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Kamal HK, Almutairi BO, Abdel-Naim AB. Asiatic acid mitigates testosterone-induced benign prostatic hyperplasia in rats via activation of PPAR-γ. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03405-z. [PMID: 39222244 DOI: 10.1007/s00210-024-03405-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
Prostate enlargement due to benign prostate hyperplasia (BPH) is a common, progressive disorder in elderly males with increasing prevalence. It causes devastating lower urinary tract symptoms with no satisfactory medication. Asiatic acid (AA), a natural pentacyclic triterpenoid, is known to have antiproliferative, antioxidant, and anti-inflammatory activities. The aim of this study was to evaluate the possible preventive activities of AA against BPH induced by testosterone in rats. Finasteride (0.5 mg/kg) was used as a reference drug. AA (10 or 20 mg/kg) administration inhibited the rise in prostatic weight and index induced by testosterone. Histopathological staining proved that AA mitigated the pathological features of BPH induced by testosterone, which was reflected as lower glandular epithelial in AA-treated groups. Also, the administration of AA along with testosterone restored the redox valance by inhibiting lipid peroxidation, and MDA production, and restoring the activities of superoxide dismutase (SOD) and catalase (CAT) activities. Also, AA reduced prostate interleukin-6 (IL-6), cyclooxygenase-2 (COX-2), tumor necrosis factor-alpha (TNF-α), and nuclear factor-kappa B (NF-κB) protein expression. In addition, AA modulated mRNA expression of Bax and Bcl-2 in favor of apoptosis. The effects of AA (20 mg/kg) were comparable to those of finasteride. Further, AA ameliorated the rise in insulin-like growth factor 1 receptor (IGF-1R) mRNA expression. This was associated with the enhancement of the prostatic content of PPAR-γ. It can be concluded that AA mitigated the features of BPH induced by testosterone in rats. This involves antioxidant, anti-inflammatory and pro-apototic activities of AA as well as its ability to down-regulate IGF-1R expression and enhance PPAR-γ concentration in prostatic tissues.
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Affiliation(s)
- Hani K Kamal
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia.
| | - Bader O Almutairi
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Ashraf B Abdel-Naim
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
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Yoneyama F, Okamoto T, Tamura Y, Ishii N, Togashi K, Soma O, Fujita N, Yamamoto H, Hatakeyama S, Kobayashi W, Ohyama C. Association between oral frailty and lower urinary tract symptoms among middle-aged and older adults in community-dwelling individuals: a cross-sectional study. Int Urol Nephrol 2024; 56:1803-1810. [PMID: 38216828 DOI: 10.1007/s11255-023-03878-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/04/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE We assessed the association between oral frailty risk and LUTS among middle-aged and older adults in a community-dwelling population. METHODS This cross-sectional study was conducted among 586 subjects aged ≥ 40 years who participated in the Iwaki Health Promotion Project in Hirosaki, Japan. We used the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS) to assess LUTS. LUTS was defined as an IPSS score of 8 or higher or meeting diagnostic criteria for OAB. Oral frailty risk was defined as experiencing two or more of the following: decreased chewing ability, decreased biting force, and dry mouth sensation. Physical performance (10-m gait speed and grip strength) was used for analysis. The association between oral frailty risk and LUTS was examined using multivariate logistic regression analyses. RESULTS The study included 218 men and 370 women, of whom 140 had LUTS. The mean age of this cohort was 59 years. Significant differences were observed between the LUTS and non-LUTS groups, including age, hypertension, history of CVD, depressive status, sleep disturbance, and 10 m gait speed. The prevalence of oral frailty risk was significantly higher in the LUTS group than in the non-LUTS group (26% vs. 11%, P < 0.001). Multivariate analysis revealed that age, male gender, and oral frailty risk (odds ratio: 2.67, 95% confidence interval: 1.57-4.51, P < 0.001) were independent factors for LUTS. Moreover, oral frailty risk was an independent factor in both participants aged < 65 years and participants aged ≥ 65 years. CONCLUSIONS Oral frailty was independently associated with LUTS.
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Affiliation(s)
- Fumiya Yoneyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan.
| | - Yoshihiro Tamura
- Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
| | - Noritaka Ishii
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
| | - Kyo Togashi
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
| | - Osamu Soma
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
| | - Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
| | - Wataru Kobayashi
- Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Chou, Hirosaki, 036-8562, Japan
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Lee J, Lee JH, Choo MS, Cho MC, Son H, Jeong H, Jeong JB, Yoo S. Lowering the percent body fat in the obese population might reduce male lower urinary tract symptoms. World J Urol 2023:10.1007/s00345-023-04397-w. [PMID: 37031331 DOI: 10.1007/s00345-023-04397-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/28/2023] [Indexed: 04/10/2023] Open
Abstract
PURPOSE This study aimed to investigate the practicality of percent body fat (PBF), calculated using bioelectrical impedance analysis (BIA), in predicting benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS). METHODS This study included 844 men who underwent medical checkups at our institution between 2014 and 2022. Demographic characteristics, serum PSA levels, and prostate volume were collected using TRUS. BPH was defined as a prostate volume ≥ 30 cc. Subjects were divided into two groups according to their quartiles of PBF: the normal PBF group (first to third quartile; PBF < 27.9%) and the high PBF group (fourth quartile; PBF ≥ 27.9%). Characteristics between the groups were compared using the chi-square test and Student's t-test. Multivariate logistic regression analysis was performed to evaluate risk factors for BPH and severe LUTS. RESULTS The prostate volume (25.21 ± 8.4 vs 27.30 ± 9.0, p = 0.005) and percentage of BPH (22.9% vs. 32.1%, p = 0.007) were greater in the high PBF group. After multivariate analysis, old age (OR = 1.066, p < 0.001), higher appendicular skeletal muscle mass index (ASMI) (OR = 1.544, p = 0.001), and PBF ≥ 27.9% (OR = 1.455, p = 0.037) were risk factors for BPH. Larger prostate volume (OR = 1.035, p = 0.002) and PBF ≥ 27.9% (OR = 1.715, p = 0.025) were risk factors for severe LUTS. However, a greater ASMI had a protective effect against severe LUTS (OR = 0.654, p = 0.011). CONCLUSIONS This study shows that PBF and ASMI are useful for predicting BPH/LUTS. We suggest that lowering PBF to the normal range in a population with high PBF might prevent BPH, while lowering PBF and maintaining adequate ASMI could lower LUTS.
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Affiliation(s)
- Jooho Lee
- Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Hoon Lee
- Department of Urology, Seoul National University Boramae Medical Center, Sindaebang 2(i)-dong, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Min Soo Choo
- Department of Urology, Seoul National University Boramae Medical Center, Sindaebang 2(i)-dong, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Min Chul Cho
- Department of Urology, Seoul National University Boramae Medical Center, Sindaebang 2(i)-dong, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Hwancheol Son
- Department of Urology, Seoul National University Boramae Medical Center, Sindaebang 2(i)-dong, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Hyeon Jeong
- Department of Urology, Seoul National University Boramae Medical Center, Sindaebang 2(i)-dong, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Ji Bong Jeong
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Sindaebang 2(i)-dong, Dongjak-gu, Seoul, 07061, Republic of Korea.
| | - Sangjun Yoo
- Department of Urology, Seoul National University Boramae Medical Center, Sindaebang 2(i)-dong, Dongjak-gu, Seoul, 07061, Republic of Korea.
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Bauer SR, Cawthon PM, Ensrud KE, Suskind AM, Newman JC, Fink HA, Lu K, Scherzer R, Hoffman AR, Covinsky K, Marshall LM. Lower urinary tract symptoms and incident functional limitations among older community-dwelling men. J Am Geriatr Soc 2022; 70:1082-1094. [PMID: 34951697 PMCID: PMC8986604 DOI: 10.1111/jgs.17633] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) are associated with frailty phenotype, a risk factor for functional decline. Our objective was to determine the association between baseline LUTS and 2-year risk of new functional limitation among older men. METHODS We analyzed data from the Osteoporotic Fractures in Men (MrOS) study with baseline at Year 7 and follow-up through Year 9. Participants included 2716 community-dwelling men age ≥ 71 years without any baseline self-reported functional limitation. LUTS severity (American Urologic Association Symptom Index) was classified as none/mild (score 0-7), moderate (8-19), and severe (20-35). At baseline and follow-up, men reported their ability to complete several mobility, activities of daily living (ADLs), and cognition-dependent tasks. Risk was estimated for 3 incident functional limitation outcomes: (1) mobility (any difficulty walking 2-3 blocks or climbing 10 steps), (2) ADL (any difficulty bathing, showering, or transferring), and (3) cognition-dependent (any difficulty managing money or medications). We used Poisson regression with a robust variance estimator to model adjusted risk ratios (ARR) and 95% CIs controlling for age, site, and comorbidities; other demographic/lifestyle factors did not meet criteria for inclusion. RESULTS Overall, the 2-year risk was 15% for mobility, 10% for ADLs, and 4% for cognition-dependent task limitations. Compared to none/mild LUTS, risk of incident mobility limitations was increased for moderate (ARR = 1.35, 95% CI: 1.12, 1.63) and severe LUTS (ARR = 1.98, 95% CI: 1.48, 2.64). Men were also at higher risk for incident ADL limitations if they reported moderate (ARR = 1.32, 95% CI: 1.05, 1.67) and severe LUTS (ARR = 1.62, 95% CI: 1.07,2.43). Results were somewhat attenuated after adjusting for the frailty phenotype but remained statistically significant. LUTS were not associated with incident cognition-dependent task limitations. CONCLUSIONS LUTS severity is associated with incident mobility and ADL limitations among older men. Increased clinical attention to risk of functional limitations among older men with LUTS is likely warranted.
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Affiliation(s)
- Scott R. Bauer
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA
- Department of Urology, University of California, San Francisco, CA
- San Francisco VA Healthcare System, San Francisco, CA
| | - Peggy M. Cawthon
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
- Research Institute, California Pacific Medical Center, San Francisco, CA
| | - Kristine E. Ensrud
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Veterans Affairs Health Care System, Minneapolis, MN
| | - Anne M. Suskind
- Department of Urology, University of California, San Francisco, CA
| | - John C. Newman
- Buck Institute for Research on Aging, Novato, CA
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA
| | - Howard A. Fink
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Veterans Affairs Health Care System, Minneapolis, MN
- Geriatric Research Education and Clinical Center, Veterans Affairs Health Care System, Minneapolis, MN
| | - Kaiwei Lu
- San Francisco VA Healthcare System, San Francisco, CA
| | - Rebecca Scherzer
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA
- San Francisco VA Healthcare System, San Francisco, CA
| | | | - Kenneth Covinsky
- San Francisco VA Healthcare System, San Francisco, CA
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA
| | - Lynn M. Marshall
- Oregon Health and Science University-Portland State University School of Public Health, Portland, OR
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Agostini LCM, Brum CS, Lopes HE, Netto JMB, Figueiredo AA. Evaluation of pedometer use in men with lower urinary tract symptoms: a randomized clinical trial. Int Urol Nephrol 2021; 53:2231-2236. [PMID: 34390436 DOI: 10.1007/s11255-021-02970-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the effect of a pedometer use in men aged between 50 and 59 years presenting lower urinary tract symptoms (LUTS). METHODS A single-center, not blind clinical trial with two parallel groups and equal randomization was performed with 38 men aged 50-59 years with LUTS. All patients received guidance and encouragement to physical activity practice. Only the intervention group received a Pedometer with a goal of 10,000 steps/day. After a period of 12 weeks, the groups were compared through the following variables: number of steps/day, IPSS score, flexibility, anthropometric values and Maximum Oxygen Consumption (VO2max). RESULTS The number of steps per day in the intervention group was 9753 ± 1549 compared to 6212 ± 1152 in the control group (p = 0.004). Pedometer use efficacy was a 50% risk reduction of not achieve the goal of 10,000 steps per day. Regarding IPSS score, the intervention group achieved lower scores (6.95 ± 2.85 vs. 10.16 ± 3.23, p = 0.007). Pedometer use efficacy was a 94% risk reduction of not achieve more than 30% reduction in IPSS score. In VO2max, the intervention group performed better than the control group (34.84 ± 3.25 vs. 32.58 ± 6.89; p = 0.011). There was no difference in flexibility and anthropometric values between the groups. CONCLUSIONS The use of pedometer in LUTS patients provided an increase in the number of steps/day, a decrease in LUTS score and an improvement in VO2max measure. CLINICAL TRIAL REGISTRATION Trial url: www.ensaiosclinicos.gov.br/rg/RBR-4vynk5/ . Register Number: RBR-4vynk5 .
