1
|
Udo CO, Robinson ED, Ijeruh OY, Nwankwo NC. Correlation between Transabdominal Sonographic Prostate Volume and Anthropometric Parameters. J Med Ultrasound 2022; 30:261-265. [PMID: 36844769 PMCID: PMC9944824 DOI: 10.4103/jmu.jmu_183_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/12/2021] [Accepted: 12/22/2021] [Indexed: 12/29/2022] Open
Abstract
Background Prostate diseases commonly present with lower urinary tract symptoms (LUTS) resulting from prostatic enlargement. Prostate volume (PV) can be evaluated using transabdominal ultrasonography. Focus is currently on relative factors of prostatic enlargement which includes obesity and central adiposity. The aim of this study is to correlate transabdominal sonographic PV and anthropometric parameters in patients with LUTS in Port Harcourt. Methods This was a prospective cross-sectional study carried out at the Radiology Department, Rivers State University Teaching Hospital, Port Harcourt, between September 2020 and January 2021. One hundred and twenty (120) males from 40 years and above who presented with LUTS were recruited. Transabdominal PV estimation was done and body mass index (BMI) as well as WC was assessed. Data were analyzed using a Statistical Package for Social Sciences; appropriate statistical tests were applied and P < 0.05 was considered significant. Results The mean PV was 69.8 ± 63.5 cm3, 79.2% of the subjects had enlarged prostate with volume ≥30 cm3. PV was found to increase with age. The correlation between PV and anthropometric measures of obesity (BMI and WC) was statistically not significant. Conclusion The work established that there is no correlation between PV and anthropometric measures of obesity - BMI and WC in negro population as opposed to nonblack population where there is correlation. Obesity may not be a considerable risk factor of prostatic enlargement in the studied population. Thus, anthropometrics may not be useful in predicting prostate size.
Collapse
Affiliation(s)
- Chibueze Okorie Udo
- Department of Radiology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - Ebbi Donald Robinson
- Department of Radiology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria,Address for correspondence: Dr. Ebbi Donald Robinson, Department of Radiology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria. E-mail:
| | - Olukunmi Yetunde Ijeruh
- Department of Radiology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - Nelson Chukwuemeka Nwankwo
- Department of Radiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| |
Collapse
|
2
|
Mampa E, Haffejee M, Fru P. The correlation between obesity and prostate volume in patients with benign prostatic hyperplasia at Charlotte Maxeke Johannesburg Academic Hospital. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00160-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
Benign prostatic hyperplasia (BPH) is on the increase placing a substantial burden on health care systems. Recent studies have shown that men with high body mass index (BMI) and central obesity, as denoted by waist circumference (WC) have bigger prostate volumes (PV) with subsequent increase in lower urinary tract symptoms (LUTS) than men with normal BMI. The purpose of this research was to investigate the correlation between Obesity and PV in patients with BPH.
Methods
The study included 178 men aged between 50 and 75 years with BPH seen at Charlotte Maxeke Johannesburg academic hospital (CMJAH) Urology Outpatient Department between September 2018 and February 2019. Weight and height measurements were obtained to calculate BMI. Furthermore, WC was measured using a measuring tape, while a transrectal ultrasound (TRUS) was used to measure PV. Patient demographics, clinical characteristics such as hypertension, diabetes, smoking and prostate specific antigen (PSA) were also noted.
Results
Patients in the study had a mean age of 64.87 ± 6.526 years and the mean BMI was 27.31 ± 3.933 kg/m2. The mean PV of each BMI group were 52.92 ± 38.49, 61.00 ± 33.10 and 64.86 ± 37.46 cm3 for normal, overweight and obese groups, respectively, and the average PV score was 59.36 ± 36.507 cm3. The mean PSA score was 4.30 ± 3.126 with a range of 1.3–6.4, while the mean WC was 98.67 cm. There was no correlation between BMI and PV (p value = 0.195) as well as between PV and WC, hypertension, diabetes or smoking. The results revealed that the relationship between PV with PSA level as well as age was significant (p value = 0.001, p value = 0.009, respectively).
Conclusion
The results showed no correlation between BMI and PV. Diabetes and hypertension as well had no positive correlation with PV. A follow-up study may be indicated to look at the correlation between obesity, LUTS and urinary flow rates to establish whether aggressive management of obesity would have significant impact on the management of BPH.
