Association of benign prostatic hyperplasia (BPH) with the metabolic syndrome (MS) and its components – ‘a growing dilemma’

Abstract

Abstract

Aim:

To determine whether the metabolic syndrome (MS) or its individual components is associated with radiologically determined prostate volume: an objective measure of benign prostatic hyperplasia (BPH).

Methods:

Between January 2008 and December 2009, a case–control study was conducted among 200 males aged over 50 years, attending an urology clinic, with patients diagnosed as having BPH being taken as cases (Group 1), while healthy volunteers were taken as a control group from a routine health camp organized by the Dept. of Urology (Group 2). The prostate volume was determined using ultrasonography, whereas the MS was assessed using the predefined criteria from the National Cholesterol Education Programme–Adult Treatment Panel-III (NCEP–ATP III). Before a physician conducted a digital rectal examination (DRE) on a subject, a blood sample was obtained for serum prostate specific antigen (PSA), fasting blood glucose (FBG), tryglyceride (TG) and high density lipoprotein (HDL) determination. A body mass index (BMI) greater than 25 kg/m² was classified as obese (this cut-off is used for Asians). Waist-to-hip ratio (WHR) was calculated from waist and hip circumferences and was categorized as greater than or equal to 0.90 (score = 1) or as less than 0.90 (score = 2) for defining obesity.

Result:

Two hundred men enrolled in the study (mean age = 65.09 years; range 50–80), of which 85 were diagnosed as having BPH with lower urinary tract symptoms (LUTS: Group 1) and 115 were healthy volunteers from the health camp (Group 2). Comparing both groups the WHR (P = 0.001) and TG levels (P = 0.002) were found to be significantly increased in BPH patients. However, HDL (P = 0.0001) was significantly decreased in BPH patients. Increased WHR, increased TG and decreased HDL were found to be associated with increased incidence of BPH. Twelve BPH patients had all three criteria of the MS.

Conclusion:

This pilot study showed that higher TG levels, a high WHR and lower HDL levels were associated with BPH patients in north Indian men. Very few men had both BPH and the MS, so the MS can act as a borderline risk factor for BPH. Individual factors of the MS may also be associated with increased risk of BPH.