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Noronha NY, Noma IHY, Fernandes Ferreira R, Rodrigues GDS, Martins LDS, Watanabe LM, Pinhel MADS, Mello Schineider I, Diani LM, Carlos D, Nonino CB. Association between the relative abundance of phyla actinobacteria, vitamin C consumption, and DNA methylation of genes linked to immune response pathways. Front Nutr 2024; 11:1373499. [PMID: 38638293 PMCID: PMC11024951 DOI: 10.3389/fnut.2024.1373499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction There is an emerging body of evidence that vitamin C consumption can modulate microbiota abundance and can also impact DNA methylation in the host, and this could be a link between diet, microbiota, and immune response. The objective of this study was to evaluate common CpG sites associated with both vitamin C and microbiota phyla abundance. Methods Six healthy women participated in this cohort study. They were divided into two groups, according to the amount of vitamin C they ingested. Ingestion was evaluated using the 24-h recall method. The Illumina 450 k BeadChip was used to evaluate DNA methylation. Singular value decomposition analyses were used to evaluate the principal components of this dataset. Associations were evaluated using the differentially methylated position function from the Champ package for R Studio. Results and discussion The group with higher vitamin C (HVC) ingestion also had a higher relative abundance of Actinobacteria. There was a positive correlation between those variables (r = 0.84, p = 0.01). The HVC group also had higher granulocytes, and regarding DNA methylation, there were 207 CpG sites commonly related to vitamin C ingestion and the relative abundance of Actinobacteria. From these sites, there were 13 sites hypomethylated and 103 hypermethylated. The hypomethylated targets involved the respective processes: immune function, glucose homeostasis, and general cellular metabolism. The hypermethylated sites were also enriched in immune function-related processes, and interestingly, more immune responses against pathogens were detected. These findings contribute to understanding the interaction between nutrients, microbiota, DNA methylation, and the immune response.
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Affiliation(s)
- Natália Yumi Noronha
- Department of Gynecology and Obstetrics, University Medical Center Groningen, Groningen, Netherlands
- Faculty of Medicine of Ribeirão Preto, Department of Internal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Isabella Harumi Yonehara Noma
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Rafael Fernandes Ferreira
- Department of Molecular Biology, Sao Jose do Rio Preto Medical School, São José do Rio Preto, Brazil
| | - Guilherme da Silva Rodrigues
- Faculty of Medicine of Ribeirão Preto, Department of Internal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Luzania dos Santos Martins
- Faculty of Medicine of Ribeirão Preto, Department of Internal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Lígia Moriguchi Watanabe
- Faculty of Medicine of Ribeirao Preto, Department of Health Sciences, University of São Paulo, Ribeirão Preto, Brazil
| | - Marcela Augusta de Souza Pinhel
- Faculty of Medicine of Ribeirão Preto, Department of Internal Medicine, University of São Paulo, Ribeirão Preto, Brazil
- Department of Molecular Biology, Sao Jose do Rio Preto Medical School, São José do Rio Preto, Brazil
| | - Isabelle Mello Schineider
- Faculty of Medicine of Ribeirão Preto, Department of Internal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Luísa Maria Diani
- Faculty of Medicine of Ribeirão Preto, Department of Internal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniela Carlos
- Faculty of Medicine of Ribeirão Preto, Department of Biochemistry and Immunology, University of São Paulo, Ribeirão Preto, Brazil
| | - Carla Barbosa Nonino
- Faculty of Medicine of Ribeirao Preto, Department of Health Sciences, University of São Paulo, Ribeirão Preto, Brazil
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Moyad MA. Embracing the Pros and Cons of the New Weight Loss Medications (Semaglutide, Tirzepatide, Etc.). Curr Urol Rep 2023; 24:515-525. [PMID: 37659049 DOI: 10.1007/s11934-023-01180-7] [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] [Accepted: 08/16/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE OF REVIEW The history of multiple weight loss medications has been a concerning paradox based on an increased cardiovascular risk despite significant reductions in adipose tissue and weight. A new class of weight loss medications could change this past narrative based on early preliminary results of cardiovascular risk (not events-still need to be determined) and weight reduction in non-diabetics that acutely competes with results achieved with bariatric surgery. The purpose of this review is to provide a comprehensive summary of the advantages and disadvantages of these newer medications, and how they could impact urology. RECENT FINDINGS Weight loss of - 15 to - 20% compared to baseline has become plausible in the short-term and preliminary guidance to reduce acute and chronic adverse events are receiving attention. However, the cost, access, conflicts of interest, supply chain, life-long adherence issues, and the long-term diverse implications on mental and physical health when exposed to this class of medications (GLP-1 agonists) are unknown. The profound caloric reductions should also result in baseline or ongoing nutritional deficiency testing, and general and specific dietary recommendations, which could theoretically mimic some bariatric surgery pre- and post-surgical protocols but has yet to be studied. Regardless, the potential impact of these medicines within a variety of medical specialties needs clinical research. Current and future lifestyle interventions, dietary patterns, and medicines in the weight loss category need to be held to a paradigm whereby cardiovascular health should improve with significant weight loss without a negative impact on mental health. In urology, the ability to impact cancer risk, ED, FSD, incontinence, infertility, nephrolithiasis, and multiple other endpoints are plausible (based on bariatric surgery data) but need preliminary clinical research. Other medicines with a similar or even larger potential impact are in clinical trials, and thus, a concise overview for clinicians and researchers was needed for objective guidance. Currently, comprehensive lifestyle changes utilized with and without these medications continue to garner positive mental, physical, and legacy effects, which suggest that they are as necessary as ever in the treatment of the numerous conditions impacted by unhealthy weight gain.