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Affiliation(s)
- Lucas Cortes Machado Agostini
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil
| | - Christiano Silva Brum
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil
| | - Humberto Elias Lopes
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil
- Department of Surgery, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - José Murillo Bastos Netto
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil
- Department of Surgery, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - André Avarese Figueiredo
- NIPU - Núcleo Interdisciplnar de Pesquisa em Urologia, Federal University of Juiz de Fora, Avenida Barão do Rio Branco, 5141, Apto 1606, Juiz de Fora, MG, 36026-500, Brazil.
- Department of Surgery, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.
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de Oliveira AM, Fonseca FMF, Reis ST, Viana NI, Oliveira EM, Leiria LO, Leite KRM, Nahas WC, Srougi M, Antunes AA. Physical activity effects on bladder dysfunction in an obese and insulin-resistant murine model. Physiol Rep 2021; 9:e14792. [PMID: 33904660 PMCID: PMC8077148 DOI: 10.14814/phy2.14792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 12/02/2022] Open
Abstract
Objective To investigate the role of physical activity in functional and molecular bladder alterations in an obese and insulin‐resistant murine model. Methods Wistar rats were randomized into 1. physical activity and standard diet; 2. physical activity and high‐fat diet; 3. no physical activity and standard diet; and 4. no physical activity and high‐fat diet. Groups 1 and 2 were subjected to a 10‐week swimming protocol. Urodynamic study (UDS) was performed, and the expression of genes in the bladder tissue related to the insulin pathway (IRS1/IRS2/PI3K/AKT/eNOS) was assessed using quantitative real‐time polymerase chain reaction. Results Groups 1 and 2 presented lower body weight gains than groups 3 (213.89 ± 13.77 vs 261.63 ± 34.20 grams (g), p = 0.04) and 4 (209.84 ± 27.40 vs 257.57 ± 32.95 g, p = 0.04), respectively. Group 4 had higher insulin level (6.05 ± 1.79 vs 4.14 ± 1.14 ng/ml, p = 0.038) and higher homeostasis model assessment of insulin resistance (HOMA‐IR) index (1.95 ± 0.73 vs 1.09 ± 0.37, p = 0.006) than group 1. On UDS, group 4 had greater number of micturition (13.6 ± 4.21 vs 6.0 ± 1.82, p = 0.04), higher postvoid pressure (8.06 ± 2.24 vs 5.08 ± 1.23, p = 0.04), lower capacity (0.29 ± 0.18 vs 0.91 ± 0.41 ml, p = 0.008), and lower bladder compliance (0.027 ± 0.014 vs 0.091 ± 0.034 ml/mmHg, p = 0.016) versus group 1. High‐fat diet was related to an underexpression throughout insulin signaling pathway, and physical activity was related to an overexpression of the pathway. Conclusions The insulin signaling pathway may be involved in the pathogenesis of bladder dysfunction related to a high‐fat diet. Physical activity may help to prevent bladder disfunction induced by a high‐fat diet through the insulin pathway.
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Affiliation(s)
- André Matos de Oliveira
- Laboratory of Medical Research - LIM 55, Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | | | - Sabrina Thalita Reis
- Laboratory of Medical Research - LIM 55, Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Nayara Izabel Viana
- Laboratory of Medical Research - LIM 55, Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | | | - Luiz Osório Leiria
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Katia Ramos Moreira Leite
- Laboratory of Medical Research - LIM 55, Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - William Carlos Nahas
- Laboratory of Medical Research - LIM 55, Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Miguel Srougi
- Laboratory of Medical Research - LIM 55, Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Alberto Azoubel Antunes
- Laboratory of Medical Research - LIM 55, Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil
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Lloyd GL, Wiesen B, Atwell M, Malykhina A. Marijuana, Alcohol, and ED: Correlations with LUTS/BPH. Curr Urol Rep 2021; 22:21. [PMID: 33554319 PMCID: PMC8054558 DOI: 10.1007/s11934-020-01031-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW Benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) is a disease complex with enormous societal burden and yet the pathogenesis of LUTS/BPH is poorly understood. We set out to review the literature on the relationship between depression, marijuana usage, and erectile dysfunction (ED) to LUTS/BPH. RECENT FINDINGS LUTS/BPH has independent associations with depression as well as with ED. In each case, the causality and mechanistic relationship is unknown. The impact of marijuana, as it increasingly pervades the general population, on the disease complex of LUTS/BPH is not well studied but recent results support short-term benefit and long-term caution. Depression, a form of central nervous dysfunction, and ED, which is likely mediated via endothelial dysfunction, are independently associated with LUTS/BPH. The presence of cannabinoid receptors in urologic organs, coupled with recent population studies, supports a modulatory effect of marijuana on voiding although an enormous knowledge gap remains.
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Affiliation(s)
- Granville L Lloyd
- Rocky Mountain Regional Veterans Hospital, Aurora, CO, USA.
- Department of Surgery/Urology, University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA.
| | - Brett Wiesen
- University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA
| | - Mike Atwell
- Division of Urology, Department of Surgery, University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA
| | - Anna Malykhina
- Department of Surgery, University of Colorado Anschutz School of Medicine, Aurora, CO, 80045, USA
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Wang SS, Li K, Liu Z, Gui S, Liu N, Liu X. Aerobic exercise ameliorates benign prostatic hyperplasia in obese mice through downregulating the AR/androgen/PI3K/AKT signaling pathway. Exp Gerontol 2020; 143:111152. [PMID: 33189835 DOI: 10.1016/j.exger.2020.111152] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Emerging evidence has suggested that physical activities can reduce the risk of benign prostatic hyperplasia (BPH). Here, we evaluated the effect of aerobic exercise in a model of BPH using obese mice. METHODS Obese C57BL/6J mice in the control group, obesity group (OB), and obesity group plus exercise (OB + E) with eight weeks training were inspected for morphological alterations via hematoxylin-eosin (H&E) staining, lipid and sex hormone metabolites via enzyme-linked immunosorbent assays (ELISAs), relative protein expression via Western blotting, and prostate cancer-up-regulated long noncoding RNA (PlncRNA) and androgen receptor (AR) mRNA levels via quantitative real-time PCR (qRT-PCR). RESULTS Aerobic exercise training slowed fat-mass gain in OB mice. Prostate volume (PV) and area of lumen was significantly decreased in OB mice and was slightly increased following aerobic exercise. Epithelial volume density in the OB group was higher than that in the control group. Furthermore, aerobic exercise lowered serum low-density lipoprotein (LDL), triglyceride, and free fatty acid (FFA) levels, whereas it raised high-density lipoprotein (HDL) levels in OB + E mice. Additionally, the hormonal ratio of estradiol/testosterone (E2/T) approached that of the control group following aerobic exercise in OB + E mice. Mechanistically, aerobic exercise downregulated the PlncRNA-AR/androgen signaling pathway via the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) axis in the prostates of OB + E mice. CONCLUSION These data demonstrate that aerobic exercise may alleviate BPH in obese mice through regulation of the AR/androgen/PI3K/AKT signaling pathway.
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Affiliation(s)
- Sha-Sha Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Kai Li
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Zhiwei Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Shukang Gui
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Nian Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xiangyun Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.
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A Prospective Study of Physical Activity, Sedentary Behavior, and Incidence and Progression of Lower Urinary Tract Symptoms. J Gen Intern Med 2020; 35:2281-2288. [PMID: 32347424 PMCID: PMC7403234 DOI: 10.1007/s11606-020-05814-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 03/19/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS), often secondary to benign prostatic hyperplasia, are a common problem for older men. Lifestyle factors, including physical activity and sedentariness, may be important LUTS risk factors and suitable targets for intervention. OBJECTIVE To determine whether physical activity and sedentariness are associated with LUTS incidence and progression. DESIGN The Health Professionals Follow-up Study is a prospective cohort of men that began in 1986. Follow-up for LUTS is complete through 2008. PARTICIPANTS Men aged 40-75 years at enrollment and members of health professions. MAIN MEASURES Total weekly metabolic equivalent of task (MET)-hour scores were calculated and were categorized (< 9, 9 to < 21, 21 to < 42, 42 to < 63, ≥ 63 MET-hours/week). Participants reported their average time/week spent sitting watching television as a measure of sedentariness, which was categorized (< 1, 1-3, 4-10, 11-29, ≥ 30 h/week). Participants completed the International Prostate Symptom Score survey and reported treatments for LUTS periodically. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) of physical activity and television watching with LUTS incidence and progression. KEY RESULTS After multivariable adjustment, including for body mass index (BMI), men with the highest physical activity were 19% (HR = 0.81, 95% CI = 0.74-0.89; p trend < 0.0001) less likely to develop incident moderate or worse LUTS than men in the lowest category. Men who watched television ≥ 30 h/week were 24% (HR = 1.24, 95% CI = 1.05-1.45; p trend = 0.004) more likely to develop incident moderate or worse LUTS than men who watched < 1 h/week. These associations persisted after mutual adjustment. We observed no associations with LUTS progression. CONCLUSIONS In this large prospective study, more activity and less sedentariness were associated with lower risk of incident LUTS independent of one another and BMI. Physical inactivity and sedentariness were not associated with LUTS worsening. Increasing physical activity and reducing sedentariness may be strategies for preventing LUTS in addition to their well-established benefits for other diseases.
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Benign prostate hyperplasia and nutrition. Clin Nutr ESPEN 2019; 33:5-11. [DOI: 10.1016/j.clnesp.2019.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/07/2019] [Accepted: 07/27/2019] [Indexed: 11/20/2022]
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Do Lifestyle Factors Affect Lower Urinary Tract Symptoms? Results from the Korean Community Health Survey. Int Neurourol J 2019; 23:125-135. [PMID: 31260612 PMCID: PMC6606931 DOI: 10.5213/inj.1938010.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/12/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the relationships between lower urinary tract symptoms (LUTS) and lifestyle factors (physical activity, smoking, alcohol consumption, body mass index, and stress) in Korean men. METHODS We analyzed the survey results of South Korean men (n=64,439) who were 40 years of age or older among whom interviews were conducted using questionnaires. Trained interviewers performed face-to-face surveys using computer-assisted personal interviewing, the International Prostate Symptom Score (IPSS), and standard questions. We assessed the relationships of lifestyle factors (physical activity, cigarette smoking, alcohol intake, height, weight, and stress) with LUTS. RESULTS We observed higher IPSS scores in participants who engaged in no exercise (n=46,008 [71.7%], IPSS=3.19±5.36) than in those who engaged in vigorous physical activity (n=10,657 [17.6%], IPSS=2.28±4.15). Former smokers showed higher total, storage, and voiding symptom IPSS scores than current smokers and nonsmokers. Nondrinkers had higher IPSS scores than current alcohol drinkers. In multivariable logistic regression analysis, we detected no relationship between LUTS and current alcohol drinking in the moderate and severe LUTS groups, using the mild LUTS group as a reference (moderate: 0.91; 95% confidence interval [CI], 0.91-0.91; P<0.001, severe: 0.78; 95% CI, 0.78-0.78; P<0.001). Participants with moderate to severe stress showed higher total IPSS scores than those with no or mild stress (3.38±5.77 vs. 2.88±4.90), with significant relationships between stress and LUTS found in the moderate and severe LUTS groups. In logistic regression analysis, stronger relationships were found for storage and voiding symptoms in the moderate and severe stress groups compared to the mild stress group. CONCLUSION A history of smoking, low levels of physical activity, low body mass index, and moderate to severe stress were associated with a greater severity of LUTS. Moderate to severe stress was also related to voiding symptoms. However, there was no association between alcohol intake and LUTS severity.
