Prevalence of Inflammation and Benign Prostatic Hyperplasia on Autopsy in Asian and Caucasian Men

Zlotta, Alexandre R.; Egawa, Shin; Pushkar, Dmitry; Govorov, Alexander; Kimura, Takahiro; Kido, Masahito; Takahashi, Hiroyuki; Kuk, Cynthia; Ковылина, М. В.; Aldaoud, Najla; Fleshner, Neil; Finelli, Antonio; Klotz, Laurence; Lockwood, Gina; Sykes, Jenna; Kwast, Theodorus van der

doi:10.1016/j.eururo.2014.06.026

Cited by 62 publications

(49 citation statements)

References 9 publications

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“…Anyway, these studies were conducted in healthy middleaged men. However, in an age-matched autopsy series, the prevalence and severity of histologic BPH were similar in Caucasian respect Southeast Asian men, despite very different diet and lifestyle [35]. These findings are in contrast with previous observations contradicting the supposition of different geographical impact and MetS at least regarding BPE.…”

Section: Discussioncontrasting

confidence: 79%

Connections between lower urinary tract symptoms related to benign prostatic enlargement and metabolic syndrome with its components: a systematic review and meta-analysis

Russo¹,

Castelli²,

Urzì³

et al. 2015

The Aging Male

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A significant amount of epidemiological evidences have underlined an emerging link between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement a (BPE). We aimed to assess the connections between LUTS and MetS with its components. Meta-analysis were conducted to determine the mean differences (MD) and confidence intervals of IPSS total score, IPSS-voiding, IPSS-storage and prostate volume (PV) in patients with or without MetS. Ln(odds-ratio) were calculated to estimate the risk of having moderate-to-severe LUTS (IPSS ≥ 8). Nineteen studies were identified as eligible for this systematic review, with a total of 18,476 participants, including 5554 (30.06%) with and 12,922 (69.94%) without MetS. Pooled analysis did not demonstrate significant MD of IPSS, IPSS-voiding and IPSS-storage in men with or without MetS but PV was significantly different (MD = 2.18; p = 0.03). Presence of MetS was not significantly associated with moderate-to-severe LUTS (odds ratio = 1.13; p = 0.53) and only altered serum triglycerides and diabetes were associated with this risk. The association between MetS and LUTS/BPE remain unclear and further observational studies in a population with metabolic disorders should be conducted in order to address it's potential role in determining LUTS/BPE.

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Section: Discussioncontrasting

confidence: 79%

Connections between lower urinary tract symptoms related to benign prostatic enlargement and metabolic syndrome with its components: a systematic review and meta-analysis

Russo¹,

Castelli²,

Urzì³

et al. 2015

The Aging Male

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“…Evidences showed that inflammatory infiltrates are commonly found in BPH lesions [18,19,20], and these inflammatory cells release cytokines and growth factors that can stimulate the proliferation of stroma and epithelial cells, thus contributing to the development and progression of BPH. Recently, it has been shown that patients affected by MetS are at higher risk of BPH/LUTS [3,4,5], suggesting that MetS has very heterogeneous clinical ramifications.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Mean Platelet Volume: The Role of Metabolic Syndrome

