultaneous suprapubic cystostomy seem to be an appropriate treatment modality in BPH patients with mild and/or moderate DU as well as in patients with severe DU and slightly reduced bladder compliance.
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25
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Breyer BN, Sarma AV. Hyperglycemia and insulin resistance and the risk of BPH/LUTS: an update of recent literature. Curr Urol Rep 2015; 15:462. [PMID: 25287259 DOI: 10.1007/s11934-014-0462-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) are highly prevalent in older men and represent a substantial challenge to public health. Increasing epidemiologic evidence suggests that diabetes and associated hyperglycemia and insulin resistance significantly increase the risks of BPH and LUTS. Plausible pathophysiologic mechanisms to explain these associations include increased sympathetic tone, stimulation of prostate growth by insulin and related trophic factors, alterations in sex steroid hormone expression, and induction of systemic inflammation and oxidative stress. This article presents a comprehensive update of the current understanding of clinical and epidemiologic research on diabetes and BPH/LUTS, describes hypothesized pathophysiologic mechanisms linking these conditions, and recommends future directions for research.
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Affiliation(s)
- Benjamin N Breyer
- Department of Urology, University of California, San Francisco, 1001 Potrero Ave, Suite 3A20, San Francisco, CA, 94110-1444, USA,
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26
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Zhang X, Zeng X, Dong L, Zhao X, Qu X. The effects of statins on benign prostatic hyperplasia in elderly patients with metabolic syndrome. World J Urol 2015; 33:2071-7. [DOI: 10.1007/s00345-015-1550-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 03/25/2015] [Indexed: 10/23/2022] Open
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27
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Rył A, Rotter I, Słojewski M, Jędrzychowska A, Marcinowska Z, Grabowska M, Laszczyńska M. Can metabolic disorders in aging men contribute to prostatic hyperplasia eligible for transurethral resection of the prostate (TURP)? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3327-42. [PMID: 25809513 PMCID: PMC4377967 DOI: 10.3390/ijerph120303327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/06/2015] [Accepted: 03/11/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE The aim of this study was to evaluate the incidence and severity of metabolic disorders occurring in the metabolic syndrome in patients with benign prostatic hyperplasia eligible for surgical treatment. METHODS The study group consisted men with diagnosed benign prostatic hyperplasia. The control group consisted patients recruited from basic health care units. Abdominal circumference, body weight and blood serum metabolic parameters were determined in the experimental and control groups. The concentrations of glucose were determined, as well as total cholesterol (ChT), low-density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides (TAG), by spectrophotometric method using reagent kits. RESULTS In the study group 91 (60.3%) cases of metabolic syndrome (MetS) were diagnosed, while in the control group 71 (46.1%) men met the diagnostic criteria for this syndrome (p=0.018). The analysis shows a relationship between MetS in patients with BPH and concentration glucose, ChT, LDL, HDL, systolic blood pressure and diastolic blood pressure. We found no significant statistical relationship between body weight, abdominal circumference and concentration TAG, hypertension in patients and controls. CONCLUSIONS in the study presented in this article, statistically significant relationships between BPH and the diagnostic parameters of the metabolic syndrome were demonstrated. These results indicate to the necessity of the modification of the lifestyle, taking preventive measures in diabetes, and evaluation of lipid metabolism disorders. It is recommended to assess symptoms that may suggest BPH (as a manifestation of LUTS) in men over 50 years of age with diagnoses of metabolic disorders (including MetS), and provide them with specialist urological care in order to prevent surgical treatment of the prostate.
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Affiliation(s)
- Aleksandra Rył
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin 71-210, Poland.
| | - Iwona Rotter
- Laboratory of Rehabilitation Medicine, Pomeranian Medical University, Szczecin 71-210, Poland.
| | - Marcin Słojewski
- Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin 71-111, Poland.
| | - Adriana Jędrzychowska
- Laboratory Diagnostics and Molecular Medicine, Department of Laboratory Medicine, Pomeranian Medical University, Szczecin 71-111, Poland.
| | - Zuzanna Marcinowska
- Laboratory Diagnostics and Molecular Medicine, Department of Laboratory Medicine, Pomeranian Medical University, Szczecin 71-111, Poland.
| | - Marta Grabowska
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin 71-210, Poland.
| | - Maria Laszczyńska
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin 71-210, Poland.
