Prostate measurements in men with benign prostatic hyperplasia (BPH) are higher in those who also have metabolic syndrome, particularly in Asian men, a literature review and analysis concluded. Since symptom severity could not be linked to the presence of metabolic syndrome, the review notes that more studies are needed to understand the impact of metabolic conditions on prostate disease.
Earlier epidemiological studies have pointed to a connection between metabolic syndrome — a condition driven by insensitivity to insulin and encompassing obesity, high blood pressure, and heart disease — and BPH. But these studies have not always reached the same conclusion.
A research team at Beijing Hospital, China, in collaboration with MSD China (known as Merck & Co. in the U.S.), identified 158 previously published studies comparing BPH and lower urinary tract symptoms (LUTS) in men with and without metabolic syndrome.
After a quality control, eight studies, including a total of 3,093 patients, were deemed to hold enough information to be included in the analysis. Among these individuals, 1,241 had metabolic syndrome, while 1,852 did not, according to the study “The Association Between Metabolic Syndrome and Characteristics of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis.“
The analysis, published in the journal Medicine, found that BPH patients with metabolic syndrome had a higher prostate growth rate and larger average prostate volume than patients with no metabolic condition. In contrast, International Prostate Symptom Scores (IPSS) or maximal flow rate did not differ between the groups.
Measurements of prostate-specific antigen (PSA) had a tendency to differ between the groups, but the difference was not statistically significant.
Since results of earlier studies from Europe and Asia have differed when analyzing these parameters, the research team also attempted to look for differences in outcomes linked to study region.
The analysis showed that Asian studies found higher prostate volumes and PSA among men with metabolic syndrome while European studies observed no such differences. Neither Asian nor European studies reported any differences in IPSS or flow rate.
Since there was no difference in LUTS scores between the two groups, the study concluded that more research is needed to examine if metabolic syndrome poses a risk for BPH disease progression.