A relationship between metabolic syndrome (MetS) and the development of benign prostatic hyperplasia (BPH) has been suggested in the past, but causality has not yet been proved. In a new study researchers compared the prevalence of MetS in patients with and without BPH. The research paper, entitled “Metabolic syndrome and benign prostatic hyperplasia: association or coincidence?” was published in Diabetology & Metabolic syndrome.

Benign prostatic hyperplasia (BPH) is the most common urological condition among older male patients, leading to augmentation of prostate volume, which can result in bladder outflow obstruction and a series of lower urinary tract symptoms (LUTS). Different studies have associated BPH development with hormonal related environments, leading to contradictory results regarding testosterone and estrogen effects on urological problems. Furthermore recent research has suggested that people with MetS or individual symptoms of this condition (insulin resistance, obesity, excess of lipids in the blood) are more prone to develop BPH, however, some studies have also presented no correlation between the same conditions.

In this study, researchers evaluated metabolic and physiological measurements of 128 males with BPH and 141 males without BPH, all within the same age group (50-75 years). The team measured and compared values of body mass index (BMI), fasting glucose, insulin, lipid profile (triglycerides, total cholesterol and high and low-density lipoproteins, HDL and LDL respectively) and did an extensive hormone profile – total and free testosterone, estradiol, sex-hormone binding protein (SHBG), dehydroepiandrosterone sulfate (DHEA-S), luteinizing hormone (LH). Insulin resistance and lipid accumulation product (LAP) were also evaluated.

Results showed that BPH patients had higher levels of cholesterol and LDL but significantly lower levels of HDL, known as the good type of cholesterol. Higher values of insulin, LH, DHEA-S, and estradiol were also found to be related to BPH development. The team also observed lower SHBG levels in individuals with BPH and MetS when compared to those who did not suffer from the metabolic condition, supporting previous suggestions that low SHBG concentrations are, along with BPH, a biomarker of MetS incidence.

Overall these data suggest that aged and obese men are at risk for MetS, a condition whose individual components are correlated with prostate enlargement. This association is thought to be related to changes in sexual hormone levels and metabolic dysfunctions linked with poor lifestyle choices. Researchers, however, do not exclude the limitations of the study where association and causality might be reversed.