Benign prostatic enlargement can be influenced by metabolic profile: results of a multicenter prospective study

Abstract

BackgroundIn last years Metabolic Syndrome (MetS) has been closely associated to Benign Prostatic Enlargement (BPE) Aim of our study is to evaluate the effect of MetS and each single MetS parameter on prostate growth in men surgically treated for BPE.MethodsOverall, 379 men were prospectively enrolled in two tertiary referral centers. Calculated prostate volume (PV) was measured with transrectal US defining the antero-posterior (AP), the cranio-caudal (CC) and the latero-lateral (LL) diameters through the ellipsoid formula, while raw PV was calculated by suprapubic US. MetS was defined according to the NCEP-ATPIII criteria.ResultsOne-hundred and forty men (36.9%) were affected by MetS. The number of MetS parameters (0 to 5) and the presence of MetS were correlated with the calculated PV. The number of MetS parameters were also directly related to increasing prostate diameters. At the binary logistic regression, MetS resulted associated to high (>60 cc) raw and calculated PV. Moreover, multivariate analysis suggested that AP diameter was mainly correlated with HDL cholesterol (r:-0.3103, p = 0.002) CC diameter with triglycerides (r:-0.191, p = 0.050) and LL diameter with systolic blood pressure (r:0.154, p = 0.044). However, at the binary logistic regression, only low HDL Cholesterol was the main determinant for the enlargement of all diameters and consequently of the whole PV.ConclusionsMetabolic factors, specially dyslipidemia, could play a central role in the pathogenesis and progression of BPE/LUTS. Interventional studies are needed to evaluate the impact of early treatment of dyslipidemia on progression of LUTS/BPH.

Clinical association of metabolic syndrome, C‐reactive protein and testosterone levels with clinically significant prostate cancer

“…As previously reported, we observed an association between MetS and/or most of its individual criterion with lower circulating levels of testosterone and higher circulating levels of CRP. Furthermore, the analysis of the different clinical characteristics comparing patients with and without MetS revealed that patients with MetS had slightly higher prostate volume compared with patients without MetS, which is consistent with a recent report indicating an association of MetS parameters with benign prostatic enlargement in men surgically treated for this pathology . These data might suggest that some component of the MetS could be connected with the prostatic growth and, therefore, given that the prevalence of MetS is increasing worldwide, the clinical control of MetS should be considered in patients at risk of PCa.…”

“…enlargement in men surgically treated for this pathology. 25 These data might suggest that some component of the MetS could be connected with the prostatic growth and, therefore, given that the prevalence of MetS is increasing worldwide, the clinical control of MetS should be considered in patients at risk of PCa.…”

The underlying mechanism of metabolic syndrome on benign prostatic hyperplasia and prostate volume

“…21 Similarly, in the meta-analysis study of Zou et al 4 that identified that the presence of MetS increased PV, the author posited that hyperinsulinemia, proinflammatory cytokines, and androgens may be linked with MetS and increased PV. A study also found that the number of MetS components (0 to 5) and the presence of MetS were significantly associated with PV levels 22 ; moreover, we also found that as the number of abnormal MetS components increases, the PV presents a trend of progressive increase (shown in Supporting Information Materials, n = 506). Zhang et al 23 reported that patients with MetS showed a significantly larger PV than non-MetS individuals and considered that insulin and insulin resistance were significant risk factors for prostate enlargement.…”

Metabolic syndrome and smoking are associated with persistence of nocturia after transurethral resection of the prostate

“…MetS is a complex disorder and worldwide epidemic, which describes the combination or clustering of several metabolic abnormalities, including central obesity, dyslipidemia, hypertension, insulin resistance with compensatory hyperinsulinemia, and glucose intolerance. Although the exact nature of the association between MetS and LUTS is still not completely understood, MetS has been associated with an increased risk of LUTS and particularly of storage LUTS (multivariate odds ratio [OR]: 1.782; 95% confidence interval [CI]: 1.045‐3.042; P = .030) …”

“…Although the exact nature of the association between MetS and LUTS is still not completely understood, MetS has been associated with an increased risk of LUTS and particularly of storage LUTS (multivariate odds ratio [OR]: 1.782; 95% confidence interval [CI]: 1.045-3.042; P = .030). [9][10][11] Smoking through different biological mechanisms including autonomic nervous system activity has been involved in LUTS pathogenesis. 12 Indeed, heavy smoking (defined as >50 pack-years) was found to increase the risk of LUTS exacerbation and can affect storage and voiding symptoms.…”