Collapse
|
3
|
Roldán Gallardo FF, Quintar AA. The pathological growth of the prostate gland in atherogenic contexts. Exp Gerontol 2021; 148:111304. [PMID: 33676974 DOI: 10.1016/j.exger.2021.111304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 02/06/2023]
Abstract
The human prostate is an androgen-dependent gland where an imbalance in cell proliferation can lead to benign prostatic hyperplasia (BPH), which results in voiding lower urinary tract symptoms in the elderly. In the last decades, novel evidence has suggested that BPH might represent an element into the wide spectrum of disorders conforming the Metabolic Syndrome (MS). The dyslipidemic state and the other atherogenic factors of the MS have been shown to induce, maintain and/or aggravate the pathological growth of different organs, with data regarding the prostate being still limited. We here review the available epidemiological and experimental studies about the association of BPH with dyslipidemias. In particular, we have focused on Oxidized Low-Density Lipoproteins (OxLDL) as a potential trigger for vascular disease and cellular proliferation in atherogenic contexts, analyzing their putative molecular mechanisms, including the induction of specific extracellular vesicles (EVs)-derived miRNAs. In addition to the epidemiological evidence, OxLDL is proposed to play a fundamental role in the upregulation of prostatic cell proliferation by activating the Rho/Akt/p27Kip1 pathway in atherogenic contexts. miR-21, miR-141, miR-143, miR-145, miR-155, and miR-221 would be involved in the transcription of genes related to the proliferative process. Although much remains to be investigated regarding the impact of OxLDL, its receptors, and molecular mechanisms on the prostate, it is clear that EVs and miRNAs represent a promising target for proliferative pathologies of the prostate gland.
Collapse
Affiliation(s)
- Franco F Roldán Gallardo
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Centro de Microscopía Electrónica, Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Investigaciones en Ciencias de la Salud (INICSA), Córdoba, Argentina
| | - Amado A Quintar
- Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Centro de Microscopía Electrónica, Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Investigaciones en Ciencias de la Salud (INICSA), Córdoba, Argentina.
| |
Collapse
|
4
|
Yue L, Ge Y, Wang T, Ge M, Zhang C, Zhang W. The correlation between body mass index and prostatic-related parameters in men 40 years or older in Zhengzhou. Aging Male 2020; 23:483-488. [PMID: 30451056 DOI: 10.1080/13685538.2018.1530754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To understand the relationship between body mass index (BMI), age, prostate volume (PV), prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS) and quality of life (QoL) in Zhengzhou. MATERIALS AND METHODS In the cross-sectional study, men living in Zhengzhou were invited to participate in this study. Men who were 40 years or older were subjected to the IPSS and related examination. A total of 1360 participants were included. Body mass index < 18.5 kg/m2 was determined as underweight, 18.5-24.99 kg/m2 normal, 25-29.99 kg/m2 overweight, and ≥30 kg/m2 obese. RESULTS The mean BMI was 24.92 ± 3.37 kg/m2. The mean PSA was 1.06 ± 0.85 ng/mL. The mean PV was 20.10 ± 9.96 mL. The mean age was 62.72 ± 11.03 years. The mean IPSS was 5.87 ± 3.48 scores. The mean QoL was 2.33 ± 1.28 scores. PSA showed a significant tendency to decrease with increasing BMI (r = -0.061, p = 0.018, ptrend = 0.037). The same with age (r = -0.109, p < .001; ptrend = .045). But the result suggested that both IPSS and QoL were positively correlated with BMI (r = 0.120, p < .001, ptrend < .001; r = 0.083, p = .001, ptrend = .021, respectively). PV increased with increasing BMI (r = 0.110, p < .001, ptrend = 0.045 ). CONCLUSIONS Age, PSA decreased with increasing BMI. But larger PV, IPSS, and QoL were associated with higher BMI.
Collapse
Affiliation(s)
- Limin Yue
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yongchao Ge
- Department of Urology, Zhengzhou Third People's Hospital, Zhengzhou, Henan, China
| | - Tao Wang
- Department of General Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mengying Ge
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Chengda Zhang
- Department of International Medicine, Beaumont Health System, Royal Oak, MI, USA
| | - Weidong Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
5
|
Noh JW, Kim KB, Kwon YD, Kim JH. Association between sodium intake and lower urinary tract symptoms: does less sodium intake have a favorable effect or not? Transl Androl Urol 2020; 9:1135-1145. [PMID: 32676397 PMCID: PMC7354310 DOI: 10.21037/tau-19-808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Sodium intake is known to be related with hypertension (HTN), which could impact lower urinary tracts symptoms (LUTS) indirectly. To date, only limited clinical evidences exist upon the association between sodium preference and LUTS. This cross-sectional study analyzed the association between sodium preference and the severity of LUTS in men. Methods A cross-sectional analysis has been performed and a total of 86,637 participants among total registered population of 229,226 in Korean Community Health Survey (KCHS) were included for final analysis. The adjusted odds ratio (OR) or coefficient with 95% confidence interval (CI) estimates were described to show the association between sodium preference and LUTS using negative binomial regression (for the IPSS total, IPSS voiding, and IPSS storage symptoms), ordinal logistic regression (for the IPSS grade), and binomial logistic regression (for the IPSS nocturia symptoms). Results Preference of salty taste group (high sodium preference) were significantly associated with higher IPSS total score (Coef =0.31; 95% CI: 0.27, 0.35), increased risk of severe IPSS grade (OR =1.46; 95% CI: 1.35, 1.57), higher IPSS voiding score (Coef =0.38; 95% CI: 0.32, 0.44), higher IPSS storage score (Coef =0.25; 95% CI: 0.22, 0.29), and increased risk of having IPSS nocturia symptoms (OR =1.21; 95% CI: 1.16, 1.27) compared to subjects with neutral group (normal sodium preference). Prediction of IPSS score according to salty taste preference showed u shaped distribution. Conclusions Sodium preference for taste were significantly associated with LUTS including voiding symptom, storage symptom and nocturia. Both higher and lower intake of sodium could be unfavorable factor for severity of LUTS.