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Al-Yahya E, Mohammad MT, Muhaidat J, Demour SA, Qutishat D, Al-Khlaifat L, Okasheh R, Lawrie S, Esser P, Dawes H. Functional Balance and Gait Characteristics in Men With Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. Am J Mens Health 2019; 13:1557988319839879. [PMID: 31081440 PMCID: PMC6537265 DOI: 10.1177/1557988319839879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/28/2019] [Accepted: 03/03/2019] [Indexed: 01/13/2023] Open
Abstract
The purpose of this cross-sectional study was to compare gait characteristics and functional balance Babilities in men with LUTS secondary to benign prostatic hyperplasia (BPH) to those of community-dwelling older adults under different conditions of increasing difficulties, and to aid health-care providers to identify those patients with decreased level of activity and increased risk of falls. We recruited a group of 43 men diagnosed with symptomatic BPH and a control group of 38 older men. Participants performed the timed up and go and 10-m walking tests under different conditions-namely, single task, dual-task motor, and dual-task cognitive. Time to complete the tests and spatial and temporal gait parameters were compared between groups and conditions via mixed-design ANOVA. Under dual-task conditions, individuals in both groups performed significantly worse compared to the single functional balance and walking tasks. As the complexity of the walking task increased-from dual-task motor to dual-task cognitive-significant differences between groups emerged. In particular, men with BPH performed worse than older adults in tasks demanding increased attentional control. Results suggest that dual-task decrements in functional balance and gait might explain decreased level of physical activity and increased risk of falls reported in men with LUTS. Health-care providers for men with LUTS due to BPH should assess for abnormal gait and remain vigilant for balance problems that may lead to decreased mobility and falls. The dual-task approach seems a feasible method to distinguish gait and balance impairments in men with BPH.
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Affiliation(s)
- Emad Al-Yahya
- School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
- Centre for Movement, Occupation and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, UK
| | - Maha T. Mohammad
- School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Jennifer Muhaidat
- School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Saddam Al Demour
- Urology Devision, Department of Special Surgery, School of Medicine, The University of Jordan, Amman, Jordan
| | - Dania Qutishat
- School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Lara Al-Khlaifat
- School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Rasha Okasheh
- School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Sophie Lawrie
- Centre for Movement, Occupation and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, UK
| | - Patrick Esser
- Centre for Movement, Occupation and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, UK
| | - Helen Dawes
- Centre for Movement, Occupation and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, UK
- Department of Clinical Neurology, University of Oxford, UK
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Silva V, Grande AJ, Peccin MS. Physical activity for lower urinary tract symptoms secondary to benign prostatic obstruction. Cochrane Database Syst Rev 2019; 4:CD012044. [PMID: 30953341 PMCID: PMC6450803 DOI: 10.1002/14651858.cd012044.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Lower urinary tract symptoms caused by benign prostatic obstruction (LUTS/BPO) represents one of the most common clinical complaints in men. Physical activity might represent a viable first-line intervention for treating LUTS/BPO. OBJECTIVES To assess the effects of physical activity for lower urinary tract symptoms caused by benign prostatic obstruction (LUTS/BPO). SEARCH METHODS We performed a comprehensive search of multiple databases (CENTRAL, MEDLINE, Embase, Web of Science, LILACS, ClinicalTrials.gov, and WHO ICTRP); checked the reference lists of retrieved articles; and handsearched abstract proceedings of conferences with no restrictions on the language of publication or publication status from database inception to 6 November 2018. SELECTION CRITERIA We included published and unpublished randomised controlled and controlled clinical trials that included men diagnosed with LUTS/BPO. We excluded studies in which medical history suggested non-BPO causes of LUTS or prior invasive therapies to physical activity or that used electrical stimulation. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, and assessed the risk of bias of included studies. We assessed primary outcomes (symptom score for LUTS; response rate, defined as 20% improvement in symptom score; withdrawal due to adverse events) and secondary outcomes (change of medication use; need for an invasive procedure; postvoid residual urine). We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS We included six studies that randomised 652 men over 40 years old with moderate or severe LUTS. The four different comparisons were as follows:Physical activity versus watchful waitingTwo RCTs randomised 119 participants. The interventions included tai chi and pelvic floor exercise. The evidence was overall of very low quality, and we are uncertain about the effects of physical activity on symptom score for LUTS (mean difference (MD) -8.1, 95% confidence interval (CI) -13.2 to -3.1); response rate (risk ratio (RR) 1.80, 95% CI 0.81 to 4.02; 286 more men per 1000, 95% CI 68 fewer to 1079 more); and withdrawal due to adverse events (RR 1.00, 95% CI 0.59 to 1.69; 0 fewer men per 1000, 95% CI 205 fewer to 345 more).Physical activity as part of self-management programme versus watchful waitingTwo RCTs randomised 362 participants. Pelvic floor exercise was one of multiple intervention components. The evidence was of very low quality, and we are uncertain about the effects of physical activity for symptom score for LUTS (MD -6.2, 95% CI -9.9 to -2.5); response rate (RR 2.36, 95% CI 1.32 to 4.21; 424 more men per 1000, 95% CI 100 more to 1000 more); and withdrawal due to adverse events (risk difference 0.00, 95% CI -0.05 to 0.06; 65 fewer men per 1000, 95% CI 65 fewer to 65 fewer).Physical activity as part of weight reduction programme versus watchful waitingOne RCT randomised 130 participants. An unclear type of intense exercise was one of multiple intervention components. The evidence was of very low quality, and we are uncertain about the effects for symptom score for LUTS (MD -1.1, 95% CI -3.5 to 1.3); response rate (RR 1.20, 95% CI 0.74 to 1.94; 67 more men per 1000, 95% CI 87 fewer to 313 more); and withdrawal due to adverse events (RR 1.63, 95% CI 1.03 to 2.57; 184 more men per 1000, 95% CI 9 more to 459 more).Physical activity versus alpha-blockersOne RCT randomised 41 participants to pelvic floor exercise or alpha-blockers. The evidence was of very low quality, and we are uncertain about the effects for symptom score for LUTS (MD 2.8, 95% CI -0.9 to 6.4) and response rate (RR 0.80, 95% CI 0.55 to 1.15; 167 fewer men per 1000, 95% CI 375 fewer to 125 more). The evidence was of low quality for withdrawal due to adverse events; the effects for this outcome may be similar between interventions (RR 0.86, 95% CI 0.06 to 12.89; 7 fewer men per 1000, 95% CI 49 fewer to 626 more). AUTHORS' CONCLUSIONS We rated the quality of the evidence for most of the effects of physical activity for LUTS/BPO as very low. We are therefore uncertain whether physical activity affects symptom scores for LUTS, response rate, and withdrawal due to adverse events. Our confidence in the estimates was lowered due to study limitations, inconsistency, indirectness, and imprecision. Additional high-quality research is necessary.
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Affiliation(s)
- Valter Silva
- Centro Universitário Tiradentes (UNIT/AL)Postgraduate Program on Society, Technology and Public Policies (SOTEPP); Department of MedicineAv. Comendador Gustavo Paiva, 5017Cruz das AlmasMaceióALBrazil57038‐000
| | - Antonio Jose Grande
- Universidade Estadual de Mato Grosso do SulLaboratory of Evidence‐Based PracticeAv. Dom Antônio Barbosa, 4155Vila Santo AmaroCampo GrandeMato Grosso do SulBrazil79115‐898
| | - Maria S Peccin
- Universidade Federal de São PauloDepartment of Human Movement SciencesR. Silva Jardim, 136 ‐ Vl. Mathias ‐SantosSão PauloBrazil11015‐020
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Physical Activity as a Protective Factor for Lower Urinary Tract Symptoms in Male Patients: A Prospective Cohort Analysis. Urology 2019; 125:163-168. [PMID: 30634026 DOI: 10.1016/j.urology.2018.12.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/25/2018] [Accepted: 12/31/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess the association between physical activity, evaluated by the Physical Activity Scale for Elderly (PASE) questionnaire and lower urinary tract symptoms (LUTS) in male patients. METHODS From 2009 onward, a consecutive series of patients with LUTS-benign prostatic enlargement were enrolled. Symptoms were evaluated using the International Prostate Symptom Score (IPSS) with its subscores and prostate volume using transrectal ultrasound. Physical activity was evaluated with the PASE questionnaire, consisting of 12 questions regarding frequency and duration of leisure activity and recently used to evaluate physical activity in patients with prostatic disorders. The risk of detecting LUTS (IPSS ≥8), voiding LUTS (vIPSS≥5), and storage LUTS (sLUTS) (sIPSS ≥4) was evaluated using binary logistic regression analysis. RESULTS Six hundred and seventeen patients were enrolled in 2 centers (Rome, Vasto, Italy). Median PASE score was 118 (IQR 73/169), and median IPSS was 9 (IQR 5/15). Overall 189 of 617 (30%) patients presented moderate/severe LUTS. These patients presented a lower PASE score (111 IQR 69/160 vs 125 IQR 83/180; P = .016) when compared to patients with total IPSS ≤7. On multivariate analysis, PASE score (OR = 0.997 per unit, 95%CI: 0.994-1.000; P = .023), and prostate volume (OR = 1.008 per mL, 1.000-1.016; P = .045) were independent predictors of LUTS severity. As well PASE score was an independent predictor of moderate/severe sLUTS (OR = 0.996, 95%CI:0.993-0.999; P = .015). CONCLUSION In our study a reduced physical activity, assessed using the PASE questionnaire, is associated with an increased risk of moderate severe LUTS, more specifically of moderate/severe sLUTS.
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Mubenga LE, Hermans MP, Chimanuka D, Muhindo L, Cikomola J, Bahizire E, Tombal B. Anthropometric and cardiometabolic correlates of prostate volume among diabetic and non-diabetic subjects in South-Kivu. Diabetes Metab Syndr 2019; 13:350-355. [PMID: 30641724 DOI: 10.1016/j.dsx.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 10/09/2018] [Indexed: 11/26/2022]
Affiliation(s)
- L E Mubenga
- Department of Urology, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo.
| | - M P Hermans
- Division of Endocrinology and Nutrition, Cliniques Universitaires St-Luc and Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
| | - D Chimanuka
- Department of Urology, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo.
| | - L Muhindo
- Department of Urology, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo.
| | - J Cikomola
- Division of Endocrinology, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo.
| | - E Bahizire
- Center of Research in Epidemiology and Biostatistics and Clinical Research. Université Libre de Bruxelles (ULB), Brussels, Belgium; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya; Centre de Recherche en Sciences Naturelles de Lwiro, Bukavu, Democratic Republic of Congo.
| | - B Tombal
- Department of Urology, Université Catholique de Louvain (UCL), Brussels, Belgium.
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Ryu JM, Jang GY, Park D, Woo KS, Kim TM, Jeong HS, Kim DJ. Effect of sorghum ethyl-acetate extract on benign prostatic hyperplasia induced by testosterone in Sprague-Dawley rats. Biosci Biotechnol Biochem 2018; 82:2101-2108. [PMID: 30124113 DOI: 10.1080/09168451.2018.1507721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Benign prostatic hyperplasia (BPH) is commonly observed in men > 50 years worldwide. Phytotherapy is one of the many treatment options. Sorghum (Sorghum bicolor L.) contains various health-improving phytochemicals with antioxidant and inhibitory activities on cell proliferation, both in vitro and in vivo. To confirm the effects of Donganme sorghum ethyl-acetate extract (DSEE) on BPH, we induced BPH in Spragye-Dawley rats using exogenous testosterone. We measured prostate weight, examined prostrates histopathologically, and analyzed mRNAs associated with male hormones and proteins associated with cell proliferation in the prostate. DSEE inhibited weight gain of the prostate; decreased mRNA expressions of androgen receptor and 5α-reductase II; and improved histopathological symptoms, the protein-expressed ratio of Bax/Bcl-2, and the oxidative status of BPH induced by testosterone in SD rats. Therefore, DSEE may have potential as a preventive or therapeutic agent against BPH.
