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Erschienen in: Diabetologia 4/2005

01.04.2005 | Article

Vascular damage induced by type 2 diabetes mellitus as a risk factor for benign prostatic hyperplasia

verfasst von: A. P. Berger, M. Deibl, E. J. Halpern, M. Lechleitner, J. Bektic, W. Horninger, G. Fritsche, H. Steiner, A. Pelzer, G. Bartsch, F. Frauscher

Erschienen in: Diabetologia | Ausgabe 4/2005

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Abstract

Aims/hypothesis

The aim of this study was to evaluate the relationship between benign prostatic hyperplasia (BPH) and arteriosclerosis shown in a model of type 2 diabetes in a trans-sectional population study using contrast-enhanced colour Doppler ultrasound for exact assessment of prostatic blood flow.

Methods

Contrast-enhanced transrectal colour Doppler ultrasound was performed using a microbubble-based ultrasound enhancer SonoVue for evaluating prostate vascularity (transitional zone [TZ] and peripheral zone [PZ]) in diabetic BPH patients, non-diabetic BPH patients and healthy subjects. Computer-assisted quantification of colour pixel intensity (CPI) was used to objectively evaluate the prostate vascularity. Resistive index measurements were obtained in the TZ and the PZ. Findings were compared between these three groups.

Results

TZ-CPI was significantly lower in diabetic patients than in non-diabetic BPH men (p=0.001), whereas the CPI of the PZ showed no difference between these two groups (p=0.978). TZ-CPI of patients with diabetic and non-diabetic BPH were significantly lower than in controls (p<0.001), but no difference was found between diabetic and healthy patients in the PZ (p=0.022) and borderline significance was seen when comparing patients of the BPH group with the control patients (p=0.019). Resistive index values of the TZ in diabetic patients showed significantly higher values (p<0.001) than the BPH and control groups.

