COMPONENTS OF THE METABOLIC SYNDROME - RISK-FACTORS FOR THE DEVELOPMENT OF BENIGN PROSTATIC HYPERPLASIA

The purpose of the present study was to perform a BPH risk factor anal ysis in men, relating the prostate gland volume to components of the m etabolic syndrome and to identify clues to the etiology of BPH. Our ma terial comprised a consecutive series of 158 patients with lower urina ry tract symptoms with or without manifestations of the metabolic synd rome. In this group, the measured volume of the prostate was related c onsecutively to potential risk factors. The diagnoses atherosclerosis, non-insulin-dependent diabetes mellitus (NIDDM) and treated hypertens ion were obtained from the patient's medical history. Data on blood pr essure, waist and hip measure, body height and weight were collected a nd body mass index (BMI) and waist/hip ratio (WHR) were calculated. Bl ood samples were drawn from fasting patients to determine insulin, cho lesterol, triglycerides, HDL and LDL-cholesterol, uric acid and ALAT. The prostate gland volume was determined using ultrasound. Our results show that there was a larger prostate gland in men with NIDDM (P = 0. 0058), treated hypertension (P = 0.0317), obesity (P < 0.0001), low HD L-cholesterol levels (P = 0.0132) and high insulin levels (P < 0.0001) than in men without these conditions. The prostate gland volume corre lated positively with the systolic blood pressure (r(s) = 0.17; P = 0. 03), obesity (r(s) = 0.34; P < 0.0001) and fasting insulin (r(s) = 0.3 8; P < 0.0001) and negatively with HDL-cholesterol (r(s) = -0.22; P = 0.009). On the basis of our findings, we concluded that NIDDM, treated hypertension, obesity, low HDL-cholesterol levels and high insulin le vels constitute risk factors for the development of BPH, The results s uggest that BPH is a facet of the metabolic syndrome and that BPH pati ents may share the same metabolic abnormality of a defective insulin-m ediated glucose uptake and secondary hyperinsulinemia as patients with the metabolic syndrome. The findings generate a hypothesis of a causa l relationship between high insulin levels and the development of BPH. In a clinical setting, the findings of the present report suggest tha t, in any patient presenting with BPH, the possible presence of NIDDM, hypertension, obesity, high insulin and low HDL-cholesterol levels sh ould be considered. Conversely, in patients suffering from these condi tions, the possibility of a clinically important BPH should be kept in mind.