Vascular damage induced by type 2 diabetes mellitus as a risk factor for benign prostatic hyperplasia

Abstract

Aims/hypothesis: The aim of this study was to evaluate the relationship between benign prostatic hyperplasia (BPH) and arteriosclerosis shown in a model of type 2 diabetes in a trans-sectional population study using contrast-enhanced colour Doppler ultrasound for exact assessment of prostatic blood flow. Methods: Contrast-enhanced transrectal colour Doppler ultrasound was performed using a microbubble-based ultrasound enhancer SonoVue for evaluating prostate vascularity (transitional zone [TZ] and peripheral zone [PZ]) in diabetic BPH patients, non-diabetic BPH patients and healthy subjects. Computer-assisted quantification of colour pixel intensity (CPI) was used to objectively evaluate the prostate vascularity. Resistive index measurements were obtained in the TZ and the PZ. Findings were compared between these three groups. Results: TZ-CPI was significantly lower in diabetic patients than in non-diabetic BPH men (p=0.001), whereas the CPI of the PZ showed no difference between these two groups (p=0.978). TZ-CPI of patients with diabetic and non-diabetic BPH were significantly lower than in controls (p<0.001), but no difference was found between diabetic and healthy patients in the PZ (p=0.022) and borderline significance was seen when comparing patients of the BPH group with the control patients (p=0.019). Resistive index values of the TZ in diabetic patients showed significantly higher values (p<0.001) than the BPH and control groups. Conclusions/interpretation: The significantly lower CPI and higher resistive index values of the TZ in diabetic patients compared with patients with nondiabetic BPH and healthy subjects indicate considerable vascular damage in the TZ of these patients. Diabetic vascular damage may cause hypoxia and may contribute to the pathogenesis of BPH.

A Meta-analysis of Diabetes Mellitus and the Risk of Prostate Cancer

“…It has been shown that DM is associated with increased risk of benign prostatic hyperplasia, which is characterized by enlargement of the prostate (38). The chance of a biopsy detecting cancerous cells in a prostate may simply be diluted as a prostate grows in size.…”

Fatores associados à realização dos exames de rastreamento para o câncer de próstata: um estudo de base populacional

“…Essa associação poderia decorrer da maior freqüência de visitas ou consultas dos pacientes diabéticos aos serviços de saúde e consequente maior exposição à oferta dos exames. Além disso, estudo aponta o diabetes mellitus como um fator de risco para a hiperplasia benigna da próstata, cujos sintomas devem aumentar a probabilidade da realização do toque retal e de PSA 32 . Embora existam evidências da associação do diabetes mellitus com vários tipos de câncer, como o de pâncreas e o de vias biliares, entre outros, estas não existem em relação ao câncer de próstata 33,34 .…”

Diabetes Mellitus and HbA1c Levels Associated with High Grade Prostate Cancer

“…In addition, the mechanism through which DM and prostate cancer are related has not been fully elucidated. Men with DM are known to generally have lower prostate-specific antigen (PSA) level but larger prostate size than others not having DM (Hammarsten and Hogstedt, 2001;Berger et al, 2005;Werny et al, 2006;Fowke et al, 2007;Turgutalp et al, 2013). Also, it can be suggested that the reported protective effect of DM may be due to the differences in PCa screening among diabetic and non-diabetic patients.…”