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Affiliation(s)
- Mark A Moyad
- Department of Urology, University of Michigan Medical Center, Ann Arbor, MI, USA.
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Nosrati F, Nikoobakht MR, Oskouie IM, Rahimdoost N, Inanloo H, Abolhassani M, Mousavi SH, Nazarpour MJ, Dialameh H. Does Significant Weight Loss After Bariatric Surgery Affect Sexual Function and Urinary Symptoms? An Iranian Study. Obes Surg 2023; 33:2509-2516. [PMID: 37402120 DOI: 10.1007/s11695-023-06717-w] [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: 03/21/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION For sexual dysfunction and lower urinary tract symptoms (LUTS), obesity is identified as an independent risk factor. The current study aimed to evaluate the effect of significant rapid weight loss by bariatric surgery on LUTS and sexual function among men and women with class III obesity. METHOD A group of patients who were planned to undergo bariatric surgery was enrolled in the study. Male patients were given the International Index of Erectile Function (IIEF) and the International Prostate Symptom Score (IPSS) questionnaires. In the female group, they filled in the female sexual function index (FSFI) and the International Consultation on Incontinence Questionnaire short form (ICIQ-SF) questionnaires. Patients were followed up 1 year after their bariatric surgery. RESULTS All questionnaires were completed by eighty-one patients. (mean age ± SD: 39.4 ± 9.2 years; mean body mass index (BMI) ± SD: 47.15 ± 5.4 kg/m2). The total score of the IPSS questionnaire decreased from 5.83 ± 3.01 preoperatively to 2.37 ± 1.66 postoperatively. The weight loss caused significant improvement in the storage phase of LUTS domains, but there were no considerable changes in the voiding phase. In the IIEF questionnaire, domains of sexual desire, overall satisfaction, and orgasmic function improved significantly. There was not a significant change in any FSFI domains after bariatric surgery. Mean ICIQ-SF decreased, but it was not substantial. CONCLUSION Bariatric surgery can significantly improve the storage phase in men, but not the voiding phase. Sexual desire, orgasmic function, and overall satisfaction were significantly improved in men. No significant improvement in sexual function and UI in women was observed.
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Affiliation(s)
- Farnoud Nosrati
- Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Hassan Inanloo
- Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Abolhassani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Hossein Dialameh
- Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Moyad MA. Nutraceuticals and Phytotherapy in Men's Health: Antioxidants, Pro-oxidants, and a Novel Opportunity for Lifestyle Changes. Urol Clin North Am 2022; 49:239-248. [DOI: 10.1016/j.ucl.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rivera-Izquierdo M, Pérez de Rojas J, Martínez-Ruiz V, Arrabal-Polo MÁ, Pérez-Gómez B, Jiménez-Moleón JJ. Obesity and biochemical recurrence in clinically localised prostate cancer: a systematic review and meta-analysis of 86,490 patients. Prostate Cancer Prostatic Dis 2022; 25:411-421. [PMID: 34987170 DOI: 10.1038/s41391-021-00481-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/15/2021] [Accepted: 11/25/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The association of obesity with biochemical recurrence (BCR) after treatment of clinically localised prostate cancer (PC) shows inconsistent results. Our aim was to systematically review all evidence evaluating obesity as a prognostic factor for BCR. METHODS We searched PubMed, Web of Science and Scopus, from inception to June 1, 2021. Cohort studies reporting BCR among PC patients stratified by body mass index (BMI) were included. To assess the quality of the selected studies, we used the Newcastle-Ottawa scale (NOS). Risk of BCR among obese patients (BMI ≥ 30 kg/m2) was compared with normal weight (BMI < 25), pooling individual hazard ratios (HR) in random-effect meta-analysis. Associations for continuous BMI per 5 kg/m2 were also calculated. Subgroup analyses were conducted to assess reasons for heterogeneity and causal criteria were formally evaluated. RESULTS We identified 46 cohort studies including 86,490 PC patients. A total of 14,719 (17.1%) patients developed BCR. There was no consistent definition of BCR. Obesity was associated with BCR (HR: 1.25, 95% CI: 1.11-1.39, I2: 70.3%), and there was a 10% increase (95% CI: 4-15%, I2: 66.3%) in BCR per 5 kg/m2 increase in BMI. The heterogeneity was high but decreased in the subgroup of highest-quality NOS score and when the BMI was measured by the researchers (I2: 0.0%). The association was consistent in patients receiving radical prostatectomy but not in patients receiving other therapies. CONCLUSIONS Obesity showed a moderate, consistent relationship with biochemical recurrence after radical prostatectomy. Measurement of BMI and BCR was variable, highlighting the need for standardised clinical guidelines. Preventive weight control programs may have a role in reducing BCR for clinically localised PC patients.
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Affiliation(s)
- Mario Rivera-Izquierdo
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain. .,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain. .,Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, Granada, Spain.
