Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis

Abstract

Objective To summarise and meta‐analyse current literature on metabolic syndrome (MetS) and benign prostatic enlargement (BPE), focusing on all the components of MetS and their relationship with prostate volume, transitional zone volume, prostate‐specific antigen and urinary symptoms, as evidence suggests an association between MetS and lower urinary tract symptoms (LUTS) due to BPE. Methods An extensive PubMed and Scopus search was performed including the following keywords: ‘metabolic syndrome’, ‘diabetes’, ‘hypertension’, ‘obesity’ and ‘dyslipidaemia’ combined with ‘lower urinary tract symptoms’, ‘benign prostatic enlargement’, ‘benign prostatic hyperplasia’ and ‘prostate’. Results Of the retrieved articles, 82 were selected for detailed evaluation, and eight were included in this review. The eight studies enrolled 5403 patients, of which 1426 (26.4%) had MetS defined according to current classification. Patients with MetS had significantly higher total prostate volume when compared with those without MetS (+1.8 mL, 95% confidence interval [CI] 0.74–2.87; P < 0.001). Conversely, there were no differences between patients with or without MetS for International Prostate Symptom Score total or LUTS subdomain scores. Meta‐regression analysis showed that differences in total prostate volume were significantly higher in older (adjusted r = 0.09; P = 0.02), obese patients (adjusted r = 0.26; P < 0.005) and low serum high‐density lipoprotein cholesterol concentrations (adjusted r = −0.33; P < 0.001). Conclusions Our results underline the exacerbating role of MetS‐induced metabolic derangements in the development of BPE. Obese, dyslipidaemic, and aged men have a higher risk of having MetS as a determinant of their prostate enlargement.

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

“…Accumulating evidence suggests that BPH is particularly observed in men with diabetes mellitus and metabolic syndrome, although the pathogenetic mechanisms underlying these connections have not yet been completely clarified (Gacci et al, 2015). Recent studies reported higher rate of surgery for enlarged prostate or BPH in diabetes (Sidney et al, 1991;Sarma & Kellogg, 2009), and a low vitamin D status in two-thirds of patients with type 2 diabetes mellitus and in particular among diabetic patients with poor glycaemic control or longer diabetes durations.…”

Association Between Prostatic Volume, Metabolic Syndrome and Left Ventricular Mass: A Cross Sectional Study

“…In a systematic review and meta-analysis of eight studies involving 5403 patients, Gacci et al [21] suggested that the occurrence of metabolic syndrome in elderly men with a larger prostate could represent a major contributing factor in BPE progression. In ameta-regression analysis of the meta-analysis, the authors further suggested that obese, dyslipidemic (low serum HDL concentration in particular) and aged patients were more at risk of having metabolic syndrome as a determinant of their increased prostate size.…”

The role of estrogens at men. Part 2. Private clinical endocrinology and pathophysiology of estrogens at men

“…Наличие ме-таболического синдрома связано с достоверно боль-шим общим объемом предстательной железы и боль-шей медианой ежегодного прироста ее переходной зоны, а также с достоверно более высоким уровнем простатспецифического антигена в крови, который может считаться, по мнению ряда авторов, индексом простатического объема и критерием выраженности СНМП [55][56][57][58][59]. Сегодня ДГПЖ рассматривается как системное гормонально-метаболическое заболевание, в основе патогенеза которого лежат дислипидемия, хроническое воспаление и нарушение соотношения тестостерон/эстрадиол [60][61][62][63]. Низкий уровень тесто-стерона наблюдается как минимум у 1 из 5 больных ДГПЖ [64].…”