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28
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Sener NC, Zengin K, Ozturk U, Bas O, Ercil H, Ekici M, Evliyaoglu Y, Imamoglu MA. The Impact of Metabolic Syndrome on the Outcomes of Transurethral Resection of the Prostate. J Endourol 2015; 29:340-3. [DOI: 10.1089/end.2014.0562] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nevzat Can Sener
- Ministry of Health, Department of Urology, Adana Numune Teaching and Research Hospital, Adana, Turkey
| | - Kursad Zengin
- Department of Urology, Bozok University, Yozgat, Turkey
| | - Ufuk Ozturk
- Ministry of Health, Department of Urology, Ankara Dişkapi Yıldırım Beyazit Teaching and Research Hospital, Ankara, Turkey
| | - Okan Bas
- Ministry of Health, Department of Urology, Ankara Onkoloji Teaching and Research Hospital, Ankara, Turkey
| | - Hakan Ercil
- Ministry of Health, Department of Urology, Adana Numune Teaching and Research Hospital, Adana, Turkey
| | - Musa Ekici
- Ministry of Health, Department of Urology, Corum Teaching and Research Hospital, Corum, Turkey
| | - Yalcin Evliyaoglu
- Ministry of Health, Department of Urology, Adana Numune Teaching and Research Hospital, Adana, Turkey
| | - M. Abdurrahim Imamoglu
- Ministry of Health, Department of Urology, Ankara Dişkapi Yıldırım Beyazit Teaching and Research Hospital, Ankara, Turkey
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29
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Russo GI, Castelli T, Urzì D, Privitera S, Fragalà E, La Vignera S, Condorelli RA, Calogero AE, Favilla V, Cimino S, Morgia G. Connections between lower urinary tract symptoms related to benign prostatic enlargement and metabolic syndrome with its components: a systematic review and meta-analysis. Aging Male 2015; 18:207-16. [PMID: 26171768 DOI: 10.3109/13685538.2015.1062980] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A significant amount of epidemiological evidences have underlined an emerging link between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement a (BPE). We aimed to assess the connections between LUTS and MetS with its components. Meta-analysis were conducted to determine the mean differences (MD) and confidence intervals of IPSS total score, IPSS-voiding, IPSS-storage and prostate volume (PV) in patients with or without MetS. Ln(odds-ratio) were calculated to estimate the risk of having moderate-to-severe LUTS (IPSS ≥ 8). Nineteen studies were identified as eligible for this systematic review, with a total of 18,476 participants, including 5554 (30.06%) with and 12,922 (69.94%) without MetS. Pooled analysis did not demonstrate significant MD of IPSS, IPSS-voiding and IPSS-storage in men with or without MetS but PV was significantly different (MD = 2.18; p = 0.03). Presence of MetS was not significantly associated with moderate-to-severe LUTS (odds ratio = 1.13; p = 0.53) and only altered serum triglycerides and diabetes were associated with this risk. The association between MetS and LUTS/BPE remain unclear and further observational studies in a population with metabolic disorders should be conducted in order to address it's potential role in determining LUTS/BPE.