Conclusions/interpretation

The significantly lower CPI and higher resistive index values of the TZ in diabetic patients compared with patients with non-diabetic BPH and healthy subjects indicate considerable vascular damage in the TZ of these patients. Diabetic vascular damage may cause hypoxia and may contribute to the pathogenesis of BPH.
Literatur
1.
Zurück zum Zitat McNeil JE (1978) Origin and evolution of benign prostatic enlargement. Invest Urol 15:340–345 McNeil JE (1978) Origin and evolution of benign prostatic enlargement. Invest Urol 15:340–345
2.
Zurück zum Zitat Ghafar MA, Puchner PJ, Anastasiadis AG, Cabelin MA, Buttyan R (2002) Does the prostatic vascular system contribute to the development of benign prostatic hyperplasia? Curr Urol Rep 3:292–296 Ghafar MA, Puchner PJ, Anastasiadis AG, Cabelin MA, Buttyan R (2002) Does the prostatic vascular system contribute to the development of benign prostatic hyperplasia? Curr Urol Rep 3:292–296
3.
Zurück zum Zitat Berger AP, Kofler K, Bektic J et al (2003) Increased growth factor production in a human prostatic stromal cell culture model caused by hypoxia. Prostate 57:57–65 Berger AP, Kofler K, Bektic J et al (2003) Increased growth factor production in a human prostatic stromal cell culture model caused by hypoxia. Prostate 57:57–65
4.
Zurück zum Zitat Thompson MM, Garland C, Barrett-Connor E, Khaw KT, Friedlander NJ, Wingard D (1989) Heart disease risk factors, diabetes and prostatic cancer in an adult community. Am J Epidemiol 129:511–517 Thompson MM, Garland C, Barrett-Connor E, Khaw KT, Friedlander NJ, Wingard D (1989) Heart disease risk factors, diabetes and prostatic cancer in an adult community. Am J Epidemiol 129:511–517
5.
Zurück zum Zitat Neugut AI, Rosenberg DJ, Ahsan H (1998) Association between coronary heart disease and cancers of the breast, prostate, and colon. Cancer Epidemiol Biomark Prev 7:869–873 Neugut AI, Rosenberg DJ, Ahsan H (1998) Association between coronary heart disease and cancers of the breast, prostate, and colon. Cancer Epidemiol Biomark Prev 7:869–873
6.
Zurück zum Zitat Michel MC, Mehlburger L, Schumacher H, Bressel HU, Goepel M (2000) Effect of diabetes on lower urinary tract symptoms in patients with benign prostatic hyperplasia. J Urol 163:1725–1729 Michel MC, Mehlburger L, Schumacher H, Bressel HU, Goepel M (2000) Effect of diabetes on lower urinary tract symptoms in patients with benign prostatic hyperplasia. J Urol 163:1725–1729
7.
Zurück zum Zitat Boon TA, Van Venrooiy GE, Eckhardt MD (2001) Effect of diabetes mellitus on lower urinary tract symptoms and dysfunction in patients with benign prostatic hyperplasia. Curr Urol Rep 2:297–301 Boon TA, Van Venrooiy GE, Eckhardt MD (2001) Effect of diabetes mellitus on lower urinary tract symptoms and dysfunction in patients with benign prostatic hyperplasia. Curr Urol Rep 2:297–301
8.
Zurück zum Zitat Wilson JL, Marks JH (1951) Calcification of the vas deferens: its relation to diabetes mellitus and arteriosclerosis. N Eng J Med 245:321–325 Wilson JL, Marks JH (1951) Calcification of the vas deferens: its relation to diabetes mellitus and arteriosclerosis. N Eng J Med 245:321–325
9.
Zurück zum Zitat Buttyan R, Chichester P, Stisser B, Matsumoto S, Ghafar MA, Levin RM (2003) Acute intravesical infusion of a cobalt solution stimulates a hypoxia response, growth and angiogenesis in the rat bladder. J Urol 169:2402–2406 Buttyan R, Chichester P, Stisser B, Matsumoto S, Ghafar MA, Levin RM (2003) Acute intravesical infusion of a cobalt solution stimulates a hypoxia response, growth and angiogenesis in the rat bladder. J Urol 169:2402–2406
10.
Zurück zum Zitat Kedar RP, Cosgrove DO, Smith IE, Mansi JL, Bamber JC (1994) Breast carcinoma: measurement of tumor response to primary medical therapy with color Doppler flow imaging. Radiology 190:825–830 Kedar RP, Cosgrove DO, Smith IE, Mansi JL, Bamber JC (1994) Breast carcinoma: measurement of tumor response to primary medical therapy with color Doppler flow imaging. Radiology 190:825–830
11.
Zurück zum Zitat Fein M, Delorme S, Weisser G, Zuna I, van Kaick G (1995) Quantification of color Doppler for the evaluation of tissue vascularization. Ultrasound Med Biol 21:1013–1019 Fein M, Delorme S, Weisser G, Zuna I, van Kaick G (1995) Quantification of color Doppler for the evaluation of tissue vascularization. Ultrasound Med Biol 21:1013–1019
12.
Zurück zum Zitat Cheng WF, Lee CN, Chu JS et al (1999) Vascularity index as a novel parameter for the in vivo assessment of angiogenesis in patients with cervical carcinoma. Cancer 85:651–657CrossRefPubMed Cheng WF, Lee CN, Chu JS et al (1999) Vascularity index as a novel parameter for the in vivo assessment of angiogenesis in patients with cervical carcinoma. Cancer 85:651–657CrossRefPubMed
