How Metabolic Syndrome Can Affect Prostatic Enlargement and BPH

With the significant rise in obesity and related heart disease and diabetes over the past several decades, clinicians have sought to properly describe the complexities of the problem. After all, there are many and varied factors that can cause heart attack, stroke and diabetes. Metabolic syndrome is the phrase now being used to describe the suite of risks that increase the chances of experiencing these very dangerous conditions. Metabolic risk factors include high blood pressure, high triglycerides, low good cholesterol (HDL) and excess abdominal fat. Each of these risk factors alone or taken in tandem can significantly increase the risk for a heart-related event.

A Chinese study correlated metabolic syndrome, Body Mass Index (BMI), low HDL cholesterol, insulin serum levels and insulin resistance as significant risk factors for enlargement of the prostate in elderly men.1 The correlation was especially strong for insulin resistant men. The study concluded that prostate volume and the duration of lower urinary tract symptoms (LUTS) were both higher in those with metabolic syndrome.

Another meta-analysis study included 8 studies concerning a total of more than 5000 patients.2 During this analysis it was clear that those with metabolic syndrome had significantly larger prostatic volume than those who did not. Interestingly the incidence of LUTS and total International Prostate Symptom Score (IPSS) was not significantly different between those with and without metabolic syndrome. This confirms that BPH may present varied symptom severity regardless of prostatic size.

There is a growing body of research showing that the effects of metabolic disease and especially type 2 diabetes can affect prostatic enlargement – the development or worsening of BPH. Since the incidence of obesity is a major contributing factor to metabolic disease, there is reason to believe that the current trend in obesity rates may significantly affect future incidence of BPH.

1Zhang X, Zeng X, Liu Y, Dong L, Zhao X, Qu X. Impact of Metabolic Syndrome on Benign Prostatic Hyperplasia in Elderly Chinese Men. Urol Int. 2014 May 22. http://www.ncbi.nlm.nih.gov/pubmed/24862628

2Gacci M, Corona G, Vignozzi L, Salvi M, Serni S, De Nunzio C, Tubaro A, Oelke M, Carini M, Maggi M. Metabolic Syndrome and Benign Prostatic Enlargement: A Systematic Review and Meta-Analysis. BJU Int. 2014 Mar 6. doi: 10.1111/bju.12728. http://www.ncbi.nlm.nih.gov/pubmed/24602293