Interrelationships Between Insulin Resistant Syndrome And Benign Prostatic Hyperplasia

ObjectiveThe objective of the present study is to investigate the epidemiology of surgically treated benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) and to explore the association between socio-demographic characteristics, insulin resistance syndrome and the development of BPH in middle aged and elderly men.MethodsA hospital based case control study was conducted between July 2009 and December 2010, including 180 male aged 55~90 years'residents who had been surgically treated on account of BPH which was histopathologically examined to confirm a final diagnosis in Jinzhou as cases group. A total of 180 patients who had been admitted to the same hospitals for many different diseases that were not related with prostatic conditions were used as controls. Cases and controls were taken for 1:1 pair-matching. All subjects were interviewed during their hospital stay, using a standardized structured questionnaire that included information on socio-demographic characteristics, lifestyle habits, medical history and insulin resistant syndrome. Odds ratios (OR) and corresponding 95% confidence intervals (95% CI) of BPH for insulin resistant syndrome were estimated to analyze the correlation of insulin resistant syndrome and development of BPH by using multivariable conditional logistic regression models in SPSS 13.0.Results1. In total, 180 valid questionnaires for cases and corresponding controls entered the study. The mean and standard deviation of age was 73.27±7.577 Analysis about socio-demographic characteristics showed that there were no significant differences between age, race, residence, education, occupation and economic status in two groups (P >0.05).2. Multivariable conditional logistic regression analysis showed that metabolic syndrome (OR =2.251, 95% CI: 1.293~3.919, P =0.004), hypertension (OR =3.006, 95% CI: 1.617~5.587, P =0.001), FBG (OR =2.122 95% CI:1.341~3.312, P =0.002), prostatitis (OR =3.310, 95% CI: 1.516~7.227, P =0.003), waist to hip ratio (OR =2.430, 95% CI: 1.421~4.155, P =0.001) and dyslipidemia(OR =2.470, 95% CI: 1.375~4.439, P =0.002) may increase the risk of clinical BPH, however, high-density lipoprotein cholesterol may be protective factors of BPH (OR =0.601, 95% CI: 0.328~0.980, P =0.039).3. Comparied with participants no diabetes, the risk of BPH increase for diabetes with smoking index≤400 (OR =0.904, 95%CI: 0.292~2.804), 400~800(OR =2.857, 95% CI: 1.077~7.577),≥800(OR =3.186, 95% CI: 1.114~9.115), and there was dose-response relationship between smoking index and BPH.Conclusions1. Insulin resistance syndrome may increase the risk of BPH.2. Hypertension, High-density lipoprotein cholesterol, waist to hip ratio, fasting plusma glucose, high triglyceride hematic disease may be risk factors of clinical BPH.3. There is obviously interaction between fasting plusma glucose and Smoking index. Diabetes was thought to be risk factor of BPH after smoking index was stratified. High smoking index was related with increasing risk of occurring BPH, and there was dose-response relationship between smoking index and BPH.Although BPH and LUTS may be viewed as an inevitable consequence of ageing, it appears to be exacerbated by lifestyle and metabolic factors. BPH can be effectively prevented by means of improving internal environment disorder and life style and maintaining normal BMI.