Erkeklerde Alt Üriner Sistem Semptomları ile C-reaktif Protein Arasında İlişki Var mı? Kesitsel Bir Çalışma

Amaç: Alt üriner sistem semptomları (AÜSS) erkeklerde benign prostat hiperplazisi ve yaşla birlikte artmaktadır. Bu artışın mekanizması henüz tam anlamıyla netlik kazanmamıştır. Literatürde AÜSS'nin nedeni olarak inflamasyonda artış ileri sürülmüştür. İnflamasyon belirleyicisi olarak C-reaktif protein (CRP) en yaygın kullanılan önemli bir belirteçtir. Bu çalışmamızdaki amacımız AÜSS'nin CRP ile ilişkisini sorgulamak ve inflamasyonun AÜSS'ye neden olabilir mi sorusuna cevap aramaktı.Yöntemler: Çalışmamız retrospektif ve kesitsel bir çalışmaydı. Üroloji polikliniğine müracaat eden, AÜSS (+) ve (-) olan, prostat spesifik antijen yükseklikleri nedeniyle prostat biyopsisi önerilen 183 hasta çalışmaya dahil edildi. Biyopsi önerilen tüm hastalara üroloji kliniği tarafından CRP istenmekteydi. CRP, hem kendi değeri üzerinden hem de cut-off değeri 0,50 mg/dL değeri temel alınarak AÜSS ile karşılaştırıldı. İstatistiksel değerlendirmede p

Is There a Relationship between Lower Urinary Tract Symptoms and C-reactive Protein Levels in Men? A Cross-Sectional Study

Objective: Lower urinary tract symptoms (LUTSs) increase with benign prostatic hyperplasia and age in men. The mechanism underlying this increase is not well known. In literature, an increase in inflammation is suggested as the reason for LUTSs. C-reactive protein (CRP) is a commonly used and important marker for inflammation. The aim of this study was to question the relationship between LUTS and CRP levels and to determine if inflammation may cause LUTSs.Methods: Our study was retrospective and cross-sectional. One hundred and eighty-three patients who were LUTS (+) and (-) and who were suggested to undergo prostate biopsy because of high PSA were included in this study in a urology polyclinic. For all patients suggested to undergo biopsy, CRP levels were routinely requested by the polyclinic. CRP levels were compared to LUTSs both based on their value in the report and their cut-off value of 0.50 mg/dL. For statistical analyses, p<0.05 was considered significant.Results: While the average age in LUTS (+) patients was 62.71±0.87 years, in LUTS (-) patients, it was 61.67±1.01 years (p=0.625). When the CRP levels of the patients with and without symptoms were compared, a statistically significant difference was not found (p=0.189). Additionally, in the evaluation made, by considering pathological if the cut-off values of CRP were 0.5 mg/dL or more, there was no difference between LUTS (+) and (-) patients (p=0.921).Conclusion: In our study, we could not find a relationship between LUTSs and CRP levels. There are many factors affecting CRP levels. Currently, to determine the relationship between LUTSs and CRP levels, wider, community-based studies where all factors affecting CRP levels are excluded and containing sub-analyses are required.

Kaynakça

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12. Rohrmann S, De Marzo AM, Smit E, Giovannucci E, Platz EA. Serum C-reactive protein concentration and lower urinary tract symptoms in older men in the Third National Health and Nutrition Examination Survey (NHANES III). Prostate 2005; 62: 27-33.[CrossRef]

13. Gokce KY, Barak A, Atalay A, Baydar T, Kucukoglu S, Tuncer T, et al. Polypharmacy in the elderly: a multicenter study. J Am Med Dir Assoc 2009; 10: 486-90.[CrossRef]

14. Hamid AR, Umbas R, Mochtar CA. Recent role of inflammation in prostate diseases: chemoprevention development opportunity. Acta Med Indones 2011; 43: 59-65.

15. Kupelian V, Rosen RC, Roehrborn CG, Tyagi P, Chancellor MB, McKinlay JB, et al. Association of overactive bladder and C-reactive protein levels. Results from the Boston Area Community Health (BACH) Survey. BJU Int 2012; 110: 401-7.[CrossRef]

16. Liu HT, Chancellor MB, Kuo HC. Decrease of urinary nerve growth factor levels after antimuscarinic therapy in patients with overactive bladder. BJU Int 2009; 103: 1668-72.[CrossRef]

17. Liao CH, Chung SD, Kuo HC. Serum C-reactive protein levels are associated with residual urgency symptoms in patients with benign prostatic hyperplasia after medical treatment. Urology 2011; 78: 1373-8.[CrossRef]

18. Choi WS, Lee WK, Lee SH, Lee SK, Cho ST, Kim DH. Is High-Sensitivity C-Reactive Protein Associated with Lower Urinary Tract Symptoms in Aging Men? Results from the Hallym Aging Study. Korean J Urol 2012; 53: 335-41.[CrossRef]

19. Nickel JC, Roehrborn CG, O'Leary MP, Bostwick DG, Somerville MC, Rittmaster RS. The relationship between prostate inflammation and lower urinary tract symptoms: examination of baseline data from the REDUCE trial. Eur Urol 2008; 54: 1379-84.[CrossRef]

20. Sauver JL, Jacobson DJ, Girman CJ, Lieber MM, McGree ME, Jacobsen SJ. Tracking of longitudinal changes in measures of benign prostatic hyperplasia in a population based cohort. J Urol 2006; 175: 1018-22.[CrossRef]

21. Bosch JL, Bangma CH, Groeneveld FP, Bohnen AM. The long-term relationship between a real change in prostate volume and a significant change in lower urinary tract symptom severity in population-based men: the Krimpen study. Eur Urol 2008; 53: 819-25.[CrossRef]

22. Di Silverio F, Gentile V, De Matteis A, Mariotti G, Giuseppe V, Luigi PA, et al. Distribution of inflammation, pre-malignant lesions, incidental carcinoma in histologically confirmed benign prostatic hyperplasia: a retrospective analysis. Eur Urol 2003; 43: 164-75.[CrossRef]

23. Rohrmann S, De Marzo AM, Smit E, Giovannucci E, Platz EA. Serum C-reactive protein concentration and lower urinary tract symptoms in older men in the Third National Health and Nutrition Examination Survey (NHANES III). Prostate 2005; 62: 27-33.[CrossRef]

24. St Sauver JL, Sarma AV, Jacobson DJ, McGree ME, Lieber MM, Girman CJ, et al. Associations between C-reactive protein and benign prostatic hyperplasia/lower urinary tract symptom outcomes in a populationbased cohort. Am J Epidemiol 2009; 169: 1281-90.[CrossRef]

25. Lu Z, Gao Y, Tan A, Yang X, Zhang H, Mo L, et al. Increased high-sensitivity C-reactive protein predicts a high risk of lower urinary tract symptoms in Chinese male: Results from the Fangchenggang Area Male Health and Examination Survey. Prostate 2012; 72: 193-200.[CrossRef]

26. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO 3rd, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003; 107: 499-511.[CrossRef]

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