Causal Associations Between Lifestyle Habits and Risk of Benign Prostatic Hyperplasia: A Two-Sample Mendelian Randomization Study

Abstract

Background Benign prostatic hyperplasia (BPH) most often occurs in older men，previous studies and clinical experience suggest a potential link between lifestyle habits such as sleep habits, sedentary behaviour, exercise levels and BPH, but whether they have a clear causal relationship and the direction of that causality is unclear. We aimed to investigate the causal relationship between lifestyle habits and BPH using two-sample Mendelian randomization (MR) analysis. Methods Instrumental genetic independent variables strongly associated with the selected exposure factors were filtered from published genome-wide association studies (GWAS) consisting primarily of European ancestry samples. GWAS from BPH was analysed as an MR outcome with the inverse variance weighted method (IVW), maximum likelihood, weighted median method, MR‒Egger regression, and several sensitivity analyses, including Cochran’s Q test, intercept of MR‒Egger, and MR pleiotropy residual sum and outlier test (MR-PRESSO). Results MR analysis showed a significant causal risk relationship between sleep duration and BPH, with an odds ratio (OR) of 0.42 (95% confidence interval (CI), 0.25-0.69, p=0.001) for BPH when sleep duration was increased by one standard deviation (SD), but we did not find a causal relationship between the two when we performed a reverse analysis. However, sedentary behaviour and different levels of exercise did not significantly affect the risk of BPH. Conclusions This study showed a strong causal relationship between sleep levels and BPH, with adequate sleep duration being a protective factor for BPH.