| | - Javier Pérez de Rojas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Virginia Martínez-Ruiz
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Beatriz Pérez-Gómez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Epidemiology of Chronic Diseases. National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - José Juan Jiménez-Moleón
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Applegate CC, Lowerison MR, Hambley E, Song P, Wallig MA, Erdman JW. Dietary tomato inhibits angiogenesis in TRAMP prostate cancer but is not protective with a Western-style diet in this pilot study. Sci Rep 2021; 11:18548. [PMID: 34535690 PMCID: PMC8448771 DOI: 10.1038/s41598-021-97539-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 08/20/2021] [Indexed: 12/09/2022] Open
Abstract
Prostate cancer (PCa) remains the second most diagnosed cancer worldwide. Higher body weight is associated with chronic inflammation, increased angiogenesis, and treatment-resistant tumor phenotypes. Dietary tomato reduces PCa risk, which may be due to tomato inhibition of angiogenesis and disruption of androgen signaling. This pilot study investigated the interplay between tomato powder (TP), incorporated into control (CON) and obesogenic (OB) diets, and PCa tumor growth and blood perfusion over time in a transgenic model of PCa (TRAMP). Ultrasound microvessel imaging (UMI) results showed good agreement with gold-standard immunohistochemistry quantification of endothelial cell density, indicating that this technique can be applied to non-invasively monitor tumor blood perfusion in vivo. Greater body weight was positively associated with tumor growth. We also found that TP significantly inhibited prostate tumor angiogenesis but that this inhibition differentially affected measured outcomes depending on CON or OB diets. TP led to reduced tumor growth, intratumoral inflammation, and intratumoral androgen-regulated gene expression (srd5a1, srd5a2) when incorporated with the CON diet but greater tumor growth and intratumoral gene expression when incorporated with the OB diet. Results from this study show that protective benefits from dietary tomato are lost, or may become deleterious, when combined with a Western-style diet.
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Affiliation(s)
- Catherine C Applegate
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.
| | - Matthew R Lowerison
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Emma Hambley
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
- Division of Biology, Kansas State University, Manhattan, KS, 66506, USA
| | - Pengfei Song
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
- Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Matthew A Wallig
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - John W Erdman
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.
- Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.
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Zhao S, Wang Y, Wu W, Yang S, Feng L, Tao F, Ge W, Shen M, Xu W. Nonalcoholic fatty liver disease and risk of prostatic diseases: Roles of insulin resistance. Andrologia 2021; 53:e14060. [PMID: 33782980 DOI: 10.1111/and.14060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 12/12/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD), the liver component of metabolic syndrome, is considered to be associated with high risk of prostatic diseases but a systematic review has not been conducted. Under a comprehensive review of the eligible clinical studies, a potential positive association between NAFLD and benign prostatic hyperplasia/prostate cancer (BPH/PCa) has been postulated. Insulin resistance and metabolic aberrations are considered to be the potential mechanism for such association. However, the relationship between NAFLD and other prostatic diseases, that is, prostatic inflammation and lower urinary tract symptoms, seems vague due to limited relevant studies in the literatures. The present review highlights that clinicians should be conscious of the detrimental effect of NAFLD on the development of BPH and PCa.
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Affiliation(s)
- Shankun Zhao
- Department of Urology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Yaoyao Wang
- Second School of Clinical Medicine, Wenzhou Medical University, Wenzhou, China
| | - Weizhou Wu
- Department of Urology, Maoming People's Hospital, Maoming, China
| | - Suqing Yang
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Lili Feng
- Nursing Department, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Fangfang Tao
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Weiwei Ge
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Maolei Shen
- Department of Urology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Weifang Xu
- Department of Orthopedics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
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Khan S, Wolin KY, Pakpahan R, Grubb RL, Colditz GA, Ragard L, Mabie J, Breyer BN, Andriole GL, Sutcliffe S. Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia. BMC Urol 2021; 21:47. [PMID: 33773592 PMCID: PMC8005244 DOI: 10.1186/s12894-021-00816-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/15/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. METHODS Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. RESULTS Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11-1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07-1.21; RRobese: 1.10, 95% CI 1.02-1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98-1.22; RRnormal to obese: 1.28, 95% CI 1.10-1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05-1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. CONCLUSIONS We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.
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Affiliation(s)
- Saira Khan
- Epidemiology Program, College of Health Sciences, University of Delaware, 100 Discovery Blvd., 7th floor, Newark, DE, 19713, USA.
| | - K Y Wolin
- Coeus Health, 222 W Merchandise Mart Plaza, Chicago, IL, 60654, USA
| | - R Pakpahan
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8100, St. Louis, MO, 63110, USA
| | - R L Grubb
- Department of Urology, Medical University of South Carolina, 135 Rutledge Ave, Charleston, SC, 29425, USA
| | - G A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8100, St. Louis, MO, 63110, USA
| | - L Ragard
- Westat, 1600 Research Blvd, Rockville, MD, 20850, USA
| | - J Mabie
- Information Management Services, Inc., 1455 Research Blvd, Suite 315 , Rockville, MD, 20850, USA
| | - B N Breyer
- Departments of Urology and Epidemiology and Biostatistics, University of California - San Francisco, 400 Parnassus Ave # 610, San Francisco, CA, 94143, USA
| | - G L Andriole
- Division of Urologic Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, 4921 Parkway Place, St. Louis, MO, 63110, USA
| | - S Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8100, St. Louis, MO, 63110, USA
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Wu Y, Xu D, Shen HB, Qian SB, Qi J, Sheng XJ. The association between body mass index and testosterone deficiency in aging Chinese men with benign prostatic hyperplasia: results from a cross-sectional study. Aging Male 2020; 23:841-846. [PMID: 31058560 DOI: 10.1080/13685538.2019.1604652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Evidence has supported obesity as a risk factor for both benign prostate hyperplasia (BPH) and hypogonadism. In this paper, we performed a retrospective study and discussed the prevalence of testosterone deficiency (TD) and its relationship to body mass index (BMI) in aging Chinese men with BPH who have surgical intervention. MATERIAL AND METHODS We reviewed the clinical data by age, BMI, medical history, serum prostate-specific antigen (PSA) levels, serum total testosterone (TT) levels, biochemical analysis, and transrectal ultrasound. BMI and other variables were considered to be independent variables in an effort to evaluate any potential associations between these factors and TD status using non-adjusted and multivariate-adjusted regression models. RESULTS Of the 795 BPH participants, 27.2% (216) patients had TD. After adjusting for all potential covariates, there was a similar J-shaped relationship between BMI and TD, with an inflection point of 19.2 kg/m2. The effect sizes and the confidence intervals on the left and right sides of this inflection point were 0.6 (0.4-1.0) (p = .043) and 1.2 (1.1-1.3) (p < .001), respectively. CONCLUSION Nearly one-third of the aging Chinese BPH patients had TD in this study. The association between BMI and TD is not simple. A J-shaped curve correlation was detected. BMI was positively correlated with TD when it was over 19.2 kg/m2 and inversely correlated with TD when it was below 19.2 kg/m2. Long-term prospective studies are needed to confirm these findings.