13.
Zurück zum Zitat Nelson TR, Pretorius DH (1988) The Doppler signal: where does it come from and what does it mean? Am J Radiol 151:439–447 Nelson TR, Pretorius DH (1988) The Doppler signal: where does it come from and what does it mean? Am J Radiol 151:439–447
14.
Zurück zum Zitat Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A (1997) The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 49:822–830CrossRefPubMed Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A (1997) The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 49:822–830CrossRefPubMed
15.
Zurück zum Zitat Hammarsten J, Hoegstedt B (2001) Hyperinsulinaemia as a risk factor for developing benign prostatic hyperplasia. Eur Urol 39:151–158 Hammarsten J, Hoegstedt B (2001) Hyperinsulinaemia as a risk factor for developing benign prostatic hyperplasia. Eur Urol 39:151–158
16.
Zurück zum Zitat Zimarino M, Cappelletti L, Venarucci V et al (2001) Age-dependence of risk factors for carotid stenosis: an observational study among candidates for coronary arteriography. Atherosclerosis 159:165–173CrossRefPubMed Zimarino M, Cappelletti L, Venarucci V et al (2001) Age-dependence of risk factors for carotid stenosis: an observational study among candidates for coronary arteriography. Atherosclerosis 159:165–173CrossRefPubMed
17.
Zurück zum Zitat Taniwaki H, Kawagishi T, Emoto M et al (1999) Correlation between the intima-media thickness of the carotid artery and aortic pulse wave velocity in patients with type 2 diabetes. Vessel wall properties in type 2 diabetes. Diabetes Care 22:1851–1857 Taniwaki H, Kawagishi T, Emoto M et al (1999) Correlation between the intima-media thickness of the carotid artery and aortic pulse wave velocity in patients with type 2 diabetes. Vessel wall properties in type 2 diabetes. Diabetes Care 22:1851–1857
18.
Zurück zum Zitat Geroulakos G, Ramaswami G, Veller MG et al (1994) Arterial wall change in type 2 diabetic subjects. Diabet Med 11:692–695 Geroulakos G, Ramaswami G, Veller MG et al (1994) Arterial wall change in type 2 diabetic subjects. Diabet Med 11:692–695
19.
Zurück zum Zitat Visona A, Lusiani L, Bonanome A et al (1995) Wall thickening of common carotid arteries in patients affected by noninsulin-dependent diabetes mellitus: relationship to microvascular complications. Angiology 46:793–799 Visona A, Lusiani L, Bonanome A et al (1995) Wall thickening of common carotid arteries in patients affected by noninsulin-dependent diabetes mellitus: relationship to microvascular complications. Angiology 46:793–799
20.
Zurück zum Zitat Temelkova-Kurktschiev T, Koehler C, Schaper F (1998) Relationship between fasting plasma glucose, atherosclerosis risk factors and corotis intima media thickness in non-diabetic individuals. Diabetologia 41:706–712 Temelkova-Kurktschiev T, Koehler C, Schaper F (1998) Relationship between fasting plasma glucose, atherosclerosis risk factors and corotis intima media thickness in non-diabetic individuals. Diabetologia 41:706–712
21.
Zurück zum Zitat Tsuru N, Kurita Y, Masuda H, Suzuki K, Fujita K (2002) Role of Doppler ultrasound and resistive index in benign prostate hypertrophy. Int J Urol 9:427–430 Tsuru N, Kurita Y, Masuda H, Suzuki K, Fujita K (2002) Role of Doppler ultrasound and resistive index in benign prostate hypertrophy. Int J Urol 9:427–430
22.
Zurück zum Zitat Leventis AK, Shariat SF, Utsunomiya T, Slawin KM (2001) Characteristics of normal prostate vascular anatomy as displayed by power Doppler. Prostate 46:281–288 Leventis AK, Shariat SF, Utsunomiya T, Slawin KM (2001) Characteristics of normal prostate vascular anatomy as displayed by power Doppler. Prostate 46:281–288
23.
Zurück zum Zitat McNeal J (1968) Regional morphology and pathology of the prostate. Am J Clin Pathol 49:347–357 McNeal J (1968) Regional morphology and pathology of the prostate. Am J Clin Pathol 49:347–357
24.
Zurück zum Zitat Kaplan SA, Te AE, Pressler LB, Olsson CA (1995) Transition zone index as a method of assessing benign prostatic hyperplasia: correlation with symptoms, urine flow and detrusor pressure. J Urol 154:1764–1769 Kaplan SA, Te AE, Pressler LB, Olsson CA (1995) Transition zone index as a method of assessing benign prostatic hyperplasia: correlation with symptoms, urine flow and detrusor pressure. J Urol 154:1764–1769
25.
