肌肉减少与中国中老年男性下尿路症状/良性前列腺增生患病风险的关联：基于CHARLS的横断面研究

Association between sarcopenia and BPH risk in middle-aged and elderly Chinese men: a CHARLS-based cross-sectional study

摘要

目的 探讨肌肉减少与中国中老年男性良性前列腺增生（BPH）的关联性。方法 基于中国健康与养老追踪调查（CHARLS）第一轮数据纳入6158例参与者。采用人体测量学指标计算经身体质量指数（BMI）校正的四肢骨骼肌质量指数（ASMBMI），并按其四分位数分为Q₁～Q₄四组。采用logistic回归模型分析ASMBMI与BPH的关联;通过亚组分析和交互作用检验探讨效应修饰因素;采用限制性立方样条（RCS）模型分析剂量-反应关系。结果 肌肉减少与中国男性较高的BPH患病率相关（P＜0.05）。亚组分析显示该关联在各亚组间趋势一致，RCS分析提示ASMBMI与BPH的患病风险呈线性负相关（P_非线性=0.421），即四肢骨骼肌质量越低，BPH患病的可能性越高。结论 肌肉减少是中国男性BPH患病风险增加的潜在预测指标。ASMBMI可精准评估个体相对肌肉水平，有助于肌肉减少的早期识别。积极维持骨骼肌质量、延缓肌少症进展，对中老年男性BPH的防控具有潜在的公共卫生价值和实践意义。

Abstract

Objective To investigate the association between sarcopenia and benign prostatic hyperplasia（BPH）in middle-aged and elderly Chinese men. Methods Based on Wave 1 data from the China Health and Retirement Longitudinal Study（CHARLS），6158 participants were enrolled.Anthropometric indicators were used to calculate the body mass index（BMI）-adjusted appendicular skeletal muscle mass index（ASMBMI），which was then categorized into quartiles（Q₁-Q₄）.Logistic regression models were employed to analyze the association between ASMBMI and BPH.Subgroup analyses and interaction tests were conducted to explore effect modifiers.Restricted cubic spline（RCS）models were applied to examine the dose-response relationship. Results Reduced muscle mass was associated with a higher prevalence of BPH among Chinese men（P＜0.05）.Subgroup analyses showed a consistent trend of this association across subgroups.RCS analysis indicated an inverse linear relationship between ASMBMI and the risk of BPH（P_nonlinearity=0.421），suggesting that lower appendicular skeletal muscle mass was associated with a higher likelihood of BPH. Conclusion Reduced muscle mass is a potential predictive indicator for increased BPH risk in Chinese men.The ASMBMI can accurately assess individual relative muscle levels and facilitate early identification of muscle loss.Actively maintaining skeletal muscle mass and delaying the progression of sarcopenia may offer potential public health value and practical significance for the prevention and control of BPH in middle-aged and elderly men.

关键词

肌肉减少 / 良性前列腺增生 / 四肢骨骼肌质量 / 中国健康与养老追踪调查（CHARLS）

Key words

sarcopenia / benign prostatic hyperplasia / appendicular skeletal muscle mass / China Health and Retirement Longitudinal Study

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基金资助

江苏省中医药管理局面上项目(MS2024048)