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Affiliation(s)
- Yu Wu
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ding Xu
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hai-Bo Shen
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Su-Bo Qian
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Qi
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xu-Jun Sheng
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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The effect of bariatric surgery on the improvement of lower urinary tract symptoms in morbidly obese male patients. Prostate Cancer Prostatic Dis 2020; 24:380-388. [PMID: 32963287 DOI: 10.1038/s41391-020-00285-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/27/2020] [Accepted: 09/10/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) are strongly linked with obesity. Whether bariatric surgery can effectively alleviate LUTS in morbidly obese men is unknown. The objective of the present study was to evaluate the effectiveness of bariatric surgery in reducing the prevalence and severity of male LUTS in obese patients. METHODS This was a prospective observational study on consecutive morbidly obese men undergoing bariatric surgery. The International Prostate Symptom Score (IPSS) was used to assess for LUTS before and at 1-3 years after surgery. The 3-year changes in IPSS, the changes in LUTS severity, and the factors associated with LUTS improvement were evaluated. RESULTS This study recruited 143 morbidly obese men (mean age 43.0 ± 10.4 years) undergoing sleeve gastrectomy (n = 89) and Roux-en-Y gastric bypass (n = 54). The rates of follow-up after surgery were 94.4% (n = 119/126) at 1 year, 90.6% (n = 96/106) at 2 years, and 81.2% (n = 69/85) at 3 years. After surgery, there was significant body mass index reduction from 39.1 ± 5.2 kg/m2 preoperatively to 30.1 ± 4.8 kg/m2 at 1 year and 31.5 ± 4.9 kg/m2 at 3 years (P < 0.001). There was significant reduction in IPSS total symptom score, quality of life score, frequency score, and nocturia score (P < 0.05). The prevalence of moderate to severe LUTS reduced from 35.0% (29.4% moderate; 5.6% severe) preoperatively to 21.8% (19.3% moderate; 2.5% severe) at 1 year and 30.4% (24.6% moderate; 5.8% severe) at 3 years (P < 0.001). LUTS improvement was significantly associated with body fat percentage reduction (P = 0.012) and was not associated with weight loss or improvement of metabolic parameters. CONCLUSIONS Bariatric surgery was an effective and durable intervention for alleviating the prevalence and severity of LUTS in morbidly obese men for up to 3 years.
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Chung GE, Yim JY, Kim D, Kwak MS, Yang JI, Park B, An SJ, Kim JS. Nonalcoholic Fatty Liver Disease Is Associated with Benign Prostate Hyperplasia. J Korean Med Sci 2020; 35:e164. [PMID: 32508064 PMCID: PMC7279945 DOI: 10.3346/jkms.2020.35.e164] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/31/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is associated with a wide spectrum of metabolic abnormalities. This study aimed to evaluate whether NAFLD is associated with benign prostatic hyperplasia (BPH) independent of other risk factors. METHODS A total of 3,508 subjects who underwent prostate and hepatic ultrasonography were enrolled. NAFLD was diagnosed and graded by ultrasonographic findings. BPH was defined by total prostate volume. RESULTS The prevalence of BPH was significantly increased according to NAFLD severity (P < 0.001). The multivariate analysis showed that NAFLD was associated with a 22% increase in the risk of BPH (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.02-1.45). In non-obese subjects, NAFLD was associated with a 41% increase in the risk of BPH (OR, 1.41; 95% CI, 1.14-1.73), and an incremental increase in the risk of BPH according to NAFLD severity was pronounced (adjusted OR [95% CI], 1.32 [1.05-1.68] for mild NAFLD, 1.55 [1.15-2.10] for moderate to severe NAFLD vs. no NAFLD, P for trend = 0.004). However, in the obese population, the association of NAFLD in the risk of BPH was insignificant (P = 0.208). CONCLUSION NAFLD is associated with an increased risk of BPH regardless of metabolic syndrome, especially in non-obese subjects. An incrementally increased risk of BPH according to NAFLD severity is prominent in non-obese subjects with NAFLD. Thus, physicians caring for non-obese patients with NAFLD may consider assessing the risk of BPH and associated urologic conditions.
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Affiliation(s)
- Goh Eun Chung
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Jeong Yoon Yim
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Min Sun Kwak
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Jong In Yang
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Boram Park
- Department of Public Health Science, Seoul National University, Seoul, Korea
| | | | - Joo Sung Kim
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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12
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Cho A, Chughtai B, Te AE. Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-019-00566-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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13
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Obesity-associated inflammation induces androgenic to estrogenic switch in the prostate gland. Prostate Cancer Prostatic Dis 2020; 23:465-474. [PMID: 32029929 DOI: 10.1038/s41391-020-0208-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/14/2020] [Accepted: 01/28/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Our patient cohort revealed that obesity is strongly associated with steroid-5α reductase type 2 (SRD5A2) promoter methylation and reduced protein expression. The underlying mechanism of prostatic growth in this population is poorly understood. Here we addressed the question of how obesity, inflammation, and steroid hormones affect the development of benign prostatic hyperplasia (BPH). MATERIAL AND METHODS We used preadipocytes, macrophages, primary human prostatic stromal cells, prostate tissues from high-fat diet-induced obese mice, and 35 prostate specimens that were collected from patients who underwent transurethral resection of the prostate (TURP). RNA was isolated and quantified with RT-PCR. Genome DNA was extracted and SRD5A2 promoter methylation was determined. Sex hormones were determined by high-performance liquid chromatography-tandem mass spectrometry. Protein was extracted and determined by ELISA test. RESULTS In prostatic tissues with obesity, the levels of inflammatory mediators were elevated. SRD5A2 promoter methylation was promoted, but SRD5A2 expression was inhibited. Inflammatory mediators and saturated fatty acid synergistically regulated aromatase activity. Obesity promoted an androgenic to estrogenic switch in the prostate. CONCLUSIONS Our findings suggest that obesity-associated inflammation induces androgenic to estrogenic switch in the prostate gland, which may serve as an effective strategy for alternative therapies for management of lower urinary tract symptoms associated with BPH in select individuals.