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Affiliation(s)
| | | | | | | | | | - Sandro La Vignera
- b Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine , University of Catania , Catania , Italy
| | - Rosita A Condorelli
- b Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine , University of Catania , Catania , Italy
| | - Aldo E Calogero
- b Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine , University of Catania , Catania , Italy
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Rył A, Rotter I, Miazgowski T, Słojewski M, Dołęgowska B, Lubkowska A, Laszczyńska M. Metabolic syndrome and benign prostatic hyperplasia: association or coincidence? Diabetol Metab Syndr 2015; 7:94. [PMID: 26516352 PMCID: PMC4625953 DOI: 10.1186/s13098-015-0089-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/14/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND It has been suggested that individuals with metabolic syndrome (MetS) may be prone to developing benign prostatic hyperplasia (BPH), but the direction of causality remains uncertain. The objective of this cross-sectional study was to evaluate the association between BPH and MetS in men who were referred to surgery for BPH. We were interested in identifying the anthropometric, metabolic, and hormonal factors that potentially influence the risk of both conditions. METHODS The study was conducted on 128 males with BPH and 141 without BPH (the control group). Fasting glucose, insulin, lipid profiles, total and free testosterone, estradiol, sex-hormone binding protein (SHBG), dehydroepiandrosterone sulfate (DHEA-S), homeostasis model assessment (HOMA-IR) index, and lipid accumulation product (LAP) were all evaluated. RESULTS The prevalence of MetS was higher in patients with BPH than in the controls (58 vs. 41 %; P = 0.007). In comparison to the controls, patients with BPH had higher levels of cholesterol, low density lipoproteins, DHEA-S, insulin, and HOMA-IR, but lower levels of high-density lipoproteins (HDL), estradiol, and SHBG. The significant predictors of BPH were MetS (OR = 1.961), age (OR = 0.11), HDL (OR = 0.91), insulin (OR = 1.224), SHBG (OR = 0.98), and estradiol (OR = 0.978). Waist circumference and LAP inversely correlated with total and free testosterone and SHBG. CONCLUSIONS Our study confirmed the frequent coexistence of MetS and BPH. This association seems to be a consequence of the MetS-related metabolic derangements, changes in the sex-hormone milieu, and lowered SHBG levels.
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Affiliation(s)
- Aleksandra Rył
- />Chair and Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin, Poland
| | - Iwona Rotter
- />Department of Medical Rehabilitation, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- />Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Marcin Słojewski
- />Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Barbara Dołęgowska
- />Department of Laboratory Diagnostics and Molecular Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Anna Lubkowska
- />Department of Physical Medicine and Functional Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Maria Laszczyńska
- />Chair and Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin, Poland
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Ito H, Yokoyama O. Metabolic syndrome and lower urinary tract symptoms. World J Clin Urol 2014; 3:330-335. [DOI: 10.5410/wjcu.v3.i3.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 06/21/2014] [Accepted: 07/29/2014] [Indexed: 02/06/2023] Open
Abstract
Recently, clinical and epidemiologic data indicating the involvement of metabolic syndrome (MetS) in the pathogenesis and progression of lower urinary tract symptom (LUTS)/benign prostatic hyperplasia (BPH) are reported. This review evaluates the reports on the influence of MetS in the development and progression of LUTS/BPH, and discusses possible clinical implications for the management and treatment of this disease. Recent studies on the epidemiological relationship between MetS and LUTS hypothesize that MetS may be associated with an overactivity of the autonomic nervous system for which hyperinsulinemia, a key element of the MetS, might be responsible. An alternative explanation is that LUTS are associated with chronic ischemia of pelvis resulting from atherosclerotic changes in blood vessels, which leads the production of reactive oxygen species, which can damage the bladder detrusor. Control of autonomic nervous system overactivity and control of chronic bladder ischemia have potential as new targets for LUTS treatment. Studies suggest an association of MetS with LUTS/BPH, although further research is needed to understand how MetS influences LUTS/BPH. MetS should be considered a new domain in basic and clinical research in patients with LUTS/BPH and as a target for treatment.
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Gacci M. Editorial Comment on Zhang et al.: Impact of Metabolic Syndrome on Benign Prostatic Hyperplasia in Elderly Chinese Men. Urol Int 2014; 93:247-8. [DOI: 10.1159/000357761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 12/04/2013] [Indexed: 11/19/2022]
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