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Affiliation(s)
- Jae-Myun Ryu
- a Veterinary Medical Center and College of Veterinary Medicine , Chungbuk National University , Cheongju , Korea
| | - Gwi Yeong Jang
- b Department of Herbal Crop Research, National Institute of Horticultural and Herbal Science , Rural Development Administration , Eumseong , Korea
| | - Dongsun Park
- c Department of Biology Education , Korea National University of Education , Cheongju , Korea
| | - Koan Sik Woo
- d Department of Central Area Science, National Institute of Crop Science , Rural Development Administration , Suwon , Korea
| | - Tae Myoung Kim
- a Veterinary Medical Center and College of Veterinary Medicine , Chungbuk National University , Cheongju , Korea
| | - Heon Sang Jeong
- e Department of Food Science and Biotechnology , Chungbuk National University , Cheongju , Korea
| | - Dae Joong Kim
- a Veterinary Medical Center and College of Veterinary Medicine , Chungbuk National University , Cheongju , Korea
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17
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Han CH, Kim SJ, Chung JH. The Association between Male Asthma and Lower Urinary Tract Symptoms Evaluated by the International Prostate Symptom Score: A Population-Based Study. Int Arch Allergy Immunol 2018; 177:334-341. [PMID: 30130757 DOI: 10.1159/000491794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/03/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES We explored the association between asthma severity and lower urinary tract symptoms (LUTS) using the International Prostate Symptom Score in a population-based study of males (aged ≥19 years) and evaluated voiding and urine storage symptoms. METHODS This was a cross-sectional study of 101,848 males, 2,544 of whom had asthma, who participated in the 2011 Korean Community Health Survey. All subjects were assessed in terms of sociodemographic data, pre-existing conditions, and the presence of LUTS. Logistic regression was used to identify risk factors for LUTS in asthmatics. RESULTS Urine storage symptoms (frequency, urgency, and nocturia) and voiding symptoms (straining, a weak stream, intermittency, and incomplete emptying) were significantly higher in the asthma group than in the non-asthma group (all p < 0.001). Moderate and severe LUTS were significantly more common in the asthma group (moderate, 24.3%; severe, 22.5%) than in the nonasthma group (moderate, 9.5%; severe, 2.9%). Compared to the mild LUTS group, the odds ratio (OR) for asthma was 2.21 (95% confidence interval [CI] 1.99-2.46) in the moderate LUTS group, and 3.04 (95% CI 2.64-3.51) in the severe LUTS group. In a model evaluating multiple variables, the OR for asthma in the moderate LUTS group was 1.95 (95% CI 1.74-2.16) and that in the severe LUTS group was 2.17 (95% CI 1.87-2.53). Asthma was associated with both voiding and storage symptoms. CONCLUSIONS Male asthma was associated with moderate-to-severe LUTS. More aggressive urological diagnosis and treatment are needed for patients with asthma.
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Affiliation(s)
- Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Seung Jun Kim
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of
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De Nunzio C, Presicce F, Tubaro A. Inflammatory mediators in the development and progression of benign prostatic hyperplasia. Nat Rev Urol 2018; 13:613-26. [PMID: 27686153 DOI: 10.1038/nrurol.2016.168] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Benign prostatic hyperplasia (BPH) is the most common urological disease in elderly men. Epidemiological data suggest a causal link between this condition and prostatic inflammation. The prostate is an immune-competent organ characterized by the presence of a complex immune system. Several stimuli, including infectious agents, urinary reflux, metabolic syndrome, the ageing process, and autoimmune response, have been described as triggers for the dysregulation of the prostatic immune system via different molecular pathways involving the development of inflammatory infiltrates. From a pathophysiological standpoint, subsequent tissue damage and chronic tissue healing could result in the development of BPH nodules.
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Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, 'Sapienza' University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Fabrizio Presicce
- Department of Urology, Sant'Andrea Hospital, 'Sapienza' University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, 'Sapienza' University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy
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Roehrborn CG, Miner MM, Sadovsky R. Over-the-counter medication availability could augment self-management of male lower urinary tract symptoms. Postgrad Med 2018; 130:452-460. [PMID: 29932780 DOI: 10.1080/00325481.2018.1487238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In this review, we focus on current trends in the management of male lower urinary tract symptoms (LUTS), defined here as LUTS, namely, storage, voiding, and post-micturition symptoms presumed secondary to benign prostatic hyperplasia (BPH), and discuss possible novel approaches toward better care. According to results of a PubMed database search covering the last 10 years and using keywords pertaining to male LUTS, this condition continues to be globally undiagnosed or diagnosed late, partly because of men's hesitation to seek help for perceived embarrassing problems or problems considered a normal part of aging. In addition, the prevalence of male LUTS is continually increasing because of a constantly aging population. Male LUTS can be bothersome and affect the quality of life (QoL) and sexual function. Additional effective alternatives for managing this condition need to be identified and incorporated into the current care model. Considering that most male LUTS such as frequency, hesitancy, urgency, and intermittency are easy to self-identify, a self-management approach toward male LUTS is proposed. Limited evidence supports the efficacy of phytotherapies and herbals as self-management options for male LUTS. However, introducing over-the-counter (OTC) medication with proven efficacy, accompanied by lifestyle and behavioral modifications, may be a promising approach that will encourage more men to treat their symptoms in a timely manner. Formal guidelines, along with appropriate education programs for patients and support from the healthcare community, will be needed to ensure that the promise of this approach is fully materialized.
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Affiliation(s)
- Claus G Roehrborn
- a Department of Urology , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Martin M Miner
- b Men's Health Center , Miriam Hospital , Providence , Rhode I , USA.,c Family Medicine and Urology , Warren Alpert School of Medicine, Brown University , Providence , RI , USA
| | - Richard Sadovsky
- d Department of Family Medicine , SUNY-Downstate Medical Center , Brooklyn , NY , USA
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Samarinas M, Gacci M, de la Taille A, Gravas S. Prostatic inflammation: a potential treatment target for male LUTS due to benign prostatic obstruction. Prostate Cancer Prostatic Dis 2018; 21:161-167. [PMID: 29686417 DOI: 10.1038/s41391-018-0039-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 12/27/2017] [Accepted: 01/11/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND The purpose of this narrative review is to evaluate the role of prostatic inflammation as a treatment target for lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO) and provide an update on the available therapies. METHODS An extensive literature search was conducted for studies on established and investigational treatments with anti-inflammatory mechanism of action that has been assessed for the management of male LUTS due to BPO. RESULTS Data on phosphodiesterase 5 inhibitors, nonsteroidal anti-inflammatory drugs, vitamin D3 receptor analogs, phytotherapy, statins, and lifestyle changes have been reviewed and analyzed. Preclinical evidence has shown the anti-inflammatory effect of these treatments on prostate. However, there is a wide variation in the degree of mature of each therapy. In addition, there are significant differences between the studies in terms of design, number of patients, and duration of follow-up. CONCLUSIONS Several drugs classes have been investigated for their impact on prostatic inflammation and improvement of male LUTS. The reviewed data support the rationale for use of agents that may alter and improve the inflammatory environment in the prostate in men with LUTS, but further high-quality long-term studies are required for the exact positioning of the new drugs in daily practice.
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Affiliation(s)
- M Samarinas
- Urology Department Mezourlo, University Hospital of Larissa, Larissa, 41100, Greece
| | - M Gacci
- Department of Urology, University of Florence, Viale Pieraccini 18, Florence, 50139, Italy
| | - A de la Taille
- Department of Urology, Robotic and Miniinvasive Surgery Assistance Publique des Hopitaux de Paris CHU Mondor - Faculté de Médecine, 54 av du Mal de Lattre de Tassigny, Créteil, 94000, France
| | - S Gravas
- Urology Department Mezourlo, University Hospital of Larissa, Larissa, 41100, Greece.
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Park HJ, Park CH, Chang Y, Ryu S. Sitting time, physical activity and the risk of lower urinary tract symptoms: a cohort study. BJU Int 2018; 122:293-299. [PMID: 29557554 DOI: 10.1111/bju.14147] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine the association of sitting time and physical activity level with the incidence of lower urinary tract symptoms (LUTS) in a large sample of Korean men. MATERIALS AND METHODS A cohort study was performed in 69 795 Korean men, free of LUTS at baseline, who were followed up annually or biennially for a mean of 2.6 years. Physical activity level and sitting time were assessed using the validated Korean version of the International Physical Activity Questionnaire Short Form. LUTS were assessed using the International Prostate Symptom Score (IPSS) and clinically significant LUTS were defined as an IPSS score ≥8. RESULTS Over 175 810.4 person-years, 9 217 people developed significant LUTS (incidence rate, 39.0 per 1 000 person-years). In a multivariable-adjusted model, both low physical activity level and prolonged sitting time were independently associated with the incidence of LUTS. The hazard ratios (95% confidence intervals [CIs]) for incident LUTS comparing minimally active and health-enhancing physically active groups vs the inactive group were 0.94 (95% CI 0.89-0.99) and 0.93 (95% CI 0.87-0.99), respectively (P for trend 0.011). The hazard ratios (95% CIs) for LUTS comparing 5-9 and ≥10 h/day sitting time vs <5 h/day were 1.08 (95% CI 1.00-1.24) and 1.15 (95% CI 1.06-1.24), respectively (P for trend <0.001). CONCLUSIONS Prolonged sitting time and low physical activity levels were positively associated with the development of LUTS in a large sample of middle-aged Korean men. This result supports the importance of both reducing sitting time and promoting physical activity for preventing LUTS.
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Affiliation(s)
- Heung Jae Park
- Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chang Hoo Park
- Department of Urology, School of Medicine, Gangneung Asan Hospital, Ulsan University, Gangneung, South Korea
| | - Yoosoo Chang
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Seungho Ryu
- Centre for Cohort Studies, Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
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Alawamlh OAH, Goueli R, Lee RK. Lower Urinary Tract Symptoms, Benign Prostatic Hyperplasia, and Urinary Retention. Med Clin North Am 2018; 102:301-311. [PMID: 29406059 DOI: 10.1016/j.mcna.2017.10.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Lower urinary tract symptoms (LUTS) consist of a common set of urologic symptoms that can affect the elderly. The prevalence of LUTS is expected to rise owing to the continued increase of numbers of the elderly. Although benign prostatic hyperplasia is considered a common cause of LUTS, the broader potential causes of LUTS are myriad. A wide range of diagnostic modalities and treatments are available to manage patients with LUTS and their utilization should not be limited to the urologist.
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Affiliation(s)
- Omar Al Hussein Alawamlh
- Department of Urology, Weill Medical College of Cornell University, James Buchanan Brady Foundation, New York, NY, USA
| | - Ramy Goueli
- Department of Urology, Weill Medical College of Cornell University, James Buchanan Brady Foundation, New York, NY, USA
| | - Richard K Lee
- Department of Urology, Weill Medical College of Cornell University, James Buchanan Brady Foundation, New York, NY, USA.