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14
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Han H, Cao Z, Qin Y, Wei X, Ruan Y, Cao Y, He J. Morbid obesity is adversely associated with perioperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy. Can Urol Assoc J 2020; 14:E574-E581. [PMID: 32520702 DOI: 10.5489/cuaj.6389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Robot-assisted laparoscopic radical prostatectomy (RALRP) may be more challenging in obese individuals. This study aimed to evaluate whether obesity had an adverse effect on perioperative outcomes following RALRP. METHODS Hospitalized patients who underwent RALRP from 2008-2014 were identified using the National Inpatient Sample database. We grouped RALRP patients into non-obese, obesity class I-II, and obesity class III (morbid obesity). Rates of blood transfusion, intraoperative and postoperative complications, in-hospital mortality, prolonged length of stay, and total costs were compared among the three groups by univariate regression, multivariate regression, and propensity score weighting analysis. RESULTS Of 53 301 patients identified, 48 725 were non-obese, 3572 were diagnosed with obesity class I-II, and 1004 were diagnosed with morbid obesity. Compared to non-obesity (7.62%), overall postoperative complications were commonly observed in obesity class I-II (10.55%) and morbid obesity (17.11%). Multivariable analyses suggested that morbid obesity was associated with increased overall postoperative (odds ratio [OR] 2.00, 95% confidence interval [CI] 1.65-2.42), cardiac (OR 1.63, 95% CI 1.03-2.58), respiratory (OR 4.03, 95% CI 3.04-5.36), genitourinary (OR 1.77, 95% CI 1.08-2.90), miscellaneous medical (OR 1.94, 95% CI 1.58-2.39) complications, prolonged hospitalization (OR 1.86, 95% CI 1.57-2.21), and 12% higher total cost. Propensity score weighting analysis yielded similar results. Adequate covariate balance was achieved for all variables after weighting. CONCLUSIONS Morbid obesity is adversely associated with perioperative outcomes in RALRP. Close management is required in patients undergoing RALRP with morbid obesity for potential worse prognosis.
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Affiliation(s)
- Hedong Han
- Department of Health Statistics, Second Military Medical University, Shanghai, China.,Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Zhexu Cao
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yingyi Qin
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Xin Wei
- Department of Cardiology, Virginia Commonwealth University, Richmond, VA, United States
| | - Yiming Ruan
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Jia He
- Department of Health Statistics, Second Military Medical University, Shanghai, China.,Tongji University School of Medicine, Shanghai, Chinaen
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15
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Leisegang K, Henkel R, Agarwal A. Obesity and metabolic syndrome associated with systemic inflammation and the impact on the male reproductive system. Am J Reprod Immunol 2019; 82:e13178. [DOI: 10.1111/aji.13178] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/08/2019] [Accepted: 07/23/2019] [Indexed: 02/06/2023] Open
Affiliation(s)
- Kristian Leisegang
- School of Natural Medicine University of the Western Cape Bellville Cape Town South Africa
| | - Ralf Henkel
- Department of Medical Biosciences University of the Western Cape Bellville Cape Town South Africa
- Department of Urology American Center for Reproductive Medicine Cleveland Clinic Cleveland Ohio
| | - Ashok Agarwal
- Department of Urology American Center for Reproductive Medicine Cleveland Clinic Cleveland Ohio
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Lloyd GL, Marks JM, Ricke WA. Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms: What Is the Role and Significance of Inflammation? Curr Urol Rep 2019; 20:54. [PMID: 31377881 PMCID: PMC7339114 DOI: 10.1007/s11934-019-0917-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the role and significance of inflammation as a putative additional factor contributing to lower urinary tract symptoms and the progression of benign prostatic hyperplasia. We review (1) the histologic definition of prostatic inflammation and its prevalence, (2) the effects inflammation in the prostate including on risk of acute urinary retention, and (3) the effects of systemic inflammation on the prostate and on voiding. RECENT FINDINGS Inflammation is a highly prevalent finding in the prostate, both on a histological and biochemical level. Men with inflammation have higher IPSS scores and increased prostate size; however, these differences appear to be imperceptibly small. Men with inflammation do experience a significantly increased risk of developing acute urinary retention, an event that is associated with significant morbidity. Recently, attempts have been made to identify more specific biochemical markers of local inflammation, and to identify regional patterns of inflamed tissue within the prostate which may be associated with higher IPSS scores, accelerated progression, and AUR. The effects of systemic inflammatory states, most notably MetS, and their role in LUTS have also been examined. Inflammation is a common finding in prostates of aging men, but its contribution to lower urinary tract symptoms and benign prostatic hyperplasia progression appears to be small when considered as a clinically relevant entity. Advances in the understanding of different forms of inflammation, and their impact when experienced in different locations within the prostate, may refine this knowledge. Systemic inflammation affects voiding, including in the absence of a prostate, but again significant effects of systemic inflammation on the prostate itself are also difficult to demonstrate. Prostatic inflammation is associated with a significantly increased risk of acute urinary retention.