Collapse
Affiliation(s)
- Jin-Won Noh
- Department of Health Administration, Dankook University, Cheonan, Korea
| | - Kyoung-Beom Kim
- Department of Health Administration, Dankook University, Cheonan, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchuhyang University Medical College, Seoul, Korea
| |
Collapse
|
6
|
Seo DH, Yoon S, Choi JH, Do J, Lee SW, Lee C, Jeh SU, Choi SM, Kam SC, Hwa JS, Chung KH, Kwon SW, Kim SC, Park DS, Song JM, Lee KS, Hyun JS. The Correlation between Body Mass Index and Routine Parameters in Men Over Fifty. World J Mens Health 2017; 35:178-185. [PMID: 28879691 PMCID: PMC5746489 DOI: 10.5534/wjmh.16032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 07/07/2017] [Accepted: 07/09/2017] [Indexed: 11/28/2022] Open
Abstract
Purpose This study aimed to investigate the relationships between body mass index (BMI) and prostate-specific antigen (PSA) levels, international prostate symptom score (IPSS), quality of life (QoL), and prostate volume (PV). Materials and Methods Height, weight, PSA levels, PV, and IPSS were analyzed in 15,435 patients who underwent a prostate examination between 2001 and 2014. Patients aged <50 years or with a PSA level ≥10 ng/mL were excluded. The relationships between BMI and PSA, IPSS, QoL, and PV were analyzed by a scatter plot, one-way analysis of variance, and the Pearson correlation coefficient. Results The mean age was 71.95±7.63 years, the mean BMI was 23.59±3.08 kg/m2, the mean PSA level was 1.45±1.45 ng/mL, the mean IPSS was 15.53±8.31, the mean QoL score was 3.48±1.25, and the mean PV was 29.72±14.02 mL. PSA, IPSS, and QoL showed a tendency to decrease with increasing BMI, and there were statistically significant differences for each parameter (p≤0.001). PV showed a significant tendency to increase with BMI (p<0.001). In the correlation analysis, BMI showed a statistically significant correlation (p<0.001) with PSA, IPSS, and QoL, although the correlations were very weak. In contrast, BMI showed a significant correlation with PV (p<0.001), with a meaningful Pearson correlation coefficient of 0.124. Conclusions Higher BMI was associated with lower PSA levels and higher IPSS and QoL scores. Meanwhile, PV increased with BMI. Although obese individuals had a greater PV, obesity did not aggravate lower urinary tract symptoms.
Collapse
Affiliation(s)
- Deok Ha Seo
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Sol Yoon
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Jae Hwi Choi
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Jungmo Do
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Sin Woo Lee
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Chunwoo Lee
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Seong Uk Jeh
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - See Min Choi
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea
| | - Sung Chul Kam
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea.,Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jeong Seok Hwa
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea.,Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ky Hyun Chung
- Department of Urology, Gyeongsang National University Changwon Hospital, Changwon, Korea.,Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sung Won Kwon
- Department of Urology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Sae Chul Kim
- Department of Urology, Seonam University Myongji Hospital, Goyang, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Dong Soo Park
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Jae Mann Song
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Kyung Seop Lee
- Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea.,Korea Prostate Health Council. Inc., Seoul, Korea
| | - Jae Seog Hyun
- Department of Urology, Gyeongsang National University Hospital, Jinju, Korea.,Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea.