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Qian X, Xu D, Liu H, Lin X, Yu Y, Kang J, Sheng X, Xu J, Zheng S, Xu D, Qi J. Genetic variants in 5p13.2 and 7q21.1 are associated with treatment for benign prostatic hyperplasia with the α-adrenergic receptor antagonist. Aging Male 2017; 20:250-256. [PMID: 28787260 DOI: 10.1080/13685538.2017.1358261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The etiology of benign prostatic hyperplasia (BPH) has not been well established. The preferred medical treatment for many men with symptomatic benign prostatic hyperplasia is either an α-adrenergic receptor antagonist (α-blocker), or a 5α-reductase inhibitor. Single nucleotide polymorphism (SNP) is a powerful tool for successful implementation of individualized treatment. METHODS Eighteen SNPs associated with drug efficacy in a Chinese population were genotyped in 790 BPH cases (330 aggressive and 460 non-aggressive BPH cases) and 1008 controls. All BPH patients were treated with α-adrenergic blockers for at least 9 months. We tested the associations between tagging single nucleotide polymorphism and BPH risk/aggressiveness, clinical characteristics at baseline, including the International Prostate Symptom Score (IPSS) and total prostate volume, and changes in clinical characteristics after treatment. RESULTS There were nine SNPs associated with BPH risk, clinical progression and therapeutic effect. (1) There were nine tSNPs been chosen in CYP3A4, CYP3A5 and RANBP3L genes. (2) The SNP, rs16902947 in RANBP3L at 5p13.2 (p = .01), was significantly associated with BPH. (3) We found two SNPs, rs16902947 in RANBP3L at 5p13.2 (p = .0388) and rs4646437 in CYP3A4 at 7q21.1 (p = .0325), associated with drug effect. (4) Allele "G" for rs16902947 was found to be risk alleles for BPH risk (OR= 2.357, 95%CI 1.01-1.48). The "A" allele of rs4646437 was associated with lower IPSS at baseline (β= -0.4232, p= .03255). CONCLUSIONS rs16902947, rs16902947 and rs4646437 single nucleotide polymorphisms are significantly associated with the clinical characteristics of benign prostatic hyperplasia and the efficacy of benign prostatic hyperplasia treatment.
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Affiliation(s)
- Xiaoqiang Qian
- a Urology Department , Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
- b Urology Department , Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Ding Xu
- b Urology Department , Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Hailong Liu
- b Urology Department , Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Xiaoling Lin
- c Fudan Institute of Urology , Huashan Hospital, Fudan University , Shanghai , China
| | - Yongjiang Yu
- b Urology Department , Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Jian Kang
- b Urology Department , Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Xujun Sheng
- b Urology Department , Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Jianfeng Xu
- c Fudan Institute of Urology , Huashan Hospital, Fudan University , Shanghai , China
- d Program for Personalized Cancer Care , NorthShore University HealthSystem , Evanston , IL , USA
| | - Siqun Zheng
- d Program for Personalized Cancer Care , NorthShore University HealthSystem , Evanston , IL , USA
| | - Danfeng Xu
- a Urology Department , Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Jun Qi
- b Urology Department , Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
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Strand DW, Costa DN, Francis F, Ricke WA, Roehrborn CG. Targeting phenotypic heterogeneity in benign prostatic hyperplasia. Differentiation 2017; 96:49-61. [PMID: 28800482 DOI: 10.1016/j.diff.2017.07.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 02/07/2023]
Abstract
Benign prostatic hyperplasia and associated lower urinary tract symptoms remain difficult to treat medically, resulting in hundreds of thousands of surgeries performed annually in elderly males. New therapies have not improved clinical outcomes since alpha blockers and 5 alpha reductase inhibitors were introduced in the 1990s. An underappreciated confounder to identifying novel targets is pathological heterogeneity. Individual patients display unique phenotypes, composed of distinct cell types. We have yet to develop a cellular or molecular understanding of these unique phenotypes, which has led to failure in developing targeted therapies for personalized medicine. This review covers the strategic experimental approach to unraveling the cellular pathogenesis of discrete BPH phenotypes and discusses how to incorporate these findings into the clinic to improve outcomes.
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Affiliation(s)
- Douglas W Strand
- Department of Urology, University of Texas Southwestern Medical Center, USA.
| | - Daniel N Costa
- Department of Radiology, University of Texas Southwestern Medical Center, USA
| | - Franto Francis
- Department of Pathology, University of Texas Southwestern Medical Center, USA
| | - William A Ricke
- Department of Urology, University of Wisconsin School of Medicine, USA
| | - Claus G Roehrborn
- Department of Urology, University of Texas Southwestern Medical Center, USA
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Matsumoto S. Effectiveness of physical activity as primary preventive care for lower urinary tract symptoms in elderly people through the " Muscle Enhancing Club". J Phys Ther Sci 2017; 29:1167-1170. [PMID: 28744039 PMCID: PMC5509583 DOI: 10.1589/jpts.29.1167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 04/17/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to examine the relationship between physical activity
(PA) in elderly people as preventive exercise for lower urinary tract symptoms (LUTS) or
overactive bladder (OAB), and how PA in primary preventive care can impact change upon
LUTS. [Subjects and Methods] An interview sheet featuring LUTS domains (IPSS/QOL and OABSS
questionnaire) was distributed to all participants (104 males and 494 females) who
attended the public elderly people’s physical exercise class “Muscle Enhancing
Club 2010” in Asahikawa city. [Results] The interview sheet was collected from
65 males (75.4 ± 5.79 years of age) and 304 females (72.7 ± 5.23 years of age). In all
cases, there was a statistically significant difference of QOL. In 77 LUTS cases, there
was a statistically significant difference in the change of the following LUTS domains:
incomplete bladder emptying, frequency, nocturia, QOL, urgency, and OABSS total score. In
61 OAB cases, there was a statistically significant difference in the change of the
following LUTS domains: QOL, urgency, and OABSS total score. [Conclusion] PA, as a
preventative exercise for elderly people, led to improvements in LUTS, especially storage
symptoms and QOL. Our data show that gross movement and education was beneficial. From the
point of preventive medicine, various exercise classes, organized by the local government
and others, also indicated that these classes increase the possibility of improvement to
LUTS.
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Affiliation(s)
- Seiji Matsumoto
- Clinical Research Support Center, Asahikawa Medical University Hospital, Japan
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Physical activity, body functions and disability among middle-aged and older Spanish adults. BMC Geriatr 2017; 17:150. [PMID: 28720075 PMCID: PMC5516319 DOI: 10.1186/s12877-017-0551-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 07/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA) is a health determinant among middle-aged and older adults. In contrast, poor health is expected to have a negative impact on PA. This study sought to assess to what extent specific International Classification of Functioning, Disability and Health (ICF) health components were associated with PA among older adults. METHODS We used a sample of 864 persons aged ≥50 years, positively screened for disability or cognition in a cross-sectional community survey in Spain. Weekly energy expenditure during PA was measured with the Yale Physical Activity Survey (YPAS) scale. The associations between body function impairment, health conditions or World Health Organization Disability Assessment Schedule (WHODAS 2.0) disability scores and energy expenditure were quantified using negative-binomial regression, and expressed in terms of adjusted mean ratios (aMRs). RESULTS Mean energy expenditure was 4542 Kcal/week. A lower weekly energy expenditure was associated with: severe/extreme impairment of mental functions, aMR 0.38, 95% confidence interval, CI (0.21-0.68), and neuromusculoskeletal and movement functions, aMR 0.50 (0.35-0.72); WHODAS 2.0 disability, aMR 0.55 (0.34-0.91); dementia, aMR 0.45 (0.31-0.66); and heart failure, aMR 0.54 (0.34-0.87). In contrast, people with arthritis/osteoarthritis had a higher energy expenditure, aMR 1.27 (1.07-1.51). CONCLUSION Our results suggest that there is a strong relationship between selected body function impairments, mainly mental, and PA. Although more research is needed to fully understand causal relationships, strategies to improve PA among the elderly may require targeting mental, neuromusculoskeletal and movement functions, disability determinants (including barriers), and specific approaches for persons with dementia or heart failure.
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Ngai HY, Yuen KKS, Ng CM, Cheng CH, Chu SKP. Metabolic syndrome and benign prostatic hyperplasia: An update. Asian J Urol 2017; 4:164-173. [PMID: 29264226 PMCID: PMC5717972 DOI: 10.1016/j.ajur.2017.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/12/2016] [Accepted: 12/15/2016] [Indexed: 01/21/2023] Open
Abstract
Metabolic syndrome (MetS) is a cluster of metabolic abnormalities related to central adiposity and insulin resistance. Its importance is increasingly recognized as it associates with increased risks of metabolic and cardiovascular diseases. These metabolic aberrations of MetS may lead to development of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) in men. A 26.5%-55.6% prevalence of MetS in men with LUTS was reported in worldwide studies. Although the exact biological pathway is not clear yet, insulin resistance, increased visceral adiposity, sex hormone alterations and cellular inflammatory reactions played significant roles in the related pathophysiological processes. Clinician should recognize the cardiovascular and metabolic impacts of MetS in men with LUTS, early risk factors optimization and use of appropriate medical therapy may possibly alter or slower the progression of LUTS/BPH, and potentially avoid unnecessary morbidities and mortalities from cardiovascular and metabolic diseases for those men.
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Affiliation(s)
- Ho-Yin Ngai
- Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Hong Kong, China
| | - Kar-Kei Steffi Yuen
- Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Hong Kong, China
| | - Chi-Man Ng
- Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Hong Kong, China
| | - Cheung-Hing Cheng
- Division of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong, China
| | - Sau-Kwan Peggy Chu
- Division of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong, China
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Peng YH, Huang CW, Liao WC, Chen HJ, Yin MC, Huang YM, Wu TN, Ho WC. Association between chronic obstructive pulmonary disease and increased risk of benign prostatic hyperplasia: a retrospective nationwide cohort study. BMJ Open 2017; 7:e015581. [PMID: 28645971 PMCID: PMC5734354 DOI: 10.1136/bmjopen-2016-015581] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Chronic obstructive pulmonary disease (COPD) and benign prostatic hyperplasia (BPH) are common disorders in ageing male populations. Nevertheless, the relationship between the two diseases has rarely been explored. The objective of this study was to examine whether patients with COPD are at an increased risk of BPH. DESIGN Retrospective nationwide cohort study. SETTING Data retrieved from the Taiwan National Health Insurance Research Database. PARTICIPANTS Overall, 19 959 male patients aged 40 years and over with newly diagnosed COPD between 2000 and 2006 were included as the COPD group, and 19 959 sex-matched and age-matched enrollees without COPD were included as the non-COPD group. Both groups were followed-up until the end of 2011. OUTCOME MEASURES A Cox proportional hazards regression model was used to compute the risk of BPH in patients with COPD compared with enrollees without COPD. RESULTS The overall incidence rate of BPH was 1.53 times higher in the COPD group than that in the non-COPD group (44.7 vs 25.7 per 1000 person-years, 95% CI 1.46 to 1.60) after adjusting for covariates. An additional stratified analysis revealed that this increased risk of BPH in patients with COPD remained significantly higher than that in enrollees without COPD in all men aged 40 years and over. CONCLUSION After adjustment for covariates, male patients with COPD were found to be at a higher risk of BPH. We suggest that clinicians should be cautious about the increased risk of BPH in male patients with COPD.