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Affiliation(s)
- Granville L Lloyd
- Department of Surgery, Rocky Mountain Regional Veterans Hospital, University of Colorado Anschutz School of Medicine, 1700 N Wheeling Street, Aurora, CO, 80045, USA.
| | - Jeffrey M Marks
- Division of Urology, UCSOM, Academic Office One Bldg., Room #5602, 12631 East 17th Ave., M/S C-319, Aurora, CO, 80045, USA
| | - William A Ricke
- Department of Urology, Wisconsin Institutes for Medical Research, University of Wisconsin, 1111 Highland Avenue, Madison, WI, 53705, USA
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17
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Preventing Lethal Prostate Cancer with Diet, Supplements, and Rx: Heart Healthy Continues to Be Prostate Healthy and "First Do No Harm" Part I. Curr Urol Rep 2018; 19:104. [PMID: 30368693 DOI: 10.1007/s11934-018-0846-4] [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: 12/13/2022]
Abstract
PURPOSE OF REVIEW To discuss the overall and latest observations of the effect of diet, lifestyle, supplements, and some prescription heart healthy medications for prostate cancer prevention. RECENT FINDINGS The concept of maximizing heart health to prevent aggressive prostate cancer continues to be solidified with the addition of more prospective observational and randomized controlled trial data. Heart healthy is prostate healthy, but heart unhealthy is prostate unhealthy. The primary goal of reducing the risk of all-cause and cardiovascular disease (CVD) morbidity and mortality also allows for maximizing prostate cancer prevention. The obesity epidemic in children and adults along with recent diverse research has only strengthened the nexus between heart and prostate health. Greater dietary adherence toward a variety of healthy foods is associated with a graded improved probability of CVD and potentially aggressive cancer risk reduction. Preventing prostate cancer via dietary supplements should encourage a "first do no harm", or less is more approach until future evidence can reverse the concerning trend that more supplementation has resulted in either no impact or an increased risk of prostate cancer. Supplements to reduce side effects of some cancer treatments appear to have more encouraging data. Medications that improve heart health including statins, aspirin, and metformin (S.A.M.), and specific beta-blocker medications are primarily generic or low-cost and should continue to garner research interest. A watershed moment in medical education has arrived where the past perception of a diverse number of trees seemingly separated by vast distances, in reality, now appear to exist within the same forest.
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18
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Traish AM, Johansen V. Impact of Testosterone Deficiency and Testosterone Therapy on Lower Urinary Tract Symptoms in Men with Metabolic Syndrome. World J Mens Health 2018; 36:199-222. [PMID: 30079638 PMCID: PMC6119850 DOI: 10.5534/wjmh.180032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/10/2018] [Indexed: 12/11/2022] Open
Abstract
Lower urinary tract function is modulated by neural, vascular and urethral and bladder structural elements. The pathophysiological mechanisms of lower urinary tract symptoms (LUTS) encompass prostate enlargement, alterations in urethra histological structure bladder fibrosis and alterations in pelvic neuronal and vascular networks, The complex pathophysiological relationship between testosterone (T) deficiency (TD) and the constellations LUTS, and metabolic dysfunction manifested in the metabolic syndrome (Met S) remains poorly understood. TD has emerged as one the potential targets by which Met S may contribute to the onset and development as well as worsening of LUTS. Because it has been recognized that treatment of men with Met S with T therapy ameliorates Met S components, it is postulated that T therapy may represent a therapeutic target in improving LUTS. Furthermore, the effect of TD on the prostate remains unclear, and often debatable. It is believed that T exclusively promotes prostate growth, however recent evidence has strongly contradicted this belief. The true relationship between benign prostatic hyperplasia, TD, and LUTS remains elusive and further research will be required to clarify the role of T in both benign prostatic hypertrophy (BPH) and LUTS as a whole. Although there is conflicting evidence about the benefits of T therapy in men with BPH and LUTS, the current body of literature supports the safety of using this therapy in men with enlarged prostate. As the population afflicted with obesity epidemic continues to age, the number of men suffering from Met S and LUTS together is expected to increase.
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Affiliation(s)
- Abdulmaged M Traish
- Department of Urology, Boston University School of Medicine, Boston, MA, USA.
| | - Vanessa Johansen
- Department of Urology, Boston University School of Medicine, Boston, MA, USA
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19
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Xu H, Cai Z, Chen Y, Gu M, Chen Q, Wang Z. Benign prostatic hyperplasia surgical scoring (BPHSS): an novel scoring system for the perioperative outcomes of holmium laser enucleation of the prostate. Lasers Med Sci 2018; 33:589-595. [PMID: 29313161 DOI: 10.1007/s10103-017-2425-1] [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: 10/19/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
To develop a standardized scoring system, the BPH surgical scoring (BPHSS) system, to quantify the ability to predict the perioperative outcomes resulting from an enlarged prostate. There are two parts included in this study: the retrospective observational study (875 patients treated with holmium laser enucleation of the prostate, HoLEP) and the prospective observational study (111 patient underwent HoLEP). All the outcome data included the following: the basic patient preoperative characteristics, operation time (OT), pre- and post- surgery hemoglobin decrease, Na+ variation, hospital stay duration, duration of bladder irrigation, catheterization time, and hospitalization time. The BPHSS, consisting of prostatic volume (PV), prostate-specific antigen (PSA), bladder stones, intravesical prostatic protrusion (IPP), and metabolic syndrome (MetS), was observed regarding the perioperative outcomes. In the retrospective study, patients in high BPHSS group (6-8 points) showed significant increase in the OT (74.61, 95%CI = 16.98-327.84, P < 0.001), hemochrome reduction (416.50, 95%CI = 35.48-4889.88, P < 0.001), hospital stay (1.80, 95%CI = 1.35-2.41, P < 0.001), and bladder irrigation duration (4.04, 95%CI = 1.35-12.10, P = 0.013) compared with the low BPHSS group (0-2 points). In the prospective study, there also existed significant differences between the three scoring grades (P < 0.01) in OT, hemochrome decrease, and the hospital stay. The BPHSS is suitable to predict the perioperative outcomes in patients undergoing HoLEP. It may help urologist to prepare more before surgery to treat the enlarged prostates. Further studies are needed to validate this scoring system in BPH patients in multiple centers.