| |
Collapse
|
7
|
Daneshgari F, Liu G, Hanna-Mitchell AT. Path of translational discovery of urological complications of obesity and diabetes. Am J Physiol Renal Physiol 2017; 312:F887-F896. [PMID: 28052873 DOI: 10.1152/ajprenal.00489.2016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/15/2016] [Accepted: 01/01/2017] [Indexed: 01/07/2023] Open
Abstract
Diabetes mellitus (DM) is a prevalent chronic disease. Type 1 DM (T1DM) is a metabolic disorder that is characterized by hyperglycemia in the context of absolute lack of insulin, whereas type 2 DM (T2DM) is due to insulin resistance-related relative insulin deficiency. In comparison with T1DM, T2DM is more complex. The natural history of T2DM in most patients typically involves a course of obesity to impaired glucose tolerance, to insulin resistance, to hyperinsulinemia, to hyperglycemia, and finally to insulin deficiency. Obesity is a risk factor of T2DM. Diabetes causes some serious microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, angiopathy and stroke. Urological complications of obesity and diabetes (UCOD) affect quality of life, but are not well investigated. The urological complications in T1DM and T2DM are different. In addition, obesity itself affects the lower urinary tract. The aim of this perspective is to review the available data, combined with the experience of our research teams, who have spent a good part of last decade on studies of association between DM and lower urinary tract symptoms (LUTS) with the aim of bringing more focus to the future scientific exploration of UCOD. We focus on the most commonly seen urological complications, urinary incontinence, bladder dysfunction, and LUTS, in obesity and diabetes. Knowledge of these associations will lead to a better understanding of the pathophysiology underlying UCOD and hopefully assist urologists in the clinical management of obese or diabetic patients with LUTS.
Collapse
Affiliation(s)
- Firouz Daneshgari
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Ann T Hanna-Mitchell
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| |
Collapse
|
8
|
Elrifai A, Kotb AF, Sharaki O, Abdelhady M. Correlation of body mass index with serum total PSA, total testosterone and prostatic volume in a sample of men. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.poamed.2015.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
9
|
Zhang JQ, Geng H, Ma M, Nan XY, Sheng BW. Metabolic Syndrome Components are Associated with Increased Prostate Cancer Risk. Med Sci Monit 2015; 21:2387-96. [PMID: 26275075 PMCID: PMC4548704 DOI: 10.12659/msm.893442] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Our study investigated the associations of metabolic syndrome (MS) and metabolic indicators with prostate cancer (PCa) risk in the Chinese Han ethnic population. Material/Methods We studied 101 PCa patients (without/with MS) and 120 healthy controls. Clinical data, including waist circumference, BMI, TG, FINS, FBG, and PCa-related indicators, were collected. The correlations between MS and PCa were analyzed. Results Compared to PCa, PV and Gleason scores increased and PSA levels decreased in PCa with MS group (all P<0.001). PV was positively correlated with BMI, FINS, and HOMA-IR (r=0.459, P<0.001; r=0.421, P=0.001; r=0.490, P=0.003, respectively), and was negatively correlated with HDL-C (r=−0.378, P<0.001). PSA level in MS patients was negatively correlated with BMI (r=−0.125, P<0.001), TG (r=−0.256, P<0.001) and FBG (r=−0.183, P<0.001). Large PV, high TG, low HDL-C, high LDL-C, and high FBG were associated with an increased risk of PCa (P<0.001, OR=1.10, 95%CI: 1.009–3.304; P<0.001, OR=2.91, 95%CI: 1.612–5.241; P<0.001, OR=7.89, 95%CI: 3.908–15.947; P=0.015, OR=1.87, 95%CI: 1.131–3.077; P=0.004, OR=2.17, 95%CI: 1.280–3.686, respectively). MS-related indicators showed a positive relationship with PCa (P<0.001, OR=1.90, 95%CI: 1.107–10.629). Conclusions Our study shows that MS and metabolic indicators are associated with an increased risk of PCa, pointing to a novel therapeutic approach for PCa management.
Collapse
Affiliation(s)
- Jian-Qin Zhang
- Department of Nutrition, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Hui Geng
- Health Examination Center, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Mao Ma
- Department of Geriatric Surgery, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Xun-Yi Nan
- Urology Institute, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Bin-Wu Sheng
- Department of Geriatric Surgery, The First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| |
Collapse
|
10
|
Yelsel K, Alma E, Eken A, Gülüm M, Erçil H, Ayyıldız A. Effect of obesity on International Prostate Symptom Score and prostate volume. Urol Ann 2015; 7:371-4. [PMID: 26229329 PMCID: PMC4518378 DOI: 10.4103/0974-7796.152056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 10/27/2014] [Indexed: 11/30/2022] Open
Abstract
Aim: The aim of this study was to investigate the relationship between obesity and lower urinary tract symptoms and prostate volume in patients who underwent prostate biopsies. Materials and Methods: Between December 2008 and November 2009, transrectal ultrasound-guided prostate biopsy was performed on patients who had elevated prostate-specific antigen levels or abnormal digital rectal examination findings. A total of 211 patients were included in this study. Prostate volumes, International Prostate Symptom Score (IPSS) values, and the patient's height and weight were all recorded during the biopsy. Body mass index (BMI) <18.5 was determined as underweight, 18.5–23.0 normal, 23.0–27.5 overweight, and >27.5 obese. Results: The mean age of the patients was 68.0 ± 6.3 years, and the mean BMI was 28.0 ± 4.9 kg/m2. The mean prostate volume of the normal, overweight, and obese groups was 30, 50, and 70 ml, respectively. The positive and statistically significant correlation between BMI and prostate volume was determined (P < 0.001). According to BMI, the mean IPSS was 8.0, 16.5, and 20.0 in the groups, respectively. Similarly, a statistically positive correlation between BMI and IPSS was demonstrated (P < 0.001). Conclusions: As the result of a rise in BMI, prostate volumes and IPSS increase in patients. Prostate volume and IPSS decrease due to weight loss, and hence that fewer urinary symptoms occur, and the quality-of-life of patients may increase.
