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Obesity and Diabetes Increase Risk for Benign Prostatic Hyperplasia: Presented at AUA

By Sophie Bainbridge

ATLANTA, G.A. -- May 29, 2006 -- Obesity, elevated fasting plasma glucose, and diabetes have been found to be risk factors for benign prostatic hyperplasia (BPH), according to a study presented at the annual meeting of the American Urological Association (AUA).

"The finding suggests that there are prostate growth pathways independent of testicular hormones that we are only just now beginning to become aware of," said J. Kellogg Parsons, MD, MSH, assistant professor of surgery and urology, University of California San Diego School of Medicine, San Diego, California. "Such pathways could potentially influence BPH pathogenesis."

Dr. Parsons was at Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, when he conducted his research.

BPH poses significant public health concerns but its etiology remains unclear, Dr. Parsons said. He and his colleagues hypothesized that obesity and associated abnormalities in glucose homeostasis may play a role in the development of BPH by influencing prostate growth.

For their study, Dr. Parsons and his colleagues measured total prostate volume using pelvic magnetic resonance imaging -- an objective measure of BPH -- in 422 adult men enrolled in The Baltimore Longitudinal Study of Aging, a prospective cohort study composed of community volunteers.

The researchers then looked for associations between prostate enlargement and body mass index (BMI), fasting glucose, or diabetes. After adjusting for age and serum testosterone levels, they identified 91 men (21.6%) who had prostate enlargement, defined as total prostate volume 40 cc or greater.

They defined normal weight as a BMI below 25 kg/m², overweight as BMI 25-29.9 kg/m², obesity as BMI 30-34 kg/m²), and severe obesity as BMI 35 kg/m² or greater.

When they compared prostate enlargement in the different weight groups, the researchers found that the greater the BMI, the more likely the men were to have an enlarged prostate.

"The age-adjusted odds ratio for prostate enlargement in overweight men was 1.41, in obese men, it was 1.27, and in severely obese men, it was 3.52," Dr. Parsons reported.

In addition, men with elevated fasting plasma glucose levels (>110 mg/dL) were 3 times more likely to have prostate enlargement, and men who had a clinical diagnosis of diabetes mellitus were more than twice as likely to have an enlarged prostate than men in the normal weight group, Dr. Parsons said. All of these associations were independent of serum testosterone levels, he added.

These findings raise the possibility that very simple alterations in lifestyle, such as diet, physical activity, and normalizing weight, might alter the natural history of BPH, Dr. Parsons noted.

"Our study raises the provocative idea that BPH is potentially a preventable disease, with modifiable risk factors," he concluded.

"We have tended to think of BPH as an immutable process, dictated by genetics, by the inexorable march of sex steroid hormones," he said. "The idea that we might be able to influence that progression by changing the way we live our lives opens up all sorts of avenues for understanding, treating, and preventing BPH."


[Presentation title: Metabolic Factors Associated With Benign Prostatic Hyperplasia: The Baltimore Longitudinal Study of Aging. Abstract 1344]

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