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Affiliation(s)
- Huan Xu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Zhikang Cai
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yanbo Chen
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Meng Gu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Qi Chen
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Zhong Wang
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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20
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Cao JJ, Huang W, Wu HS, Cao M, Zhang Y, Jin XD. Prostatic Calculi: Do They Matter? Sex Med Rev 2017; 6:482-491. [PMID: 29157875 DOI: 10.1016/j.sxmr.2017.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Prostatic calculi (PC) are frequently detected at computed tomography or ultrasound in men attending the health center or the urology outpatient department. PC have attracted more attention from urologists, but the clinical significance of PC is unknown. AIM To review the available literature on the effects of PC on prostatic diseases and sexual function in men. METHODS Relevant clinical trials were identified by searching the PubMed, Embase, and Cochrane Library databases. Results were classified, summarized, and analyzed. MAIN OUTCOME MEASURES Transabdominal and rectal ultrasonography; urodynamics analysis; International Prostate Symptom Score; pathologic examination of prostatic tissue; prostate-specific antigen; and expressed prostatic secretion. RESULTS PC can not only prolong the duration of bothersome symptoms but also decrease the cure rate of antibacterial therapy in patients with chronic prostatitis. Patients with PC usually have more severe lower urinary tract symptoms (LUTS), and some studies reported that moderate to marked PC are a predisposing factor for moderate to severe LUTS. Studies also reported that the serum level prostate-specific antigen is not influenced by PC. In addition, the presence of PC is not associated with an increased risk of prostate cancer. However, the correlation between PC in the peripheral zone and prostate cancer is statistically significant. In addition, the association between PC and Gleason scores is controversial. Some novel studies suggested that PC might play an important role in sexual impairment in middle-age men or men with chronic pelvic pain syndrome or chronic prostatitis. Recently, PC were found to increase the incidence of severe LUTS, urinary retention, and hematospermia after transrectal ultrasound-guided prostate biopsy. CONCLUSION PC can aggravate LUTS, chronic prostatitis, and sexual dysfunction in men, but the association between PC and prostate cancer is still controversial. Cao J-J, Huang W, Wu H-S, et al. Prostatic Calculi: Do They Matter? Sex Med Rev 2018;6:482-491.
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Affiliation(s)
- Jun-Jie Cao
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Wei Huang
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Hong-Shen Wu
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Min Cao
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Yan Zhang
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Xiao-Dong Jin
- Department of Urology, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.
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21
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Plata M, Caicedo JI, Trujillo CG, Mariño-Alvarez ÁM, Fernandez N, Gutierrez A, Godoy F, Cabrera M, Cataño-Cataño JG, Robledo D. Prevalence of metabolic syndrome and its association with lower urinary tract symptoms and sexual function. Actas Urol Esp 2017; 41:522-528. [PMID: 28390836 DOI: 10.1016/j.acuro.2016.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/12/2016] [Accepted: 12/13/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To estimate the frequency of metabolic syndrome (MetS) in a daily urology practice and to determine its association with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). MATERIAL AND METHODS A retrospective study was conducted. Data from all male patients aged ≥40 years who attended our outpatient urology clinic from 2010 to 2011 was collected. Prevalence of MetS was determined, and LUTS and ED were assessed. A logistic model was used to determine possible associations, controlling for confounders and interaction factors. RESULTS A total of 616 patients were included. MetS was observed in 43.8% (95% CI 39.6-48.3). The bivariate model showed an association between MetS and LUTS (p<0.01), but not between MetS and ED. The logistic model showed an association between MetS and the International Prostate Symptom Score (IPSS), while controlling for other variables. Patients exhibiting moderate LUTS had a greater risk for MetS than patients with mild LUTS (OR 1.83, 95% CI 1.14-2.94). After analyzing for individual components of MetS, positive associations were found between diabetes and severe LUTS (OR 1.3, 95% CI 1.24-7.1), and between diabetes and ED (OR 2.57, 95% CI 1.12-5.8). CONCLUSION This study was able to confirm an association between MetS and LUTS, but not for ED. Specific components such as diabetes were associated to both. Geographical differences previously reported in the literature might account for these findings. Given that MetS is frequent among urological patients, it is advisable that urologists actively screen for it.