Collapse
Affiliation(s)
- Kazım Yelsel
- Urology Clinic, Kozan State Hospital, Adana, Turkey
| | - Ergün Alma
- Urology Clinic, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Alper Eken
- Urology Clinic, Acıbadem Hospital, Adana, Turkey
| | - Mehmet Gülüm
- Department of Urology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Hakan Erçil
- Urology Clinic, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Ali Ayyıldız
- Department of Urology, Faculty of Medicine, Ordu University, Ordu, Turkey
| |
Collapse
|
11
|
Park JH, Cho IC, Kim YS, Kim SK, Min SK, Kye SS. Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health. Korean J Urol 2015; 56:386-92. [PMID: 25964840 PMCID: PMC4426511 DOI: 10.4111/kju.2015.56.5.386] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 02/23/2015] [Indexed: 11/26/2022] Open
Abstract
Purpose There is no reported evidence for an anthropometric index that might link obesity to men's sexual health. We evaluated the ability of an anthropometric index and the symptom scores of five widely used questionnaires to detect men's health problems. We determined the predictive abilities of two obesity indexes and other clinical parameters for screening for lower urinary tract symptoms and sexual dysfunction in middle-aged men. Materials and Methods A total of 1,910 middle-aged men were included in the study. Participants underwent a detailed clinical evaluation that included recording the symptom scores of five widely used questionnaires. The participants' body mass index and waist-to-hip ratio were determined. Serum prostate-specific antigen, urinalysis, testosterone, estimated glomerular filtration rate, evaluation of metabolic syndrome, and transrectal ultrasonography were assessed. Results By use of logistic regression analysis, age and total prostate volume were independent predictors of lower urinary tract symptoms. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis symptoms. Age and metabolic syndrome were independent predictive factors for erectile dysfunction. Waist-to-hip ratio had a statistically significant value for predicting erectile dysfunction. Conclusions Our data showed that total prostate volume is a significant predictor of lower urinary tract symptoms, and central obesity has predictive ability for erectile dysfunction. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis-like symptoms. The management of correctable factors such as waist-to-hip ratio and metabolic syndrome may be considered preventive modalities against the development of men's health problems.
Collapse
Affiliation(s)
- Jung Hyun Park
- Department of Family Medicine, National Police Hospital, Seoul, Korea
| | - In-Chang Cho
- Department of Urology, National Police Hospital, Seoul, Korea
| | - Yoo Seok Kim
- Department of Urology, National Police Hospital, Seoul, Korea
| | - Soon Ki Kim
- Department of Urology, National Police Hospital, Seoul, Korea
| | - Seung Ki Min
- Department of Urology, National Police Hospital, Seoul, Korea
| | - So Shin Kye
- Department of Family Medicine, National Police Hospital, Seoul, Korea
| |
Collapse
|
12
|
Kim JH, Doo SW, Yun JH, Yang WJ. Lower Likelihood of Having Moderate-to-severe Lower Urinary Tract Symptoms in Middle-aged Healthy Korean Men With Metabolic Syndrome. Urology 2014; 84:665-9. [DOI: 10.1016/j.urology.2014.05.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/29/2014] [Accepted: 05/13/2014] [Indexed: 10/24/2022]
|
13
|
Bhindi B, Margel D, Trottier G, Hamilton RJ, Kulkarni GS, Hersey KM, Finelli A, Trachtenberg J, Zlotta A, Toi A, Evans A, van der Kwast T, Fleshner NE. Obesity is associated with larger prostate volume but not with worse urinary symptoms: analysis of a large multiethnic cohort. Urology 2013; 83:81-7. [PMID: 24044911 DOI: 10.1016/j.urology.2013.07.039] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 07/23/2013] [Accepted: 07/31/2013] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the associations between body mass index (BMI) and prostate volume (PV) and lower urinary tract symptoms in a multiethnic cohort. METHODS A cohort of men without prostate cancer seen at our institution was assembled, excluding those with previous transurethral resection of the prostate. Height and weight were measured to compute BMI, PV was measured by transrectal ultrasound, and the International Prostate Symptom Score (IPSS) questionnaire was administered. After stratified bivariate analyses, multiple linear regression and ordinal logistic regression models were used to assess the independent effect of BMI on PV and IPSS, respectively. RESULTS The cohort included 1613 patients, and mean BMI was 27.1 kg/m(2). Patients with a BMI of <25.0, 25.0-29.9, and 30.0-34.9 had a median PV of 44.0 mL, 48.0 mL, and 52.0 mL, respectively. The African ethnicity subgroup generally had larger median PVs than European and Asian subgroups and had the largest differences in median PV between normal and obese men. There were no significant differences in IPSS or usage of benign prostatic hyperplasia medications between BMI categories. In multivariable analyses, higher BMI was associated with larger PV (P <.001) but not IPSS (P = .91). On the basis of our model, given a PV of 40 mL, 50 mL, and 60 mL, each 5 kg/m(2) increase in BMI was associated with a 2.19 mL, 2.74 mL, and 3.29 mL increase in PV, respectively. Body weight (P <.001) but not height (P = .13) was associated with PV. CONCLUSION Higher BMI is associated with larger PV but not worse lower urinary tract symptoms (measured using IPSS). Usage rate of alpha blockers or 5 alpha reductase inhibitors was not significantly different between BMI categories.