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Affiliation(s)
- Yi-Hao Peng
- Department of Public Health, China Medical University, Taichung, Taiwan
- Division of Respiratory Therapy, Asia University Hospital, Asia University, Taichung, Taiwan
- Department of Respiratory Therapy, China Medical University, Taichung, Taiwan
| | - Chien-Wen Huang
- Division of Chest Medicine, Department of Internal Medicine, Asia University Hospital, Taichung, Taiwan
- Department of Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Institute of Molecular Biology, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Wei-Chih Liao
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Hsuan-Ju Chen
- College of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Ming-Chien Yin
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Respiratory Therapy, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yu-Ming Huang
- Division of Respiratory Therapy, Asia University Hospital, Asia University, Taichung, Taiwan
| | - Trong-Neng Wu
- Department of Health Care Administration, Asia University, Taichung, Taiwan
| | - Wen-Chao Ho
- Department of Public Health, China Medical University, Taichung, Taiwan
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Fu S, Xu H, Gu M, Liu C, Wang Q, Wan X, Chen Y, Chen Q, Peng Y, Cai Z, Zhou J, Wang Z. Adiponectin deficiency contributes to the development and progression of benign prostatic hyperplasia in obesity. Sci Rep 2017; 7:43771. [PMID: 28256562 PMCID: PMC5335662 DOI: 10.1038/srep43771] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/30/2017] [Indexed: 01/04/2023] Open
Abstract
The incidence of benign prostatic hyperplasia (BPH) is increasing among obese individuals, but few studies have fully explained the underlying mechanisms. We aimed to elucidate the relationship between obesity and BPH. Herein, we show that in prostatic epithelial and stromal cells, adiponectin exerts multifunctional effects including anti-proliferation, blocking of G1/S-phase progression and the promotion of apoptosis via inhibiting the MEK-ERK-p90RSK axis. Furthermore, we found that a high-fat diet (HFD) led to adiponectin deficiency and microscopic BPH in a mouse model of obesity. And an adiponectin supplement protected the obese mice from microscopic BPH. The present study provides evidence that adiponectin is a protective regulator in the development and progression of BPH and that adiponectin deficiency causally links BPH with obesity.
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Affiliation(s)
- Shi Fu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Huan Xu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Meng Gu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Chong Liu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Qiong Wang
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Xiang Wan
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Yanbo Chen
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Qi Chen
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Yubing Peng
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Zhikang Cai
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Juan Zhou
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
| | - Zhong Wang
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai, 200011, China
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Ho Lee S, Kon Lee S. Does Race/Ethnicity Have a Role in a Link Between Lower Urinary Tract Symptoms and Metabolic Syndrome? EUROPEAN MEDICAL JOURNAL 2017. [DOI: 10.33590/emj/10313733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
Metabolic syndrome (MS) is a highly prevalent disease related to the risk of cardiovascular disease and diabetes. A large body of evidence has suggested a link between MS and the components of MS with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) complex. The pathogenesis of MS is complex and not fully understood. Furthermore, recent results from epidemiological studies, including multiple Asian reports, have not been consistent. The risk of BPH is lower in Asian men compared with white men and the prevalence of MS varies by race and ethnicity. An elevated risk of Type 2 diabetes mellitus, hypertension, and dyslipidaemia is closely related to MS and is observed in Asian men even if their body mass index is low. However, the role of race and ethnic disparity in the link between MS and LUTS secondary to BPH is not elucidated. It has been suggested that the pathogenesis of LUTS is multifactorial rather than developing from BPH, which is the traditional concept. Lifestyle and genetic factors may substantially modify the risk of MS and LUTS/BPH. This comprehensive literature review summarises the scientific evidence of the racial/ethnic disparity regarding the association between MS and LUTS/BPH in order to improve current understanding of this controversial issue.
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Affiliation(s)
- Seong Ho Lee
- Department of Urology, School of Medicine, Hallym University, Chuncheon, South Korea
| | - Sang Kon Lee
- Department of Urology, School of Medicine, Hallym University, Chuncheon, South Korea
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Obesity as a Risk Factor for Prostatic Enlargement: A Retrospective Cohort Study in Korea. Int Neurourol J 2016; 20:321-328. [PMID: 28043110 PMCID: PMC5209576 DOI: 10.5213/inj.1632584.292] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 04/25/2016] [Indexed: 01/16/2023] Open
Abstract
PURPOSE We aimed to evaluate obesity, a risk factor of metabolic syndrome, and its association with prostatic enlargement in a retrospective cohort in Korea. METHODS Baseline data were obtained from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population (KoGES-ARIRANG). Between March 2015 and November 2015, 2,127 male participants of KoGES-ARIRANG were invited to the Korean Prostate Health Council Screening Program, and 602 participants underwent urological examination, including serum prostate specific antigen measurement and transrectal ultrasonography, and completed the International Prostate Symptom Score questionnaire. The data for 571 participants were analyzed, after excluding 31 men who had a history of prostatic disease or testosterone replacement, or had undergone a prior prostatic surgery or procedure. RESULTS Among components of metabolic syndrome, waist circumference had a statistically significant linear correlation with incremental increases in prostate volume (B=0.181, P=0.004). Abdominal obesity as determined by anthropometric measures including body mass index (odds ratio [OR], 1.205; 95% confidence interval [CI], 1.088-1.336), waist circumference (OR, 1.073; 95% CI, 1.032-1.115), body fat (OR, 1.126; 95% CI, 1.056-1.202), and visceral fat composition (OR, 1.667; 95% CI, 1.246-2.232) was significantly associated with the presence of high-volume benign prostatic hyperplasia (BPH) (prostate volume≥ 40 mL). Furthermore, the highest quartile of serum leptin (OR, 3.541; 95% CI, 1.103-11.365) and adiponectin levels (OR, 0.315; 95% CI, 0.102-0.971) were significantly correlated with high-volume BPH compared to the lowest quartile of levels. CONCLUSIONS Abdominal obesity and serum leptin level are positively associated with prostate growth, whereas serum adiponectin level is inversely associated with the presence of prostatic enlargement.
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Buncharoen W, Saenphet K, Saenphet S, Thitaram C. Uvaria rufa Blume attenuates benign prostatic hyperplasia via inhibiting 5α-reductase and enhancing antioxidant status. JOURNAL OF ETHNOPHARMACOLOGY 2016; 194:483-494. [PMID: 27732901 DOI: 10.1016/j.jep.2016.10.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/20/2016] [Accepted: 10/09/2016] [Indexed: 06/06/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Traditional medicine has used Uvaria rufa Blume as an ethnomedicinal plant for treating fever, skin allergies, intestinal ulcers and prostate disorders including BPH. However, no scientific evidence supports the traditional use. AIM OF THE STUDY This study aimed to evaluate the therapeutic potential of U. rufa on BPH using in vitro and in vivo models. MATERIALS AND METHODS In vitro studies screened the efficacy of a 5α-reductase (5αR) inhibition and antioxidant activity of petroleum ether, ethyl acetate, ethanol and aqueous extracts from the stem of U. rufa. Phytochemical screening was performed to determine the active compound using high-performance liquid chromatography (HPLC). Ethyl acetate extract (UR-EtOAc) of U. rufa was used to evaluate the therapeutic efficacy in vivo models. BPH was induced by subcutaneous injection of testosterone propionate (3mg/kg) to male rats for 30 days. After 30 days of oral administration of UR-EtOAc at doses of 10 and 20mg/kg and finasteride at a dose of 1mg/kg, the prostate weight, prostate index (PI), testosterone and androgen receptor (AR) levels, and histopathological alteration of prostate gland were determined. Also, oxidative status and toxicity indices were assessed. RESULTS UR-EtOAc exhibited the highest potency of inhibition of 5αR and possessed potent antioxidants rich in phenolics and flavonoids contents. The active compound analyzed by HPLC was β-sitosterol. In vivo results show a significant reduction in prostate weight, PI, and AR in all treated groups when compared to the BPH model group (P<0.001). Also, the UR-EtOAc and finasteride treated groups had increased prostatic and serum testosterone levels when compared to the BPH model group. A histopathological investigation of the prostate glands supported the above results. UR-EtOAc elevated the antioxidant enzymes and reduced the malondialdehyde level in BPH-induced rats. Moreover, treatment of UR-EtOAc at all doses had no toxic effects on the vital organs and serum biochemical indices. CONCLUSIONS UR-EtOAc from the stem of Uvaria rufa Blume appears to have the potential as a phytotherapeutic agent in the management of BPH, which provides the scientific evidence for traditional use.
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Affiliation(s)
- Wararut Buncharoen
- Department of Biology, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand.
| | - Kanokporn Saenphet
- Department of Biology, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand.
| | - Supap Saenphet
- Department of Biology, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand.
| | - Chatchote Thitaram
- Department of Companion Animal and Wildlife Clinical Small Animal Clinic, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
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Liu X, Huang G, Chen P, Li Y, Xiang J, Chen T, Wang R. Comparative effects of Yi Jin Jing versus Tai Chi exercise training on benign prostatic hyperplasia-related outcomes in older adults: study protocol for a randomized controlled trial. Trials 2016; 17:319. [PMID: 27422168 PMCID: PMC4947249 DOI: 10.1186/s13063-016-1448-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 06/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) and its associated lower urinary tract symptoms (LUTS) occur very commonly in older men. BPH and LUTS cause substantial physical and psychological impairment that could seriously affect the quality of late life and greatly cost the health-care systems. Current surgical and pharmacological therapies are expensive, may not effectively improve prostate function and health but cause adverse effects. There is an urgent need to find new and effective non-pharmacological preventions and treatments. Yi Jin Jing and Tai Chi are two common traditional Chinese mind-body exercises with different movements and techniques, but both emphasize regulating functional homeostasis and keeping whole body harmony. Yi Jin Jing and Tai Chi have not been studied much for potentially use in the treatment of BPH-related problems. The primary purpose of this protocol is to assess the effectiveness of Yi Jin Jing versus Tai Chi on the monographic and functional changes of prostate in older men. METHODS/DESIGN A prospective single-center randomized controlled trial will be conducted. A total of 150 old men (60-70 years old) will be recruited from the urban tertiary of Shanghai, China. Of these, 50 eligible participants will be randomly assigned to a control group and two intervention groups with either Yi Jin Jing or Tai Chi exercise training. They will undergo 30 minutes for each exercise for five times a week for 6 months. The primary outcomes are changes of signs and symptoms in BPH and lower urinary tract from baseline to post-intervention. The main secondary outcomes are exercise-induced effects on the circulating levels of estrogen and androgen. All the outcome measures will be assessed at baseline, immediately after the 6-month intervention, and at the 3-month post-intervention follow-up. DISCUSSION This proposed study will be the first comparative randomized clinical trial to evaluate the effectiveness of Yi Jin Jing versus Tai Chi exercise on prostate health among older adults. The results will provide an evidence-based recommendation for Chinese older men on the use of Yi Jin Jing and Tai Chi training to promote prostatic function and health. Potential mechanisms for the regulatory effect of the two exercises elucidated by multiple outcomes are also explored. A clarification of the effects and mechanisms may provide information for the development of new strategies in the prevention and treatment of BPH-related conditions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: ChiCTR-IOR-16007698 . This trial was registered on 4 January 2016.
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Affiliation(s)
- XiangYun Liu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education at the Shanghai University of Sport, 188 Hengren Road, Shanghai, 200438, China
| | - Guoyuan Huang
- Pott College of Science, Engineering & Education, University of Southern Indiana, Evansville, USA
| | - Peijie Chen
- Key Laboratory of Exercise and Health Sciences of Ministry of Education at the Shanghai University of Sport, 188 Hengren Road, Shanghai, 200438, China
| | - Yong Li
- FuDan University, 130 Dongan Road, Shanghai, 200032, China
| | - JiuLin Xiang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education at the Shanghai University of Sport, 188 Hengren Road, Shanghai, 200438, China
| | - Ting Chen
- Key Laboratory of Exercise and Health Sciences of Ministry of Education at the Shanghai University of Sport, 188 Hengren Road, Shanghai, 200438, China
| | - Ru Wang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education at the Shanghai University of Sport, 188 Hengren Road, Shanghai, 200438, China.