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Affiliation(s)
- M Plata
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia.
| | - J I Caicedo
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia
| | - C G Trujillo
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia
| | - Á M Mariño-Alvarez
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia
| | - N Fernandez
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - A Gutierrez
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - F Godoy
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - M Cabrera
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - J G Cataño-Cataño
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - D Robledo
- Departamento de Urología, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia; Facultad de Medicina de la Universidad de los Andes, Bogotá D.C., Colombia
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22
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Molecular features and physiological roles of K +-Cl - cotransporter 4 (KCC4). Biochim Biophys Acta Gen Subj 2017; 1861:3154-3166. [PMID: 28935604 DOI: 10.1016/j.bbagen.2017.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/15/2017] [Indexed: 12/27/2022]
Abstract
A K+-Cl- cotransport system was documented for the first time during the mid-seventies in sheep and goat red blood cells. It was then described as a Na+-independent and ouabain-insensitive ion carrier that could be stimulated by cell swelling and N-ethylmaleimide (NEM), a thiol-reacting agent. Twenty years later, this system was found to be dispensed by four different isoforms in animal cells. The first one was identified in the expressed sequence tag (EST) database by Gillen et al. based on the assumption that it would be homologous to the Na+-dependent K+-Cl- cotransport system for which the molecular identity had already been uncovered. Not long after, the three other isoforms were once again identified in the EST databank. Among those, KCC4 has generated much interest a few years ago when it was shown to sustain distal renal acidification and hearing development in mouse. As will be seen in this review, many additional roles were ascribed to this isoform, in keeping with its wide distribution in animal species. However, some of them have still not been confirmed through animal models of gene inactivation or overexpression. Along the same line, considerable knowledge has been acquired on the mechanisms by which KCC4 is regulated and the environmental cues to which it is sensitive. Yet, it is inferred to some extent from historical views and extrapolations.
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23
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Hu W, Dong T, Wang L, Guan Q, Song L, Chen D, Zhou Z, Chen M, Xia Y, Wang X. Obesity aggravates toxic effect of BPA on spermatogenesis. ENVIRONMENT INTERNATIONAL 2017; 105:56-65. [PMID: 28501790 DOI: 10.1016/j.envint.2017.04.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 06/07/2023]
Abstract
Both bisphenol A (BPA) and obesity affect male reproductive system. However, whether there is an interaction between them remains poorly understood. The aim of the present study was to evaluate the interaction between BPA exposure and obesity on semen quality and elucidate the mechanism in humans and animals. We firstly analyzed the interaction on semen volume, sperm count per ejaculate, sperm concentration and sperm motility in 357 men, and found that urinary BPA concentration was significantly correlated with sperm count per ejaculate in obese men (β=-34.62; 95% CI: -60.75, -8.48; P=0.01). Then we validated the interaction using lean and obese mice with administration of BPA. Significant interactions between BPA exposure and obesity on sperm count and sperm concentration was observed in mice. Finally, we conducted metabolomics analyses to identify metabolites related to the interaction. Metabolites related to the interaction, including capric acid, dodecanoic acid, l-palmitoylcarnitine, niacinamide, etc., are known to play critical roles in fatty acid oxidation and tricarboxylic acid cycle indicating increased oxidative stress associated with male reproductive dysfunction. Thus, our study finds an interaction between BPA exposure and obesity on sperm count and reveals potential metabolic mechanisms. It emphasizes the importance to study interactions between endocrine disrupting chemicals and obesity, and opens avenues for the possible use of animal models in identifying the interactions.
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Affiliation(s)
- Weiyue Hu
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Tianyu Dong
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Lingling Wang
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Quanquan Guan
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ling Song
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Daozhen Chen
- Wuxi Maternal and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China
| | - Zuomin Zhou
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China
| | - Minjian Chen
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Wuxi Maternal and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China.
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Xinru Wang
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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Accurate Estimation of Prostate Size in the Evaluation of Nocturia. CURRENT BLADDER DYSFUNCTION REPORTS 2017. [DOI: 10.1007/s11884-017-0420-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kyung YS, You D, Jeong IG, Han S, Kim HK, Kim CS. Changes in Weight and Metabolic Syndrome Are Associated With Prostate Growth Rate Over a 5-Year Period. Urology 2017; 103:185-190. [DOI: 10.1016/j.urology.2016.09.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/08/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
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Dutasteride is associated with reduced risk of transrectal prostate biopsy-associated urinary tract infection and related hospitalizations. World J Urol 2017; 35:1525-1530. [PMID: 28396999 DOI: 10.1007/s00345-017-2036-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 04/06/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To evaluate whether the use of dutasteride is associated with a lower risk of transrectal prostate biopsy-associated urinary tract infection (TPBA-UTI) among men in the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study. METHODS Retrospective analysis of 6045 men undergoing 2-year repeat prostate biopsy in REDUCE. Participants were randomized to receive dutasteride 0.5 mg or placebo daily. TPBA-UTI was defined as the presence of urinary symptoms and the prescription of antibiotics by the treating physician within 30 days after biopsy. Severe TPBA-UTI was defined as TPBA-UTI requiring hospitalization. Comparison of TPBA-UTI between treatment arms was done using Chi-square test and logistic regression adjusting for participant characteristics. RESULTS Of the subjects included in the study, 3067 (50.7%) were randomized to the placebo arm and 2978 (49.3%) to the dutasteride arm. A total 51 (0.8%) men had TPBA-UTI, including 38 (1.2%) in the placebo arm and 13 (0.4%) in the dutasteride arm (univariable relative risk [RR] = 0.35, P = 0.001; multivariable odds ratio [OR] = 0.34, P = 0.003). The number needed to treat (NNT) to prevent one TPBA-UTI was 125 subjects. Of these, 14 (28%) had severe TPBA-UTI, including 12 (0.4%) in the placebo arm and only 2 (0.07%) in the dutasteride arm (univariable RR = 0.17, P = 0.021; multivariable OR = 0.17, P = 0.031). The NNT to prevent one severe TPBA-UTI was 309 subjects. CONCLUSION Among men undergoing a 2-year repeat prostate biopsy, the use of dutasteride for 2 years was associated with a reduced the risk of overall and severe TBPA-UTI. CLINICALTRIALS. GOV IDENTIFIER NCT00056407.
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Klaassen Z, Howard LE, Moreira DM, Andriole GL, Terris MK, Freedland SJ. