Objectives
Obesity and metabolic status are both modifiable risk factors of lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH). However, the association between metabolically healthy obesity (MHO) and LUTS/BPH is largely unexplored. This study aimed to investigate the risk of LUTS/BPH among different metabolic syndrome‐body mass index (MetS‐BMI) phenotypes in a cohort of Chinese males.
Methods
A total of 3321 males from the China Health and Retirement Longitudinal Study (CHARLS) without history of LUTS/BPH at baseline were included into the analyses. Participants were categorized into six mutually exclusive groups according to presence or absence of MetS combined with BMI status: metabolically healthy normal weight/overweight/obesity (MHN/MHOW/MHO) and metabolically unhealthy normal weight/overweight/obesity (MUN/MUOW/MUO). Adjusted odds ratios (OR) and 95% CI of LUTS/BPH across MetS‐BMI categories were estimated with multivariable logistic regression models.
Results
A total of 394 (11.86%) participants developed LUTS/BPH during the follow‐up. After adjusting for age, educational level, smoking status, drinking status, and BMI change, the multivariable‐adjusted OR (95% CI) for incident LUTS/BPH comparing MUO, MHO, MUOW, MHOW, and MUN with MHN were 1.99 (1.23‐3.22), 2.04 (1.14‐3.66), 1.61 (1.11‐2.34), 1.45 (1.02‐2.05), and 0.91 (0.54‐1.56), respectively.
Conclusions
MHO and MHOW were risk populations of LUTS/BPH, suggesting that overweight and obesity can independently contribute to LUTS/BPH, even among metabolically healthy individuals. These findings emphasize metabolically healthy individuals may still benefit from maintaining normal body weight to prevent LUTS/BPH. Our findings also support that those recommendations for LUTS/BPH should highlight the importance of maintaining metabolic health across all BMI groups among Chinese males.
