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This version published online on April 11, 2006
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-2799
A more recent version of this article appeared on July 1, 2006
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Submitted on December 22, 2005
Accepted on March 31, 2006

Metabolic Factors Associated with Benign Prostatic Hyperplasia*

J. Kellogg Parsons MD, MHS*, H. Ballentine Carter MD, Alan W. Partin MD, PhD, B. Gwen Windham MD, MHS, E. Jeffrey Metter MD, Luigi Ferrucci MD, PhD, Patricia Landis BA, and Elizabeth A. Platz ScD, MPH

The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD 21287; The National Institute of Aging, Clinical Research Branch, Harbor Hospital, 3001 South Hanover Street, Baltimore, MD 21225; The Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205

* To whom correspondence should be addressed. E-mail: k0parsons{at}ucsd.edu.

Context: Benign prostatic hyperplasia poses a significant public health problem, but its etiology remains unclear. Obesity and associated abnormalities in glucose homeostasis may play a role in benign prostatic hyperplasia development by influencing prostate growth.

Objective: To determine if obesity, fasting plasma glucose concentration, and diabetes are associated with radiologically determined prostate enlargement, an objective measure of benign prostatic hyperplasia.

Design: Cross-sectional analysis with robust variance estimates to account for multiple measures over time in the same individuals.

Setting: A prospective cohort study composed of community volunteers.

Patients: 422 adult men enrolled in The Baltimore Longitudinal Study of Aging.

Main Outcome Measurements: Total prostate volume as determined by pelvic magnetic resonance imaging.

Results: Among 422 participants, 91 (21.6%) had prostate enlargement (defined as total prostate volume ≥ 40 cc) at first visit. Compared with men of normal weight (BMI < 25 kg/m2), the age-adjusted odds ratio (OR) for prostate enlargement for overweight men (BMI 25-29.9 kg/m2) was 1.41 (95% CI, 0.84-2.37), for obese men (BMI 30-34 kg/m2) was 1.27 (95% CI, 0.68-2.39), and for severely obese men (BMI ≥ 35 kg/m2) was 3.52 (95% CI, 1.45-8.56) (P-trend = 0.01). Men with elevated fasting glucose (>110 mg/dL) were more likely to have an enlarged prostate than men with normal fasting glucose (≤110 mg/dL) (OR 2.98, 95% CI 1.70 to 5.23), as were men with a diagnosis of diabetes (OR 2.25, 95% CI 1.23 to 4.11).

Conclusions: Obesity, elevated fasting plasma glucose, and diabetes are risk factors for benign prostatic hyperplasia.
Key words: Obesity • glucose • diabetes • benign prostatic hyperplasia • metabolic syndrome • prostate • lower urinary tract • symptoms






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