Zhao

Tang²,

Shao³

et al. 2016

Urol Int

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Objective: The aim of the present study was to investigate the relationship among serum mean platelet volume (MPV) levels, benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and metabolic syndrome (MetS), and study the potential role of serum MPV levels in BPH/LUTS progression in an indirect manner. Methods: Five hundred fifty-one men aged 45 or older with moderate to severe LUTS due to benign prostatic enlargement were recruited into this study by consecutive routine physical examination programs. Urologic evaluation included transrectal ultrasound, International Prostate Symptom Score and maximum urinary flow rate (Qmax). Overnight fasting venous blood specimens were collected and serum levels of prostate-specific antigen, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, triglyceride and C-reactive protein (CRP) were recorded. In addition, MPV were determined by automated hematology analyzer. We divided subjects into 2 groups according to the presence of MetS. We also took the MPV values as a categorical variable and divided subjects into 2 groups (≥11.8 or <11.8 fl) or 4 groups according to the different levels of MPV (9.3-11.0, 11.1-11.5, 11.6-11.9, 12.0-12.5 and ≥12.5 fl). The clinical characteristics and parameters of BPH/LUTS in different groups were measured and compared to identify their relationships. Results: MetS was diagnosed in 37.0% of the subjects. There were significant interactive correlation among the number of positive MetS components, CRP, MPV and parameters of BPH/LUTS. The ratio of PV ≥31 ml and Qmax <10.6 ml/s were positively correlated with the increased level of MPV. Additionally, the OR in relation to PV ≥31 ml and Qmax <10.6 ml/s significantly rose as the level of MPV increased after adjusting for age, suggesting of a threshold effect at 12.0-12.5 fl for PV ≥31 ml (OR 2.678, 95% CI 1.425-5.035) and at >12.5 fl for Qmax <10.6 ml/s (OR 3.190, 95% CI 1.768-5.755). However, only the value of MPV more than 12.5 fl still showed statistically significant effect on Qmax <10.6 ml/s after adjusting for age and the presence of MetS (OR 2.164, 95% CI 1.162-4.032). Conclusions: Our results add to the evidence that chronic inflammation is a candidate mechanism at the crossroad between MetS and BPH/LUTS, and the presence of elevated MPV may serve as a predictor of MetS-induced inflammation in the progression of BPH/LUTS.

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“…In the recent years, chronic inflammation has been identified as a pivotal player in the pathogenesis of BPH by several crosssectional and longitudinal large cohort studies (Zlotta et al, 2014). On the other hand, vitamin D, that shows pronounced immunoregulatory and anti-inflammatory properties (Kramer et al, 2007), seems to exert an anti-hypertrophic action by regulating the growth of prostate stromal cells (Adorini et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Hypovitaminosis D is associated with lower urinary tract symptoms and benign prostate hyperplasia in type 2 diabetes

et al. 2015

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SUMMARYLower urinary tract symptoms (LUTS) may develop more commonly in men with type 2 diabetes mellitus (T2DM). LUTS are often associated with benign prostate hyperplasia (BPH), in general population. An association between LUTS and hypovitaminosis D, and between hypovitaminosis D and type 2 diabetes (T2DM), has also been suggested. Thus, we aim to evaluate possible relationships between hypovitaminosis D, LUTS, and BPH in T2DM men. In this prospective observational study, 67 T2DM males (57.9 AE 9.28 years) underwent medical history collection, International Prostate Symptom Score (IPSS) questionnaire, that allows the identification and grading of LUTS, physical examination, biochemical/hormonal blood tests (fasting plasma glucose, glycated haemoglobin, total cholesterol, high-density lipoprotein cholesterol, triglycerides, creatinine, LH, total testosterone, estradiol (E 2 ), 25-OH-vitamin D, PTH, calcium, phosphate, and PSA) and ultrasound transrectal prostate examination. Subdividing patients into three groups, on the base of 25-OH-vitamin D concentration (sufficiency ≥50; insufficiency >25 < 50; and deficiency ≤25 nM), a significant progressive increase of prostate volume (p = 0.037), IPSS score (p = 0.019), diastolic blood pressure (p = 0.018), and a significant decrease in HDL cholesterol (p = 0.038) were observed. 25-OH-Vitamin D levels were inversely correlated with both IPSS (R = À0.333; p = 0.006) and prostate volume (R = À0.311; p = 0.011). At multivariate analysis, hypovitaminosis D remained an independent predictor of both IPSS and prostate volume. In conclusion, we showed, for the first time, an association between 25-OH-vitamin D deficiency, LUTS, and BPH in T2DM men.

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Prevalence of Inflammation and Benign Prostatic Hyperplasia on Autopsy in Asian and Caucasian Men

Cited by 62 publications

References 9 publications

Connections between lower urinary tract symptoms related to benign prostatic enlargement and metabolic syndrome with its components: a systematic review and meta-analysis

Connections between lower urinary tract symptoms related to benign prostatic enlargement and metabolic syndrome with its components: a systematic review and meta-analysis

The Relationship between Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Mean Platelet Volume: The Role of Metabolic Syndrome

Hypovitaminosis D is associated with lower urinary tract symptoms and benign prostate hyperplasia in type 2 diabetes

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