Korean J Urol.  2011 Jun;52(6):390-395.

Relationship between Metabolic Syndrome and Prostate Volume in Korean Men under 50 Years of Age

• Yim SJ
• Cho YS
• Joo KJ

Abstract

PURPOSE
The metabolic syndrome (MS) has been accepted as an important cause of benign prostatic hyperplasia (BPH) in old age. However, there are no studies of the influence of MS on prostate volume in relatively young adults. We evaluated the relationship between parameters of MS and prostate volume in men under 50 years of age who visited our health promotion center.
MATERIALS AND METHODS
A total of 968 men aged 30 to 49 years were enrolled from March 2009 to June 2010. Prostate volume by transrectal ultrasonography of the prostate, serum prostate-specific antigen, digital rectal examination, urinalysis, and MS-related parameters were investigated. We evaluated the correlations of prostate volume with MS and MS-related parameters.
RESULTS
Prostate volume was not significantly larger in the MS group (18.4 cc; range: 14.3-23.1 cc) than in the non-MS group (17.8 cc; range, 13.6-21.6 cc). The prostate volumes in subjects with abnormal fasting plasma glucose (FPG) (18.9 cc; range, 14.3-22.7 cc) and abnormal waist circumference (WC) (19.5 cc; range, 15.6-23.7 cc) were significantly larger than those of subjects with normal parameters (16.9 [range, 12.7-20.4] cc and 17.5 [range, 13.3-21.2] cc, respectively; p=0.001). The logistic regression analysis showed the FPG level and WC to have a significantly positive correlation with the prostate volume (odds ratios: 1.441 [95% CI: 1.303-1.643] and 2.305 [95% CI: 1.470-3.614], respectively).
CONCLUSIONS
Groups with abnormal FPG and WC had larger prostate volumes than did normal groups. The abnormal FPG and WC could be more important factors than MS in prostate volume enlargement in relatively young adults.

Keyword

Metabolic syndrome; Prostate; Prostatic hyperplasia; Risk factors

MeSH Terms

Aged
Digital Rectal Examination
Fasting
Glucose
Health Promotion
Humans
Logistic Models
Male
Plasma
Prostate
Prostate-Specific Antigen
Prostatic Hyperplasia
Risk Factors
Urinalysis
Waist Circumference
Young Adult
Glucose
Prostate-Specific Antigen

Reference

1. Oesterling JE. Benign prostatic hyperplasia: a review of its histogenesis and natural history. Prostate Suppl. 1996. 6:67–73.

2. Lee C, Kozlowski JM, Grayhack JT. Etiology of benign prostatic hyperplasia. Urol Clin North Am. 1995. 22:237–246.

3. Hammarsten J, Högstedt B, Holthuis N, Mellström D. Components of the metabolic syndrome-risk factors for the development of benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 1998. 1:157–162.

4. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005. 112:2735–2752.

5. Lim S, Park KS, Lee HK, Cho SI. Changes in the characteristics of metabolic syndrome in Korea over the period 1998-2001 as determined by Korean National Health and Nutrition Examination Surveys. Diabetes Care. 2005. 28:1810–1812.

6. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002. 287:356–359.

7. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984. 132:474–479.

8. Moul S, McVary KT. Lower urinary tract symptoms, obesity and the metabolic syndrome. Curr Opin Urol. 2010. 20:7–12.

9. Bosch RJ. Pathogenesis of benign prostatic hyperplasia. Eur Urol. 1991. 20:Suppl 1. 27–30.

10. Marker PC, Donjacour AA, Dahiya R, Cunha GR. Hormonal, cellular, and molecular control of prostatic development. Dev Biol. 2003. 253:165–174.

11. Ikeda K, Wada Y, Foster HE Jr, Wang Z, Weiss RM, Latifpour J. Experimental diabetes-induced regression of the rat prostate is associated with an increased expression of transforming growth factor-beta. J Urol. 2000. 164:180–185.