Collapse
Affiliation(s)
- Bimal Bhindi
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
| | - David Margel
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Greg Trottier
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Robert J Hamilton
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Girish S Kulkarni
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Karen M Hersey
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Antonio Finelli
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - John Trachtenberg
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Alexandre Zlotta
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ants Toi
- Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Evans
- Department of Pathology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Theodorus van der Kwast
- Department of Pathology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Neil E Fleshner
- Division of Urology, Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
14
|
Relationship between predictors of the risk of clinical progression of benign prostatic hyperplasia and metabolic syndrome in men with moderate to severe lower urinary tract symptoms. Urology 2013; 81:1325-9. [PMID: 23602796 DOI: 10.1016/j.urology.2013.01.042] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 01/27/2013] [Accepted: 01/28/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the association between the metabolic syndrome (MetS) and the predictors of the progression of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS A total of 778 male police officers in their 50s with moderate to severe lower urinary tract symptoms (International Prostate Symptom Score > 7) were included in the present study. We defined the predictors of the risk of clinical progression of BPH as the total prostate volume ≥31 cm(3), prostate-specific antigen level ≥1.6 ng/mL, maximal flow rate <10.6 mL/s, and postvoid residual urine volume of ≥39 mL. The MetS was defined using the National Cholesterol Education Program-Adult Treatment Panel III guidelines. We used the Mantel-Haenszel extension test and logistic regression analyses to statistically examine their relationship. RESULTS The percentage of participants with ≥1 predictor for the progression of BPH, the percentage of participants with a total prostate volume of ≥31 cm(3), and the percentage of participants with a postvoid residual urine volume of ≥39 mL increased significantly with the increase in the number of components of the MetS (P = .003, P = .001, and P = .007, respectively). After adjusting for age and serum testosterone levels, the MetS was shown to be significantly associated with the presence ≥1 predictor for the progression of BPH (odds ratio 1.423, 95% confidence interval 1.020-1.986). CONCLUSION Our data have shown that the MetS is associated with the predictors of the risk of clinical progression of BPH in men in their 50s with moderate to severe lower urinary tract symptoms.
Collapse
|
15
|
Chung JH, Yu JH, Sung LH, Noh CH, Chung JY. Effect of prostatitis on lower urinary tract symptoms: retrospective analysis of prostate biopsy tissue. Korean J Urol 2012; 53:109-13. [PMID: 22379590 PMCID: PMC3285705 DOI: 10.4111/kju.2012.53.2.109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 10/13/2011] [Indexed: 11/18/2022] Open
Abstract
Purpose Most patients, even some urologists, assume that prostate volume is the most important prognostic factor for lower urinary tract symptoms (LUTS). In some cases, however, prostatic inflammation is a more important factor in LUTS than is prostate volume. For this reason, comparison of the impact on LUTS of inflammation and prostate volume is an attractive issue. Materials and Methods From January 2000 to May 2009, 1,065 men aged between 47 and 91 years (who underwent transrectal ultrasound-guided prostate needle biopsy and transurethral prostatectomy) were retrospectively investigated. Components such as age, serum prostate-specific antigen (PSA) level, prostate volume, and the presence of prostatitis were investigated through independent-sample t-tests, chi-square tests, and univariate and multivariate analyses. Results Chi-square tests between prostatitis, prostate volume, serum PSA, and severe LUTS showed that prostate volume (R=0.173; p=0.041) and prostatitis (R=0.148; p<0.001) were related to LUTS. In particular, for a prostate volume under 50 ml, prostatitis was a stronger risk factor than was prostate volume. Among the multivariate predictors, prostatitis (odds ratio [OR]: 1.945; p<0.001) and prostate volume (OR, 1.029; p<0.001) were found to be aggravating factors of LUTS. Conclusions For patients with prostate volume less than 50 ml, prostatitis was found to be a more vulnerable factor for LUTS. For those with prostate volume over 50 ml, on the other hand, the volume itself was a more significant risk factor than was prostatitis. In conclusion, the presence of prostatitis is one of the risk factors for LUTS with increased prostate volume.
