Effect of obesity on prostatic hyperplasia: Its relation to sex steroid levels

Abstract

In 68 men with benign prostatic hyperplasia, we evaluated the association between obesity and prostatic enlargement, as well as changes in serum levels of oestradiol, testosterone, dihydroepiandrosterone and dihydroepiandrosterone sulphate. Despite the larger adenomas, no increase in the symptom score for BPH was observed with increasing obesity. Average specimen weights increased with increasingly obesity and increasing host age from 46 to 80 g. We also found the serum oestradiol level significantly elevated in obese men who were 140% or over recommended weight compared to underweight men younger than 60 years (51.3 pg/ml versus 26.8 pg/ml, p < 0.01). This pattern was present in all age groups. These results indicate that obesity is a risk factor for prostatic enlargement but not for obstruction. Also the degree of obesity appears to have a direct effect on oestradiol levels through transformation of androgens in adipose tissue to oestrogens. In conclusion, further studies to evaluate the pathogenesis, pathophysiology, natural history and symptomatology of BPH would be of great interest and should help to define better the associations that we have recognized.

The association between body size, prostate volume and prostate-specific antigen

“…3 However, results from research investigating the association between body mass index (BMI) 4,5 or estimated visceral adiposity 4,6 and clinically diagnosed BPH are inconsistent. Investigation of prostate volume or prostate weight may avoid subjective diagnostic criteria associated with a BPH diagnosis, and several recent studies reported BMI associated with prostate volume 7,8 and prostate weight. 9 However, BMI was not associated with prostate volume in the Baltimore Longitudinal Study of Aging.…”

PTEN Loss and Reactive Microenvironments in Prostate Cancer Progression

“…Analysis of the PCPT trial also demonstrated increased LUTS in men with higher WHR (Kristal et al, 2007) and a study of Korean men found that waist circumference was positively associated with increased LUTS (Lee et al, 2009a, b). A small study of 68 men with BPH found an association between obesity and prostate volume but not worse symptoms, although this was an underpowered study compared to those discussed previously (Soygur et al, 1996). Finally, approaching the question from a slightly different perspective, a report from Maserejian et al (2009) on 1545 men from the Boston Area Community Health Survey found that increased total caloric intake was associated with higher LUTS.…”

“…There has been a strong association found consistently across studies between measures of obesity and increased prostate volume (Fowke et al, 2007b;Hogstedt, 1999, 2001;Hammarsten et al, 1998;Lee et al, 2006aLee et al, , 2009aParsons et al, 2006;Soygur et al, 1996;Xie et al, 2007). Some of the larger studies have included the 422 men in the Baltimore Longitudinal Study of Aging, showing that obesity was associated with increased prostate size based on MRI (Parsons et al, 2006).…”

“…As with diabetes there is a large body of evidence that supports a strong association between obesity and BPH/LUTS (Dahle et al, 2002;Fowke et al, 2007b;Giovannucci et al, 1994;Hogstedt, 1999, 2001;Hammarsten et al, 1998;Kristal et al, 2007;Lee et al, 2006bLee et al, , 2009aMaserejian et al, 2009;Parsons, 2007;Parsons et al, 2006;Soygur et al, 1996;Xie et al, 2007); although this finding is not universal (Meigs et al, 2001;Seitter and Barrett-Connor, 1992;Zucchetto et al, 2005). This is particularly relevant given the known ''epidemic'' of obesity in the United States, which appears to be getting steadily worse.…”

Voiding dysfunction in men: pathophysiology and risk factors

“…39 In the Kaiser Permanente cohort study, BMI was negatively correlated with BPH-related surgery. 35 Both Soygur et al 40 and Daniell 41 found a positive association between obesity and prostate size but no such correlation was found between obesity and symptom severity. Men between the age of 40 and 75 years in the Health Professionals Follow-up Study without cancer or previous prostatectomy provided measurements such as weight, height, and waist and hip circumferences.…”