Race/Ethnicity, Obesity, Health Related Behaviors and the Risk of Symptomatic Benign Prostatic Hyperplasia: Results From the Prostate Cancer Prevention Trial
ABSTRACT We examined risk factors for incident symptomatic benign prostate hyperplasia in 5,667 Prostate Cancer Prevention Trial placebo arm participants who were free of benign prostatic hyperplasia at baseline.
During 7 years benign prostatic hyperplasia symptoms were assessed annually using the International Prostate Symptom Score and benign prostatic hyperplasia treatment was assessed quarterly by structured interview. Total benign prostatic hyperplasia was defined as receipt of treatment or report of 2 International Prostate Symptom Score values greater than 14. Severe benign prostatic hyperplasia was defined as treatment or 2 International Prostate Symptom Score values of 20 or greater. Weight and body circumferences were measured by trained staff and demographic health related characteristics were collected by questionnaire. Cox proportional hazards models were used to calculate the covariate adjusted relative hazards of benign prostatic hyperplasia developing.
The incidence of total benign prostatic hyperplasia was 34.4 per 1,000 person-years. The risk of total benign prostatic hyperplasia increased 4% (p <0.001) with each additional year of age. Risks for total benign prostatic hyperplasia were 41% higher for black (p <0.03) and Hispanic men (p <0.06) compared to white men, and for severe benign prostatic hyperplasia these increases were 68% (p <0.01) and 59% (p <0.03), respectively. Each 0.05 increase in waist-to-hip ratio (a measure of abdominal obesity) was associated with a 10% increased risk of total (p <0.003) and severe (p <0.02) benign prostatic hyperplasia. Neither smoking nor physical activity was associated with risk.
Black race, Hispanic ethnicity and obesity, particularly abdominal obesity, are associated with increased benign prostatic hyperplasia risk. Weight loss may be helpful for the treatment or prevention of benign prostatic hyperplasia.
- SourceAvailable from: Madhu Goel
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- "WHR provides an estimate of abdominal obesity (Wajchenberg, 2000), and a value greater than 0.9 is generally considered obese (Dobbelsteyn et al, 2001). It is now well known that abdominal obesity is associated with an increased risk of heart disease and diabetes, but recent studies have also looked into its relationship with prostate health (Gong et al, 2007; Hsing et al, 2007; Kristal et al, 2007). One study involving men in China found that those in the highest quartile of WHR had an almost 3-fold increased risk of prostate cancer (Hsing et al, 2001). "
ABSTRACT: Prostate problems, such as benign prostatic hyperplasia, prostatic intra-epithelial neoplasia, prostatitis, and prostate cancer have been recognized as problems largely related to androgens and genetic factors. They affect a large fraction of the elderly population, contributing significantly to morbidity and mortality. Estrogen has also now been recognized as one of the important regulators of prostate growth. Diet, general health, and obesity were disregarded as the causative or complicating factors until very recently. Increasing episodes of prostate problems, complications in overweight/obese individuals, or both have attracted attention toward these contemporary risk factors. Prostate problems are reportedly less frequent or less severe in areas in which a plant-based diet is predominant. Consumption of certain fatty acids, particularly of animal origin, has been correlated with increased prostate problems. As adipose tissue is increasingly being regarded as hormonally active tissue, high body fat and obesity need in-depth exploration to understand the associated risk of prostate problems. Adipose tissue is now known to affect circulating levels of several bioactive messengers and therefore could affect the risk of developing prostate problems in addition to several other well-recognized health problems. Nevertheless, increased plasma volume, excess tissue growth, and fat deposition could affect resection and number of biopsies required, thus adding further complications because of a delayed diagnosis. In short, evidence is gathering to support the influence of diet and obesity on prostate health. In this review article, we have tried to make this connection more apparent using supporting published data.Journal of Andrology 02/2012; 33(5):763-76. DOI:10.2164/jandrol.111.015578 · 1.69 Impact Factor
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- "For example, the study by Giovannucci et al of 25,892 men in the Health Professional Follow Up Study found a strong association between obesity and increased LUTS (Giovannucci et al, 1994). Analysis of the PCPT trial also demonstrated increased LUTS in men with higher WHR (Kristal et al, 2007) and a study of Korean men found that waist circumference was positively associated with increased LUTS (Lee et al, 2009a, b). A small study of 68 men with BPH found an association between obesity and prostate volume but not worse symptoms, although this was an underpowered study compared to those discussed previously (Soygur et al, 1996). "
ABSTRACT: The emergent epidemic of metabolic syndrome and its complex list of sequelae mandate a more thorough understanding of benign prostatic hyperplasia and lower urinary tract symptoms (BPH/LUTS) in the context of systemic metabolic disease. Here we discuss the nature and origins of BPH, examine its role as a component of LUTS and review retrospective clinical studies that have drawn associations between BPH/LUTS and type II diabetes, inflammation and dyslipidemia. PPARγ signaling, which sits at the nexus of systemic metabolic disease and BPH/LUTS through its regulation of inflammation and insulin resistance, is proposed as a candidate for molecular manipulation in regard to BPH/LUTS. Finally, we introduce new cell and animal models that are being used to study the consequences of obesity, diabetes and inflammation on benign prostatic growth.Differentiation 06/2011; 82(4-5):220-36. DOI:10.1016/j.diff.2011.05.008 · 2.84 Impact Factor
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- "While these factors are important contributors, modifiable risk factors of cardiovascular disease are also linked to BPH and LUTS. Obesity  , elevated fasting plasma glucose  , diabetes   , dyslipidemia  , and the metabolic syndrome   may all significantly increase the risks of BPH and LUTS. Since cardiovascular risk factors potentially contribute to BPH and LUTS pathogenesis, it is plausible that factors that protect against cardiovascular disease may also protect against BPH and LUTS. "
ABSTRACT: While some studies have indicated that physical activity may protect against benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS), others have not. To evaluate the association of physical activity with BPH and LUTS. Systematic review and meta-analysis using MEDLINE, the Cochrane Library, EMBASE, and abstracts from the Annual Meeting of the American Urological Association. We selected observational studies that provided empirical data and analyzed abstracted data with random effects models. BPH, LUTS, and physical activity levels. Eleven (n=43 083 men) studies met selection criteria. Eight studies observed inverse, 2 studies null, and 1 study equivocal associations of physical activity with BPH or LUTS. Eight studies (n=35675) were eligible for pooled analyses. We stratified physical activity levels into light, moderate, and vigorous categories, with a sedentary category for reference. Compared to the sedentary group, the pooled odds ratios for BPH or LUTS were 0.70 (95% CI 0.44-1.13, p=0.14), 0.74 (95% CI 0.60-0.92, p=0.005), and 0.74 (95% CI 0.59-0.92, p=0.006) for men engaging in light, moderate, and heavy physical activity, respectively. Physical activity reduces the risks of BPH and LUTS. These findings are consistent with other studies demonstrating that the BPH/LUTS complex is associated with modifiable risk factors of cardiovascular disease and suggest that increased physical activity may prevent or attenuate these conditions.European Urology 07/2008; 53(6):1228-35. DOI:10.1016/j.eururo.2008.02.019 · 12.48 Impact Factor