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Association of Functional Ability and Benign Prostatic Hyperplasia With Urinary Incontinence in Older Korean Men. Int Neurourol J 2016; 20:137-42. [PMID: 27377946 PMCID: PMC4932637 DOI: 10.5213/inj.1630432.216] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 10/22/2015] [Indexed: 11/23/2022] Open
Abstract
Purpose: The purpose of this study was to determine the prevalence of urinary incontinence (UI) and analyze its association with instrumental activities of daily living (IADL) and benign prostatic hyperplasia (BPH) in community-dwelling older men in Korea. Methods: This study was a secondary analysis of data from the Actual Living Condition of the Elderly and Welfare Need Survey conducted in the year 2008. Data was subjected to hierarchical logistic regression analysis to examine the association of IADL and BPH with UI in older men, entering IADL and BPH in model 1, and age, body mass index (BMI) and education in model 2, and then comorbidities and walking speed in model 3. Results: Of 6,185 men, 243 (3.9%) had self-reported UI. The prevalence of UI was 1.8% in men aged 60–64 years and 11.7% in those aged 85 years and above, indicating an increase in the prevalence of UI with their age. IADL and BPH remained the only significant factors associated with UI in model 1 (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.44–1.64 and OR, 2.73; 95% CI, 1.47–5.10, respectively), model 2 (OR, 1.50; 95% CI, 1.40–1.61 and OR, 2.68; 95% CI, 1.42–5.07), and model 3 (OR, 1.43; 95% CI, 1.32–1.54 and OR, 2.58; 95% CI, 1.36–4.90). Conclusions: IADL limitations and presence of BPH were associated with UI in older men after controlling for BMI, education, comorbidities, and walking speed. Thus, UI should be assessed in older Korean men with IADL decline and BPH. Gender-sensitive interventions to attenuate IADL limitations and manage BPH should be developed and applied to improve UI in older men.
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Aoun F, Chemaly AK, Albisinni S, Zanaty M, Roumeguere T. In Search for a Common Pathway for Health Issues in Men - the Sign of a Holmesian Deduction. Asian Pac J Cancer Prev 2016; 17:1-13. [DOI: 10.7314/apjcp.2016.17.1.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Silva V, Grande AJ, Stanton KR, Peccin MS. Physical activity for lower urinary tract symptoms secondary to benign prostatic obstruction. Hippokratia 2016. [DOI: 10.1002/14651858.cd012044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Valter Silva
- Universidade Federal de São Paulo; Department of Human Movement Sciences; Santos Brazil
| | - Antonio Jose Grande
- Universidade do Extremo Sul Catarinense; Laboratory of Evidence-Based Practice; Av. Universitária, 1105 Predio S, LABEPI Criciuma Santa Catarina Brazil 88806-000
| | | | - Maria S Peccin
- Universidade Federal de São Paulo; Department of Human Movement Sciences; Santos Brazil
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Vignozzi L, Gacci M, Maggi M. Lower urinary tract symptoms, benign prostatic hyperplasia and metabolic syndrome. Nat Rev Urol 2016; 13:108-19. [PMID: 26754190 DOI: 10.1038/nrurol.2015.301] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Epidemiological studies have shown that age is the principal unmodifiable risk factor of lower urinary tract symptoms (LUTS). Until the past decade, the process of lower urinary tract ageing was, therefore, considered unmodifiable - as ageing per se. However, the traditional dogma that BPH-related LUTS (BPH-LUTS) is an immutable consequence of old age is no longer acceptable. Results from multiple preclinical and clinical studies indicate that several modifiable, age-related metabolic aberrations (metabolic syndrome, obesity, dyslipidaemia, diabetes) are important determinants in both the development and the progression of BPH-LUTS. Metabolic syndrome and its related comorbidities, such as sex steroid alterations and low-grade inflammation, have been related to BPH-LUTS development and progression. With the correct treatment and recommended lifestyle changes, many individuals with metabolic syndrome might be able to prevent or delay the onset of metabolic-syndrome-related complications; however, whether promoting healthier lifestyles can really alter a man's propensity to develop BPH-LUTS remains to be clarified.
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Affiliation(s)
- Linda Vignozzi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - Mauro Gacci
- Urology Department, Careggi Hospital, Largo Brambilla, 50134 Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
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Alcohol, Smoking, Physical Activity, Protein, and Lower Urinary Tract Symptoms: Prospective Longitudinal Cohort. Int Neurourol J 2015; 19:197-206. [PMID: 26620903 PMCID: PMC4582093 DOI: 10.5213/inj.2015.19.3.197] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 08/06/2015] [Indexed: 11/28/2022] Open
Abstract
Purpose: To evaluate risk factors for deterioration of lower urinary tract symptoms (LUTS) in elderly men in a community-based, prospective longitudinal cohort study. Methods: In a suburban area in Korea, 1,514 subjects aged ≥45 years were randomly selected by systematic sampling. A total of 918 elderly subjects were enrolled in this in-depth clinical study in 2004. Of these, 547 participants were followed up for 3 years and the data was analyzed in 2014. Standard questionnaires were administered face-to-face by trained interviewers. After excluding women, 224 male participants with complete data including transrectal ultrasonography were included in the final analysis. LUTS were diagnosed using the International Prostate Symptom Score (IPSS) questionnaire. Symptom deterioration was defined as a score of ≥8 points during the 3-year follow-up period. Results: LUTS prevalence increased to 13.1% and the mean IPSS increased by 2.6 points during the 3-year period. After adjusting for confounders, a smoking history of ≥50 pack-years was an independent risk factor for deterioration of LUTS and storage subsymptoms compared with no history of smoking (3.1 and 5.1 odds, respectively). Physical activity had a protective effect on voiding subsymptoms. However, high protein diet and alcohol intake were not associated with LUTS deterioration. Conclusions: The LUTS prevalence among elderly men living in a suburban area increased to 13.1% and the IPSS increased by 2.6 points during the 3-year period. A history of heavy smoking, low physical activity, and high protein intake were associated with LUTS deterioration. However, there was no significant association between alcohol intake and LUTS deterioration.
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The prevalence of benign prostatic hyperplasia in mainland China: evidence from epidemiological surveys. Sci Rep 2015; 5:13546. [PMID: 26306721 PMCID: PMC4549711 DOI: 10.1038/srep13546] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 07/30/2015] [Indexed: 02/06/2023] Open
Abstract
The epidemiological characteristics of benign prostate hyperplasia (BPH) in mainland China are not completely understood. We performed this meta-analysis to assess the prevalence of BPH from 1989 through 2014. A total of 14 articles and 19 datasets were included. The pooled overall prevalence of BPH among men aged 40 years and older was 36.6% [95% CI, 32.3–44.8]. The occurrence rate of BPH in the age groups 40–49 years, 50–59 years, 60–69 years, 70–79 years and 80 years and older was 2.9%, 29.0%, 44.7%, 58.1% and 69.2%, respectively. The pooled occurrence rate of BPH was 41.5% [95% CI, 34.5–48.4] in urban areas and 38.6% [95% CI, 22.7–54.6] in rural areas; this difference in prevalence was not statistically significant [OR, 1.51; 95% CI, 0.97–2.36]. BPH is highly prevalent in mainland China, and its prevalence increased with age. The trend in the prevalence of BPH in mainland China was not steady; the prevalence map based on a geographic information system (GIS) showed an unequal geographic distribution. High-quality surveys on BPH with a larger sample size are needed throughout mainland China to confirm these findings.
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Abstract
PURPOSE OF REVIEW The primary purpose of this review is to provide an overview of the current evidence linking lifestyle factors and lower urinary tract symptoms (LUTS), and their relevance in men. An extensive literature search from January 2013 to August 2014 was conducted, reviewed, and summarized in conjunction with key prior evidence. RECENT FINDINGS The main findings from this review include 1) epidemiological data repeatedly show a favorable relationship between a healthy eating habits and regular physical activity level and a lower risk for LUTS or progression of LUTS, 2) certain specific nutrients or dietary factors may contribute to the link between diet and LUTS because of their anti-inflammatory potential, and 3) very little research has been conducted to test the epidemiological findings in randomized controlled trials. SUMMARY Rigorously designed clinical trials are needed to confirm the association between lifestyle factors and LUTS and the effect of lifestyle modification on the development or progression of LUTS. Nevertheless, a healthy lifestyle is known to closely relate with chronic diseases such as cardiovascular disease and diabetes. Thus, promoting a healthy lifestyle with good quality diet and regular physical activity is beneficial not only for potentially improving or reducing LUTS but also for cardiovascular and overall health. Clinicians are encouraged to include healthy lifestyle counseling in their routine care for patients with LUTS.
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Giri A, Edwards TL, Motley SS, Byerly SH, Fowke JH. Genetic Determinants of Metabolism and Benign Prostate Enlargement: Associations with Prostate Volume. PLoS One 2015; 10:e0132028. [PMID: 26158673 PMCID: PMC4497718 DOI: 10.1371/journal.pone.0132028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 06/09/2015] [Indexed: 11/18/2022] Open
Abstract
Prostate enlargement leading to clinical benign prostatic hyperplasia (BPH) is associated with metabolic dysregulation and obesity. The genetic basis of this association is unclear. Our objective was to evaluate whether single nucleotide polymorphisms (SNPs) previously associated with metabolic disorders are also associated with prostate volume (PV). Participants included 876 men referred for prostate biopsy and found to be prostate cancer free. PV was measured by transrectal ultrasound. Samples were genotyped using the Illumina Cardio-MetaboChip platform. Multivariable adjusted linear regression models were used to evaluate SNPs (additive coding) in relation to natural-log transformed (log) PV. We compared SNP-PV results from biopsy-negative men to 442 men with low-grade prostate cancer with similar levels of obesity and PV. Beta-coefficients from the discovery and replication samples were then aggregated with fixed effects inverse variance weighted meta-analysis. SNP rs11736129 (near the pseudo-gene LOC100131429) was significantly associated with log-PV (beta: 0.16, p-value 1.16x10-8) after adjusting for multiple testing. Other noteworthy SNPs that were nominally associated (p-value < 1x10-4) with log-PV included rs9583484 (intronic SNP in COL4A2), rs10146527 (intronic SNP in NRXN3), rs9909466 (SNP near RPL32P31), and rs2241606 (synonymous SNP in SLC12A7). We found several SNPs in metabolic loci associated with PV. Further studies are needed to confirm our results and elucidate the mechanism between these genetic loci, PV, and clinical BPH.
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Affiliation(s)
- Ayush Giri
- Institute for Medicine and Public Health, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Todd L. Edwards
- Institute for Medicine and Public Health, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, United States of America
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, United States of America
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Saundra S. Motley
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Susan H. Byerly
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Jay H. Fowke
- Institute for Medicine and Public Health, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, TN, United States of America
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
- Department of Surgical Urology, Vanderbilt University Medical Center, Nashville, TN, United States of America
- * E-mail:
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De Nunzio C, Presicce F, Lombardo R, Cancrini F, Petta S, Trucchi A, Gacci M, Cindolo L, Tubaro A. Physical activity as a risk factor for prostate cancer diagnosis: a prospective biopsy cohort analysis. BJU Int 2015; 117:E29-35. [PMID: 25908534 DOI: 10.1111/bju.13157] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the association between physical activity, evaluated by the Physical Activity Scale for the Elderly (PASE) questionnaire, and prostate cancer risk in a consecutive series of men undergoing prostate biopsy. PATIENTS AND METHOD From 2011 onwards, consecutive men undergoing 12-core prostate biopsy were enrolled into a prospective database. Indications for a prostatic biopsy were a prostate-specific antigen (PSA) value of ≥4 ng/mL and/or a positive digital rectal examination. Body mass index (BMI) and waist circumferences were measured before the biopsy. Fasting blood samples were collected before biopsy and tested for: total PSA, glucose, high-density lipoprotein cholesterol, and trygliceride levels. Blood pressure was recorded. Metabolic syndrome (MetS) was defined according to the Adult Treatment panel III. The PASE questionnaire was completed before the biopsy. RESULTS In all, 286 patients were enrolled with a median (interquartile range, IQR) age and PSA level of 68 (62-74) years and 6.1 (5-8.8) ng/mL, respectively. The median (IQR) BMI was 26.4 (24.6-29) kg/m(2) and waist circumference was 102 (97-108) cm, with 75 patients (26%) presenting with MetS. In all, 106 patients (37%) had prostate cancer at biopsy. Patients with prostate cancer had higher PSA levels (median [IQR] 6.7 [5-10] vs 5.6 [4.8-8] ng/mL; P = 0.007) and lower LogPASE scores (median [IQR] 2.03 [1.82-2.18] vs 2.10 [1.92-2.29]; P = 0.005). On multivariate analysis, in addition to well-recognised risk factors such as age, PSA level and prostate volume, LogPASE score was an independent risk factor for prostate cancer diagnosis (odds ratio [OR] 0.146, 95% confidence interval [CI] 0.037-0.577; P = 0.006]. LogPASE score was also an independent predictor of high-grade cancer (OR 0.07, 95% CI 0.006-0.764; P = 0.029). CONCLUSION In our single-centre study, increased physical activity, evaluated by the PASE questionnaire, is associated with a reduced risk of prostate cancer and of high-grade prostate cancer at biopsy. Further studies should clarify the molecular pathways behind this association.
