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Higher BMI is associated with more severe BPH


Paris-Significant statistical correlations are seen between body mass index (BMI) and BPH symptoms, according to Claus G. Roehrborn, MD, who led a global 4-year treatment study evaluating the relationships of BMI and both measures of lower urinary tract symptoms (LUTS)/BPH severity and metabolic syndrome. Results of the study were presented at the European Association of Urology annual congress here.

Dr. Roehrborn, professor and chairman of urology at the University of Texas Southwestern Medical Center in Dallas, found that a higher BMI is associated with more severe irritative LUTS, a greater peak urine flow (Qmax), a higher prostate volume and transition zone volume (TZV), a greater girth, higher systolic and diastolic blood pressures, and higher fasting glucose and fasting insulin levels.

Irritative LUTS common

"As we expected, an increasing BMI was associated with other factors of the metabolic syndrome, such as a higher systolic blood pressure as well as higher diastolic blood pressure, elevated fasting glucose levels, insulin and triglyceride levels, and finally, a greater waist circumference as well as lower HDL cholesterol levels. These findings support an association between aspects of the metabolic syndrome and LUTS associated with BPH," Dr. Roehrborn said.

He pointed out that irritative symptoms in patients consistently showed a positive correlation with BMI at both screening and baseline, and obstructive symptoms did not.

From the results, Dr. Roehrborn observed that age may have an influence on the relationship between BMI and IPSS, Qmax, prostate volume, triglycerides, LDL cholesterol level, and blood pressure, but it does not appear to have an effect on the correlation between BMI and fasting glucose levels, insulin levels, or HDL cholesterol.

A participant from the audience remarked that Dr. Roehrborn has frequently advocated the use of PSA as a surrogate for prostate size, and the findings from this study, at least in obese men, call into question its use as a surrogate marker. He then asked if Dr. Roehrborn had changed his view on the usefulness of PSA as a surrogate for prostate size, given the increase in obesity.

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