Optimal high‐density lipoprotein cholesterol level for decreasing benign prostatic hyperplasia in men not taking statin medication: A historical cohort study

Abstract

Background We evaluated the optimal high‐density lipoprotein cholesterol level for benign prostatic hyperplasia (BPH) prevention in men not taking statin medication using a large historical cohort. Methods We initially selected 130 454 men who underwent health checkups in 2009 from the National Health Information Database of the National Health Insurance Service. After excluding 36 854 men with BPH in 2009, and 45 061 men for statin use, 48 539 men were ultimately included in the analysis. A Kaplan‐Meier analysis and multivariable Cox regression analysis was performed to assess the optimal high‐density lipoprotein cholesterol level for preventing BPH. Results High‐density lipoprotein cholesterol levels were less than 40 mg/dL in 7431 (15.3%) men, 40 to 49 in 15 861 (32.7%), 50 to 59 in 15 328 (27.5%), and greater than or equal to 60 in 11 919 (24.6%). The overall cumulative incidence of BPH was 4.4%, 8.7%, 13.0%, and 17.8% at the 1‐, 2‐, 3‐, and 4‐year follow‐up periods, respectively. In multivariable analysis, high‐density lipoprotein greater than or equal to 60 mg/dL were significantly associated with a decreased incidence of BPH, as were age, residence, income, body mass index, diabetes, hypertension, triglyceride, and increased annual clinic visits, especially in men in their 40s. Conclusion Elevated serum high‐density lipoprotein cholesterol levels were negatively associated with BPH incidence. In addition, maintaining high‐density lipoprotein greater than or equal to 60 mg/dL was associated with a decreased BPH incidence compared with high‐density lipoprotein less than 40 mg/dL, especially in men in their 40s.

Tissue immunoexpression of IL-6 and IL-18 in aging men with BPH and MetS and their relationship with lipid parameters and gut microbiota - derived short chain fatty acids

“…It has also been shown again that HDL is the MetS component that shows the strongest relationship with the spread of BPH in men [ 43 ]. Similar results were obtained in a study by Yoo et al [ 44 ], in which among men not taking statins, it was shown that HDL liporptotein levels higher than 60 mg/dL reduce the incidence of BPH, while HDL concentrations below 40 mg/dL, especially in men under 40, predispose to BPH. Moreover, decreased HDL concentrations are significantly associated with the severity of LUTS symptoms [ 45 ].…”

Analysis of platelet and monocyte-to-lymphocyte ratio and diabetes mellitus with benign prostatic enlargement

“…Lymphocytes have a scavenging effect on foreign antigens, and the LHR reflects the body’s inflammatory status. Increased HDL is negatively associated with the risk of developing BPH ( 39 ). Lipid-lowering drugs have a therapeutic effect on BPH ( 40 ).…”

Serenoa Repens (Saw Palmetto) for Lower Urinary Tract Symptoms (LUTS): The Evidence for Efficacy and Safety of Lipidosterolic Extracts. Part III

“…In fact, such lifestyle issues interact with each other and are consequential in the processes of inflammation, aging, and cancer. The patient's medical history, the presence of co-existent chronic inflammation, the proper assessment of diabetes, metabolic syndrome, and details about medications and supplements and possible drug interactions need to be taken into account when determining the clinical efficacy of LSESr vs. LUTS [80][81][82][83][84][85][86][87]. Study design should stratify patients into subsets of those who may have lingering pharmacologic effects of alpha-blockers vs. those who were never on them.…”