Collapse
Affiliation(s)
- Jai Hyun Chung
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | | | | | | | | |
Collapse
|
16
|
Lee RK, Chung D, Chughtai B, Te AE, Kaplan SA. Central obesity as measured by waist circumference is predictive of severity of lower urinary tract symptoms. BJU Int 2012; 110:540-5. [PMID: 22243806 DOI: 10.1111/j.1464-410x.2011.10819.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED Study Type - Prognosis (cohort). Level of Evidence 2a. What's known on the subject? and What does the study add? The metabolic syndrome, or Syndrome X, has traditionally been associated with an increased risk of cardiovascular disease and sexual dysfunction. Emerging data however now suggest that the metabolic syndrome may also have a heretofore unrecognized negative effect on voiding function as well. Weight loss through either behavioural modification or bariatric surgery has been shown to lead to improvement in stress and urge incontinence as well as LUTS. A potential relationship may be drawn between obesity and BPH. This study adds the knowledge that WC can represent a simple metric not only for elements of the metabolic syndrome but also for worsened voiding. These obese men may be at high risk of male pelvic dysfunction. OBJECTIVES • To determine if central obesity as measured by waist circumference (WC) is a risk factor in metabolic dysfunction, which includes hypertension, dyslipidaemia and type 2 diabetes (DM2). • To test the hypothesis that central obesity and WC are associated with and predictive of the severity of voiding dysfunction. METHODS • Men aged ≥ 40 years with moderate or severe lower urinary tract symptoms (LUTS, International Prostate Symptom Score ≥ 8) with no previous treatment were included for study. • Subjects were divided into three groups according to WC (<90, 90-99 and ≥ 100 cm). • Baseline parameters including International Prostate Symptom Score, prostate volume, serum prostate-specific antigen, presence of erectile dysfunction and ejaculatory dysfunction, and the prevalence of hypertension, coronary artery disease and DM2 were compared among the three WC categories. • The association between WC and all parameters assessed was tested using multivariate logistic regression analysis. RESULTS • In the 409 consecutive men analysed, WC was significantly and positively associated with prostate volume, serum prostate-specific antigen and International Prostate Symptom Score. • Higher WCs were also significantly associated with a greater prevalence of hypertension, coronary artery disease, DM2 and obesity as well as the presence of erectile dysfunction and ejaculatory dysfunction. CONCLUSIONS • Increased WC is associated with worsened voiding. • There was a significantly increased prevalence of components of the metabolic syndrome in patients with higher WC. • Obese men, in particular those with other features of the metabolic syndrome, are at increased risk of male pelvic dysfunction and can be easily recognized by measurement of WC.
Collapse
Affiliation(s)
- Richard K Lee
- James Buchanan Brady Foundation, Department of Urology, Weill Medical College of Cornell University, New York, NY 10065, USA
| | | | | | | | | |
Collapse
|
17
|
Jeong JH, Kim ET, Kim DK. Association of metabolic syndrome and benign prostate enlargement in young korean males. Korean J Urol 2011; 52:757-62. [PMID: 22195265 PMCID: PMC3242989 DOI: 10.4111/kju.2011.52.11.757] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 07/18/2011] [Indexed: 12/05/2022] Open
Abstract
Purpose This study was designed to evaluate the association of metabolic syndrome and benign prostate enlargement in young Korean males. We analyzed the clinical data associated with metabolic syndrome and prostate volume in the study population. Materials and Methods We retrospectively analyzed the clinical data obtained from 1,506 young men under the age of 60 who visited the health promotion center in our institution for routine checkups. The patients were interviewed with a questionnaire including the International Prostate Symptom Score (IPSS) and were evaluated by medical history, blood chemistry, digital rectal examination, and prostate volume via transrectal ultrasonography. The presence of metabolic syndrome was determined according to the modified National Cholesterol Education Program Expert Panel on Detection, Evalution, And Treatment of High Blood Cholesterol in Adults criteria. We divided the subjects into two groups: those with metabolic syndrome and those without. Logistic regression analysis was carried out to determine which metabolic components were associated with an increased risk of benign prostate enlargement. Results Significant differences in prostate volume were noted between the groups. The prostate volumes were significantly larger in the metabolic syndrome group than in the non-metabolic syndrome group in all subgroups divided by age (in decades). However, no significant differences in IPSS or voiding or storage subscore were noted. In the multivariate regression analysis, only diabetes and obesity were identified as risk factors for benign prostate enlargement among the metabolic components. Conclusions Metabolic syndrome and prostate volume were significantly related, even in young males. Diabetes and obesity were identified as significant risk factors for benign prostate enlargement in young males under the age of 60.