12. Barnard RJ, Aronson WJ. Benign prostatic hyperplasia: does lifestyle play a role? Phys Sportsmed. 2009. 37:141–146.

13. Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD, et al. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes. 2004. 53:2087–2094.

14. Giovannucci E, Rimm EB, Chute CG, Kawachi I, Colditz GA, Stampfer MJ, et al. Obesity and benign prostatic hyperplasia. Am J Epidemiol. 1994. 140:989–1002.

15. Hammarsten J, Högstedt B. Hyperinsulinaemia as a risk factor for developing benign prostatic hyperplasia. Eur Urol. 2001. 39:151–158.

16. Dahle SE, Chokkalingam AP, Gao YT, Deng J, Stanczyk FZ, Hsing AW. Body size and serum levels of insulin and leptin in relation to the risk of benign prostatic hyperplasia. J Urol. 2002. 168:599–604.

17. Parsons JK, Carter HB, Partin AW, Windham BG, Metter EJ, Ferrucci L, et al. Metabolic factors associated with benign prostatic hyperplasia. J Clin Endocrinol Metab. 2006. 91:2562–2568.

18. Hammarsten J, Damber JE, Karlsson M, Knutson T, Ljunggren O, Ohlsson C, et al. Insulin and free oestradiol are independent risk factors for benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2009. 12:160–165.

19. Sarma AV, Kellogg Parsons J. Diabetes and benign prostatic hyperplasia: emerging clinical connections. Curr Urol Rep. 2009. 10:267–275.

20. Kasturi S, Russell S, McVary KT. Metabolic syndrome and lower urinary tract symptoms secondary to benign prostatic hyperplasia. Curr Urol Rep. 2006. 7:288–292.

21. Gupta A, Gupta S, Pavuk M, Roehrborn CG. Anthropometric and metabolic factors and risk of benign prostatic hyperplasia: a prospective cohort study of Air Force veterans. Urology. 2006. 68:1198–1205.

22. Park HK, Lee HW, Lee KS, Byun SS, Jeong SJ, Hong SK, et al. Relationship between lower urinary tract symptoms and metabolic syndrome in a community-based elderly population. Urology. 2008. 72:556–560.

23. Kogai MA, Lutov UV, Selyatitskaya VG. Hormonal and biochemical parameters of metabolic syndrome in male patients with body weight excess and obesity. Bull Exp Biol Med. 2008. 146:806–808.

24. Becker S, Dossus L, Kaaks R. Obesity related hyperinsulinaemia and hyperglycaemia and cancer development. Arch Physiol Biochem. 2009. 115:86–96.

25. Jang TH, Son JH, Kim JI, Jang SH. Metabolic syndrome and benign prostatic hyperplasia: a study focused on the correlation between metabolic syndrome factors and prostate volume and prostate-specific antigen. Korean J Urol. 2008. 49:986–991.

26. Koo KC, Cho KS, Kang EM, Kwon SW, Hong SJ. The relationship between metabolic syndrome and prostate volume in men over sixties who underwent prostate health check-up. Korean J Urol. 2008. 49:813–817.

27. Peehl DM, Cohen P, Rosenfeld RG. The role of insulin-like growth factors in prostate biology. J Androl. 1996. 17:2–4.

28. Rohrmann S, Smit E, Giovannucci E, Platz EA. Association between markers of the metabolic syndrome and lower urinary tract symptoms in the Third National Health and Nutrition Examination Survey (NHANES III). Int J Obes (Lond). 2005. 29:310–316.

29. Burke JP, Rhodes T, Jacobson DJ, McGree ME, Roberts RO, Girman CJ, et al. Association of anthropometric measures with the presence and progression of benign prostatic hyperplasia. Am J Epidemiol. 2006. 164:41–46.

30. Gann PH, Hennekens CH, Longcope C, Verhoek-Oftedahl W, Grodstein F, Stampfer MJ. A prospective study of plasma hormone levels, nonhormonal factors, and development of benign prostatic hyperplasia. Prostate. 1995. 26:40–49.