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Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Sant' Andrea Hospital, 'La Sapienza' University of Rome, Rome, Italy
| | - Fabrizio Presicce
- Department of Urology, Sant' Andrea Hospital, 'La Sapienza' University of Rome, Rome, Italy
| | - Riccardo Lombardo
- Department of Urology, Sant' Andrea Hospital, 'La Sapienza' University of Rome, Rome, Italy
| | - Fabiana Cancrini
- Department of Urology, Sant' Andrea Hospital, 'La Sapienza' University of Rome, Rome, Italy
| | - Stefano Petta
- Department of Urology, Sant' Andrea Hospital, 'La Sapienza' University of Rome, Rome, Italy
| | - Alberto Trucchi
- Department of Urology, Sant' Andrea Hospital, 'La Sapienza' University of Rome, Rome, Italy
| | - Mauro Gacci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Luca Cindolo
- Department of Urology, Padre Pio Hospital, Vasto, Italy
| | - Andrea Tubaro
- Department of Urology, Sant' Andrea Hospital, 'La Sapienza' University of Rome, Rome, Italy
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The prevalence of physical activity and its socioeconomic correlates in Kingdom of Saudi Arabia: A cross-sectional population-based national survey. J Taibah Univ Med Sci 2015. [DOI: 10.1016/j.jtumed.2014.11.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Trumble BC, Stieglitz J, Eid Rodriguez D, Cortez Linares E, Kaplan HS, Gurven MD. Challenging the Inevitability of Prostate Enlargement: Low Levels of Benign Prostatic Hyperplasia Among Tsimane Forager-Horticulturalists. J Gerontol A Biol Sci Med Sci 2015; 70:1262-8. [PMID: 25922348 DOI: 10.1093/gerona/glv051] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 04/02/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Often considered an inevitable part of male aging, benign prostatic hyperplasia (BPH) is the most common non-life threatening disease to affect men in Western populations. We examine age-related change in prostate size and BPH risk and related serum biomarkers among the Tsimane Amerindians of the Bolivian Amazon who live a traditional lifestyle of hunting and small-scale horticulture. The Tsimane are a critical case study for understanding the etiology of BPH as they have low levels of obesity and metabolic syndrome, as well as lower levels of testosterone than age matched U.S. males, factors associated with BPH in previous research. METHODS Ultrasounds were conducted on 348 men aged 28-89 years (median age 56 years). Testosterone, prostate specific antigen, sex hormone binding globulin, and glycosylated hemoglobin were examined in relationship to prostate size and BPH. RESULTS Tsimane have less than half of the BPH prevalence experienced by U.S. men, and prostate volumes 62.6% smaller. While Tsimane have low levels of testosterone and subclinical levels of metabolic syndrome compared to U.S. men, Tsimane with high testosterone were more likely to experience BPH, as were those with higher glycosylated hemoglobin, suggesting targets for clinical interventions to reduce BPH. CONCLUSIONS These results have clinical significance for the growing number of men taking testosterone supplementation; even at low levels the additional testosterone exposure could be placing these men at higher risk of BPH. Overall, these data suggest that BPH may not have been an inevitable part of male aging throughout human evolutionary history.
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Affiliation(s)
| | - Jonathan Stieglitz
- Department of Anthropology, University of New Mexico, Albuquerque. Institute for Advanced Study in Toulouse, France
| | | | | | - Hillard S Kaplan
- Department of Anthropology, University of New Mexico, Albuquerque
| | - Michael D Gurven
- Department of Anthropology, University of California Santa Barbara
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Chu KF, Rotker K, Ellsworth P. The Impact of Obesity on Benign and Malignant Urologic Conditions. Postgrad Med 2015; 125:53-69. [DOI: 10.3810/pgm.2013.07.2679] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Wolin KY, Grubb RL, Pakpahan R, Ragard L, Mabie J, Andriole GL, Sutcliffe S. Physical activity and benign prostatic hyperplasia-related outcomes and nocturia. Med Sci Sports Exerc 2015; 47:581-92. [PMID: 25010403 PMCID: PMC4342314 DOI: 10.1249/mss.0000000000000444] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Benign prostatic hyperplasia (BPH) and its associated lower urinary tract symptoms (LUTS), including nocturia, are extremely common among middle- and older-age American men. Although studies on physical activity (PA) and prevalent BPH-related outcomes suggest that PA may protect against the development of this common condition, only a few studies have examined the relation between PA and incident BPH-related outcomes and LUTS with mixed findings. In addition, although nocturia is the most commonly reported and most bothersome LUTS in men with or without evidence of BPH, few studies have examined the association of PA and nocturia independent of BPH. The purpose of this analysis was to examine the association of PA with BPH-related outcomes and nocturia in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial. METHODS We examined this association with both prevalent (n = 28,404) and incident (n = 4710) BPH-related outcomes (measured by self-report of physician diagnosis, BPH surgery, finasteride use, and clinical indicators) and nocturia. Poisson regression with robust variance was used to calculate prevalence ratios and relative risks. RESULTS PA was weakly positively associated with several prevalent BPH-related outcomes and was strongly inversely associated with prevalent nocturia. In incident analyses, PA was only associated with nocturia. Men who were active ≥1 h·wk(-1) were 13% less likely (95% confidence interval, 2%-22%) to report nocturia and 34% less likely (95% confidence interval, 15%-49%) to report severe nocturia as compared with men who reported no PA. The associations were similar for men with and without additional BPH-related outcomes, except for prevalent nocturia, where the association was stronger for men without other BPH-related outcomes. CONCLUSIONS Combined with other management strategies, PA may provide a strategy for the management of BPH-related outcomes, particularly nocturia.
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Affiliation(s)
- Kathleen Y Wolin
- 1Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL; 2Department of Surgery and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO; 3Westat, Rockville, MD; and 4Information Management Services, Inc., Rockville, MD
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Pashootan P, Ploussard G, Cocaul A, de Gouvello A, Desgrandchamps F. Association between metabolic syndrome and severity of lower urinary tract symptoms (LUTS): an observational study in a 4666 European men cohort. BJU Int 2014; 116:124-30. [DOI: 10.1111/bju.12931] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
| | | | - Arnaud Cocaul
- Endocrinology and Metabolism Department; Pitié-Salpêtrière Hospital; APHP; Paris France
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TIAN Y, GUAN Y, WEN J, SHANG X, LI J, WANG Y. Survey and Risk Factors for Lower Urinary Tract Storage Symptoms in Middle-Aged and Older Stroke Patients in Urban China. Low Urin Tract Symptoms 2014; 8:91-9. [PMID: 27111620 DOI: 10.1111/luts.12078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 07/21/2014] [Accepted: 08/06/2014] [Indexed: 12/28/2022]
Affiliation(s)
- Yudong TIAN
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Yanbin GUAN
- School of Medicine, The Henan University of Traditional Chinese Medicine; Zhengzhou China
| | - Jianguo WEN
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Xiaoping SHANG
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Jinsheng LI
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Yan WANG
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
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Relationship between lifestyle and health factors and severe lower urinary tract symptoms (LUTS) in 106,435 middle-aged and older Australian men: population-based study. PLoS One 2014; 9:e109278. [PMID: 25333345 PMCID: PMC4198085 DOI: 10.1371/journal.pone.0109278] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 08/29/2014] [Indexed: 11/19/2022] Open
Abstract
Background Despite growing interest in prevention of lower urinary tract symptoms (LUTS) through better understanding of modifiable risk factors, large-scale population-based evidence is limited. Objective To describe risk factors associated with severe LUTS in the 45 and Up Study, a large cohort study. Design, Setting, and Participants A cross-sectional analysis of questionnaire data from 106,435 men aged ≥45 years, living in New South Wales, Australia. Outcome Measures and Statistical Analysis LUTS were measured by a modified version of the International Prostate Symptom Score (m-IPSS). The strength of association between severe LUTS and socio-demographic, lifestyle and health-related factors was estimated, using logistic regression to calculate odds ratios, adjusted for a range of confounding factors. Results Overall, 18.3% reported moderate, and 3.6% severe, LUTS. Severe LUTS were more common among men reporting previous prostate cancer (7.6%), total prostatectomy (4.9%) or having part of the prostate removed (8.2%). After excluding men with prostate cancer or prostate surgery, the prevalence of moderate-severe LUTS in the cohort (n = 95,089) ranged from 10.6% to 35.4% for ages 45–49 to ≥80; the age-related increase was steeper for storage than voiding symptoms. The adjusted odds of severe LUTS decreased with increasing education (tertiary qualification versus no school certificate, odds ratio (OR = 0.78 (0.68–0.89))) and increasing physical activity (high versus low, OR = 0.83 (0.76–0.91)). Odds were elevated among current smokers versus never-smokers (OR = 1.64 (1.43–1.88)), obese versus healthy-weight men (OR = 1.27 (1.14–1.41)) and for comorbid conditions (e.g., heart disease versus no heart disease, OR = 1.36 (1.24–1.49)), and particularly for severe versus no physical functional limitation (OR = 5.17 (4.51–5.93)). Conclusions LUTS was associated with a number of factors, including modifiable risk factors, suggesting potential targets for prevention.
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The study about physical activity for subjects with prevention of benign prostate hyperplasia. Int Neurourol J 2014; 18:155-62. [PMID: 25279244 PMCID: PMC4180167 DOI: 10.5213/inj.2014.18.3.155] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 08/31/2014] [Indexed: 11/19/2022] Open
Abstract
Purpose The number of benign prostatic hyperplasia (BPH) subjects has been increasing worldwide, and many studies have been conducted to determine the treatment that can delay drug therapy or surgery. Subsequently, most of these studies involved physical activity (PA) and associated factors. Therefore, we aimed to determine factors associated with BPH prevalence based on a review of past and present studies and to investigate the effect of a healthy lifestyle as a protective factor of BPH occurrence. Methods We selected 582 subjects aged ≥40 years from an initial 779 subjects recruited from Gyeonggi, Yangpyeong, South Korea, during August 2009 to August 2011. Trained investigators surveyed International Prostate Symptom Score and demographic information, including PA and lifestyle questionnaire during face-to-face interviews; further, they performed digital rectal examination, rectal ultrasonography, and measured prostate-specific antigen levels. The statistical association between PA and BPH was analyzed by logistic regression analysis using multivariable regression models which use categorical variables by the Cochran-Mantel-Haenszel test and continuous variables by the general linear model. Results Seven statistically significant variables for PA were selected. Regular exercise, frequency of exercise, sedentary time, nonsedentary time, leisure time PA (metabolic equivalent, hr/wk) were not statistically associated with prostate volume but sedentary time (hr/day) was the only factor that showed a significant association in the multivariable model, including a linear effect relationship. Subjects with lower levels of sedentary time (4.5-7.0 hr/day) had a significantly lower risk of BPH (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.52-1.67) than those with a higher sedentary time (>7 hr/day) (OR, 1.72; 95% CI, 0.96-3.09) (P for trend=0.05). Conclusions Our study showed that reducing sedentary time could have a protective effect and reduce the prevalence of BPH. Further prospective studies with a larger sample size are needed to assess the impact of reducing sedentary time on BPH risk.
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