Obesity and Benign Prostatic Hyperplasia: Clinical Connections, Emerging Etiological Paradigms and Future Directions

No AccessJournal of UrologyVoiding Dysfunction1 Jan 2013Obesity and Benign Prostatic Hyperplasia: Clinical Connections, Emerging Etiological Paradigms and Future Directionsis accompanied byObesity and Benign Prostatic Hyperplasia: Clinical Connections, Emerging Etiological Paradigms and Future Directions J. Kellogg Parsons, Aruna V. Sarma, Kevin McVary, and John T. Wei J. Kellogg ParsonsJ. Kellogg Parsons Division of Urologic Oncology, Moores Cancer Center, University of California, San Diego and Section of Surgery, San Diego Veterans Affairs Medical Center, La Jolla, California Financial interest and/or other relationship with American Medical Systems. More articles by this author , Aruna V. SarmaAruna V. Sarma Department of Epidemiology, Ann Arbor, Michigan Department of Urology, Ann Arbor, Michigan More articles by this author , Kevin McVaryKevin McVary Department of Urology, Northwestern University, Chicago, Illinois Financial interest and/or other relationship with GlaxoSmithKline, Pfizer, Lilly/ICOS, Sanofi-Aventis, Allergan and National Institute of Diabetes and Digestive and Kidney Diseases. More articles by this author , and John T. WeiJohn T. Wei Department of Urology, Ann Arbor, Michigan Financial interest and/or other relationship with Sanofi, American Medical Systems, Envisioneering, Gen-Probe and Beckman. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.11.029AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Benign prostatic hyperplasia is a highly prevalent disease in older men with substantial adverse effects on public health. Classic etiological paradigms for benign prostatic hyperplasia focus on nonmodifiable risk factors. However, obesity also potentially promotes benign prostatic hyperplasia. Materials and Methods: We performed a structured, comprehensive literature review to identify studies of obesity, benign prostatic hyperplasia, lower urinary tract symptoms and physical activity. Results: A preponderance of published evidence suggests strong positive associations of obesity with benign prostatic hyperplasia and lower urinary tract symptoms. This evidence encompasses most established metrics of adiposity, including body mass index, waist circumference and waist-to-hip ratio, and falls under 3 general categories, including prostate volume, clinical benign prostatic hyperplasia and lower urinary tract symptoms. 1) Prior studies consistently showed that increased adiposity is positively associated with radiographically determined prostate volume and enlargement, suggesting that obesity promotes prostate growth. 2) Most studies revealed that obesity increases the risk of clinical benign prostatic hyperplasia by several measures, including the initiation of benign prostatic hyperplasia medical treatment, noncancer prostate surgery, physician diagnosed benign prostatic hyperplasia, histological diagnosis and urinary flow rate. 3) Prior studies demonstrated that obesity increases the risk of lower urinary tract symptoms, as measured by a validated questionnaire. Also, most studies showed that physical activity significantly decreases the risk of benign prostatic hyperplasia. Conclusions: Obesity markedly increases the risk of benign prostatic hyperplasia. Since physical activity decreases the risk of benign prostatic hyperplasia, these observations support the development of novel prevention strategies and treatment targeted toward adiposity, weight loss and lifestyle. References 1 : Urologic Diseases in America project: benign prostatic hyperplasia. J Urol2005; 173: 1256. Link, Google Scholar 2 : Self-assessed health, sadness and happiness in relation to the total burden of symptoms from the lower urinary tract. BJU Int2005; 95: 810. Google Scholar 3 : Impact on quality of life of different lower urinary tract symptoms in men measured by means of the SF 36 questionnaire. Scand J Urol Nephrol2006; 40: 485. Google Scholar 4 : Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study. 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Google Scholar © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byKaplan S (2018) Re: Association between Chronic Obstructive Pulmonary Disease and Increased Risk of Benign Prostatic Hyperplasia: A Retrospective Nationwide Cohort StudyJournal of Urology, VOL. 200, NO. 6, (1138-1141), Online publication date: 1-Dec-2018.Griebling T (2016) Re: Challenging the Inevitability of Prostate Enlargement: Low Levels of Benign Prostatic Hyperplasia among Tsimane Forager-HorticulturalistsJournal of Urology, VOL. 197, NO. 3 Part 1, (773-773), Online publication date: 1-Mar-2017.Kaplan S (2018) Re: Changes in Weight and Metabolic Syndrome are Associated with Prostate Growth Rate over a 5-Year PeriodJournal of Urology, VOL. 198, NO. 6, (1184-1185), Online publication date: 1-Dec-2017.Bechis S, Otsetov A, Ge R, Wang Z, Vangel M, Wu C, Tabatabaei S and Olumi A (2018) Age and Obesity Promote Methylation and Suppression of 5α-Reductase 2: Implications for Personalized Therapy of Benign Prostatic HyperplasiaJournal of Urology, VOL. 194, NO. 4, (1031-1037), Online publication date: 1-Oct-2015.Bechis S, Otsetov A, Ge R and Olumi A (2018) Personalized Medicine for the Management of Benign Prostatic HyperplasiaJournal of Urology, VOL. 192, NO. 1, (16-23), Online publication date: 1-Jul-2014.Related articlesJournal of Urology20 Oct 2009Obesity and Benign Prostatic Hyperplasia: Clinical Connections, Emerging Etiological Paradigms and Future Directions Volume 189Issue 1SJanuary 2013Page: S102-S106 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordsprostatic hyperplasiaobesityprostatemetabolic syndrome Xurination disordersMetricsAuthor Information J. Kellogg Parsons Division of Urologic Oncology, Moores Cancer Center, University of California, San Diego and Section of Surgery, San Diego Veterans Affairs Medical Center, La Jolla, California Financial interest and/or other relationship with American Medical Systems. More articles by this author Aruna V. Sarma Department of Epidemiology, Ann Arbor, Michigan Department of Urology, Ann Arbor, Michigan More articles by this author Kevin McVary Department of Urology, Northwestern University, Chicago, Illinois Financial interest and/or other relationship with GlaxoSmithKline, Pfizer, Lilly/ICOS, Sanofi-Aventis, Allergan and National Institute of Diabetes and Digestive and Kidney Diseases. More articles by this author John T. Wei Department of Urology, Ann Arbor, Michigan Financial interest and/or other relationship with Sanofi, American Medical Systems, Envisioneering, Gen-Probe and Beckman. More articles by this author Expand All Advertisement PDF downloadLoading ...