Collapse
Affiliation(s)
- Jee Hoon Jeong
- Department of Urology, Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea
| | | | | |
Collapse
|
18
|
Lotti F, Corona G, Colpi GM, Filimberti E, Degli Innocenti S, Mancini M, Baldi E, Noci I, Forti G, Adorini L, Maggi M. Elevated body mass index correlates with higher seminal plasma interleukin 8 levels and ultrasonographic abnormalities of the prostate in men attending an andrology clinic for infertility. J Endocrinol Invest 2011; 34:e336-42. [PMID: 21738005 DOI: 10.3275/7855] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Obesity is associated with a systemic, low-grade inflammatory state. Although the relationship between obesity and semen parameters or prostate diseases has been previously investigated, the association between body mass index (BMI), prostate inflammatory diseases and color- Doppler ultrasound (CDU) of the male genital tract (MGT) has been poorly studied. AIM To evaluate the association between BMI and CDU features of the MGT, signs and symptoms of prostate inflammation, semen parameters. MATERIALS/SUBJECTS AND METHODS We studied 222 men seeking medical care for couple infertility. According to the World Health Organization classification, subjects were divided into 3 groups: normal weight (no.=131, BMI=18.5-24.9 kg/m2), overweight (no.=71, BMI=25.0-29.9 kg/m2), obese (no.=20, BMI≥30.0 kg/m2). All patients underwent simultaneous testosterone evaluation and seminal analysis, including interleukin 8 (sIL-8), along with scrotal and transrectal CDU, before and after ejaculation. Prostatitis symptoms were evaluated by National Institutes of Health- Chronic Prostatitis Symptom Index questionnaire. RESULTS After adjusting for age and testosterone levels, higher BMI was significantly related to higher prostate volume and several CDU features of the prostate, including macro-calcifications, inhomogeneity, higher arterial peak systolic velocity (the latter adjusted also for blood pressure), but not with abnormalities of testis, epididymis, seminal vesicles. Furthermore, higher BMI and BMI class were significantly related to higher sIL-8, a reliable surrogate marker of prostate inflammatory diseases, even after adjustment for age. Conversely, no associations among BMI, clinical symptoms of prostatitis or semen parameters were observed. CONCLUSIONS Subjects with higher BMI might develop CDU and biochemical signs suggestive of prostate inflammation, although not clinically overt.
Collapse
Affiliation(s)
- F Lotti
- Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Kim JM, Song PH, Kim HT, Moon KH. Effect of obesity on prostate-specific antigen, prostate volume, and international prostate symptom score in patients with benign prostatic hyperplasia. Korean J Urol 2011; 52:401-5. [PMID: 21750751 PMCID: PMC3123816 DOI: 10.4111/kju.2011.52.6.401] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 05/31/2011] [Indexed: 12/02/2022] Open
Abstract
PURPOSE We examined the correlation between body mass index (BMI) as a marker of obesity and prostate-specific antigen (PSA), prostate volume (PV), and International Prostate Symptom Score (IPSS) in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS From January 2008 to December 2008, we examined 258 patients diagnosed with BPH. Patients taking 5α-reductase inhibitors or those diagnosed with prostate cancer were excluded from this study. BPH was defined as PV≥25 ml and IPSS≥8. BMI (kg/m(2)) was categorized into 4 groups as follows: BMI<18.5 (underweight), BMI 18.5-23.0 (normal), BMI 23.0-27.5 (overweight), and BMI>27.5 (obese). The relationships between PSA, PV, IPSS, and BMI were analyzed by correlation analysis and one-way ANOVA. RESULTS The mean age of the patients was 65.19±9.13 years and their mean BMI was 23.7±4.4 kg/m(2). The mean PSA values of each BMI group were as follows: 3.42±1.53, 3.07±1.88, 2.74±1.75, and 2.60±1.44 ng/ml. The PSA value was lowest in the obese group. The correlation analysis showed a negative correlation between BMI and PSA (Pearson's correlation coefficient=-0.142, p=0.023) and positive correlations between BMI and PV (Pearson's correlation coefficient=0.32, p=0.001) and IPSS (Pearson's correlation coefficient=0.470, p=0.02). These correlations were also confirmed by one-way ANOVA. CONCLUSIONS Patients with an elevated BMI tended to have lower PSA values, larger PVs, and a higher IPSS. We suggest that weight loss could be helpful for BPH symptom relief as well as for detection of coexisting prostate cancer in BPH patients.
Collapse
Affiliation(s)
- Jong Min Kim
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Phil Hyun Song
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Hyun Tae Kim
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Ki Hak Moon
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| |
Collapse
|