Metabolic syndrome and prostate abnormalities in male subjects of infertile couples

Abstract

No previous study has evaluated systematically the relationship between metabolic syndrome (MetS) and prostate-related symptoms and signs in young infertile men. We studied 171 (36.5 ± 8.3-years-old) males of infertile couples. MetS was defined based on the National Cholesterol Education Program Third Adult Treatment Panel. All men underwent hormonal (including total testosterone (TT) and insulin), seminal (including interleukin-8 (IL-8), seminal plasma IL-8 (sIL-8)), scrotal and transrectal ultrasound evaluations. Because we have previously assessed correlations between MetS and scrotal parameters in a larger cohort of infertile men, here, we focused on transrectal features. Prostate-related symptoms were assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS). Twenty-two subjects fulfilled MetS criteria. In an age-adjusted logistic ordinal model, insulin levels increased as a function of MetS components (Wald = 29.5, P < 0.0001) and showed an inverse correlation with TT (adjusted r = -0.359, P< 0.0001). No association between MetS and NIH-CPSI or IPSS scores was observed. In an age-, TT-, insulin-adjusted logistic ordinal model, an increase in number of MetS components correlated negatively with normal sperm morphology (Wald = 5.59, P< 0.02) and positively with sIL-8 levels (Wald = 4.32, P < 0.05), which is a marker of prostate inflammation, with prostate total and transitional zone volume assessed using ultrasound (Wald = 17.6 and 12.5, both P < 0.0001), with arterial peak systolic velocity (Wald = 9.57, P = 0.002), with texture nonhomogeneity (hazard ratio (HR) = 1.87 (1.05–3.33), P < 0.05), with calcification size (Wald = 3.11, P < 0.05), but not with parameters of seminal vesicle size or function. In conclusion, in males of infertile couples, MetS is positively associated with prostate enlargement, biochemical (sIL8) and ultrasound-derived signs of prostate inflammation but not with prostate-related symptoms, which suggests that MetS is a trigger for a subclinical, early-onset form of benign prostatic hyperplasia.

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

“…In addition, higher BMI was significantly related to higher value of IL-8 in seminal vesicle tissues, a reliable surrogate marker of prostate inflammatory diseases [20]. In the same population we also found that MetS severity was associated with increased prostate volume [21]. This association indicates that the effect of MetS on prostate growth begins very early and is detectable even in young adulthood.…”

Metabolic syndrome and benign prostatic hyperplasia: association or coincidence?

“…Moreover, these subjects also had significantly higher insulin levels and HOMA-IR values. From previous studies, it can be determined that MetS—and in particular abnormal lipid profiles including hypertriglyceridemia, low HDL cholesterol, and up-regulation of LDL cholesterol—could induce or maintain an inflammatory state within the prostate [ 26 , 32 , 33 ]. This process could be exacerbated by changes in sex-hormone levels (as observed in our study), such as relative hyperestrogenism, decreases in SHBG levels, and androgen deficiency—that is, medical conditions commonly associated with MetS, and in particular with abdominal obesity.…”

Metabolic syndrome and benign prostatic hyperplasia: An update

“…Although early-stage hyperinsulinaemia might have a beneficial effect on men with LUTS [43] , chronic hyperinsulinaemia induces prostate inflammation and overgrowth, and has been shown to be associated with LUTS deterioration [44] , [45] .…”