Abstract
Chronic prostatitis (CP) is a complex disease. Fragmentary evidence suggests that factors such as infection and autoimmunity might be associated with CP. To further elucidate potential risk factors, the current study utilized the Fangchenggang Area Male Health and Examination Survey (FAMHES) project; where 22 inflammatory/immune markers, hormone markers, tumor-related proteins, and nutrition-related variables were investigated. We also performed baseline, regression, discriminant, and receiver operating characteristic (ROC) analyses. According to NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), participants were divided into chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS, pain ≥ 4; divided into IIIa and IIIb sub-groups) and non-CPPS (pain = 0; divided into IV and normal sub-groups). Analyses revealed osteocalcin as a consistent protective factor for CP/CPPS, NIH-IIIb, and NIH-IV prostatitis. Further discriminant analysis revealed that ferritin (p = 0.002) and prostate-specific antigen (PSA) (p = 0.010) were significantly associated with NIH-IIIa and NIH-IV prostatitis, respectively. Moreover, ROC analysis suggested that ferritin was the most valuable independent predictor of NIH-IIIa prostatitis (AUC = 0.639, 95% CI = 0.534–0.745, p = 0.006). Together, our study revealed inflammatory/immune markers [immunoglobulin E, Complement (C3, C4), C-reactive protein, anti-streptolysin, and rheumatoid factors], hormone markers (osteocalcin, testosterone, follicle-stimulating hormone, and insulin), tumor-related proteins (carcinoembryonic and PSA), and a nutrition-related variable (ferritin) were significantly associated with CP or one of its subtypes.
Highlights
Devised a new classification system[1], in which four types were specified: acute prostatitis (NIH-I), chronic bacterial prostatitis (NIH-II), chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS, NIH-III), and asymptomatic inflammatory prostatitis (NIH-IV)
The results showed that 8.4% of participants had prostatitis-like symptoms, and 5.4% were diagnosed with Chronic prostatitis (CP) according to the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) criteria, with a cost of 8059 China Yuan (CNY) annually for each patient
In order to investigate the associations between prostatitis and the biochemical markers investigated, correlation analyses were conducted for CPPS vs non-CPPS, IIIa vs normal, and IIIb vs normal sub-groups
Summary
Devised a new classification system[1], in which four types were specified: acute prostatitis (NIH-I), chronic bacterial prostatitis (NIH-II), chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS, NIH-III), and asymptomatic inflammatory prostatitis (NIH-IV). Infection-related factors, including bacteria, viruses, and yeast, were first under suspicion as potential causative factors for CP/CPPS (NIH-III)[15,16,17,18]. In 2011, Rudick et al.[19] induced sustained chronic pelvic pain in mice with Uropathogenic Escherichia coli, and confirmed the role of bacteria in the development of CP/CPPS. Another case-control study revealed no difference in the rate of positive bacteria cultures in prostatic secretion between CP/CPPS and asymptomatic men[20]. While the accumulating evidence point out diverse risk factors, few studies have been conducted by focusing on comprehensive biochemical markers, including inflammatory/ immune markers, hormone markers, tumor-related proteins, and nutrition markers
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