Zurück zum Zitat Caspary L, Creutzig A, Alexander K (1987) Comparison of laser-Doppler-Flux and tcPO2 in healthy probands and patients with arterial ischemia. Adv Exp Med Biol 220:235–240 Caspary L, Creutzig A, Alexander K (1987) Comparison of laser-Doppler-Flux and tcPO2 in healthy probands and patients with arterial ischemia. Adv Exp Med Biol 220:235–240
26.
Zurück zum Zitat Schuster A, Pinggera G, Pallwein L, Strasser H, Recheis W, Frauscher F (2003) Assessment of transrectal color Doppler ultrasound (TRCDUS) for measurement of urinary bladder neck blood flow in a porcine model: comparison to laser Doppler flowmetry. Eur Radiol [Suppl 1] 13:A315 Schuster A, Pinggera G, Pallwein L, Strasser H, Recheis W, Frauscher F (2003) Assessment of transrectal color Doppler ultrasound (TRCDUS) for measurement of urinary bladder neck blood flow in a porcine model: comparison to laser Doppler flowmetry. Eur Radiol [Suppl 1] 13:A315
27.
Zurück zum Zitat Palmer LA, Semenza GL, Stoler MH, Johns RA (1998) Hypoxia induces type II NOS gene expression in pulmonary artery endothelial cells via HIF-1. Am J Physiol 274:212–219 Palmer LA, Semenza GL, Stoler MH, Johns RA (1998) Hypoxia induces type II NOS gene expression in pulmonary artery endothelial cells via HIF-1. Am J Physiol 274:212–219
28.
Zurück zum Zitat Harris AL (2001) Hypoxia—a key regulatory factor in tumour growth. Nat Rev Cancer 2:38–47 Harris AL (2001) Hypoxia—a key regulatory factor in tumour growth. Nat Rev Cancer 2:38–47
29.
Zurück zum Zitat Oeztuerk Y, Altan VM, Yildizoglu-Ari N (1996) Effects of experimental diabetes and insulin on smooth muscle functions. Pharmacol Rev 69:69–112 Oeztuerk Y, Altan VM, Yildizoglu-Ari N (1996) Effects of experimental diabetes and insulin on smooth muscle functions. Pharmacol Rev 69:69–112
30.
Zurück zum Zitat Turner WH, Brading AF (1997) Smooth muscle of the bladder in the normal and diseased state: pathophysiology, diagnosis and treatment. Pharmacol Ther 75:77–110 Turner WH, Brading AF (1997) Smooth muscle of the bladder in the normal and diseased state: pathophysiology, diagnosis and treatment. Pharmacol Ther 75:77–110
31.
Zurück zum Zitat Henderson BE, Bogdanoff E, Gerkins V, SooHoo J, Arthur M (1974) Evaluation of cancer risk factors in a retirement community. Cancer Res 34:1045–1048 Henderson BE, Bogdanoff E, Gerkins V, SooHoo J, Arthur M (1974) Evaluation of cancer risk factors in a retirement community. Cancer Res 34:1045–1048
32.
Zurück zum Zitat Hammarsten J, Hogstedt B (2004) Clinical, haemodynamic, anthropometric, metabolic and insulin profile of men with high-stage and high-grade clinical prostate cancer. Blood Press 13:47–55 Hammarsten J, Hogstedt B (2004) Clinical, haemodynamic, anthropometric, metabolic and insulin profile of men with high-stage and high-grade clinical prostate cancer. Blood Press 13:47–55
33.
Zurück zum Zitat Montorsi P, Montorsi F, Schulman CC (2003) Is erectile dysfunction the “tip of the iceberg” of a systemic vascular disorder? Eur Urol 44:352–354 Montorsi P, Montorsi F, Schulman CC (2003) Is erectile dysfunction the “tip of the iceberg” of a systemic vascular disorder? Eur Urol 44:352–354
34.
Zurück zum Zitat Belenky A, Abarbanel Y, Cohen M, Yossepowitch O, Livne PM, Bachar GN (2003) Detrusor resistive index evaluated by Doppler ultrasonography as a potential indicator of bladder outlet obstruction. Urology 62:647–650 Belenky A, Abarbanel Y, Cohen M, Yossepowitch O, Livne PM, Bachar GN (2003) Detrusor resistive index evaluated by Doppler ultrasonography as a potential indicator of bladder outlet obstruction. Urology 62:647–650
35.
Zurück zum Zitat Loran OB, Vishnevskii EL, Vishnevskii AE (1996) The role of detrusor hypoxia in the pathogenesis of urination disorders in patients with benign prostatic hyperplasia. Urol Nefrol 6:33–37 Loran OB, Vishnevskii EL, Vishnevskii AE (1996) The role of detrusor hypoxia in the pathogenesis of urination disorders in patients with benign prostatic hyperplasia. Urol Nefrol 6:33–37
36.
Zurück zum Zitat Zimmet P, Alberti KG, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414:782–787CrossRefPubMed Zimmet P, Alberti KG, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414:782–787CrossRefPubMed
Metadaten
Titel
Vascular damage induced by type 2 diabetes mellitus as a risk factor for benign prostatic hyperplasia
verfasst von
A. P. Berger
M. Deibl
E. J. Halpern
M. Lechleitner
J. Bektic
W. Horninger
G. Fritsche
H. Steiner
A. Pelzer
G. Bartsch
F. Frauscher
Publikationsdatum
01.04.2005
Erschienen in
Diabetologia / Ausgabe 4/2005
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-005-1678-6

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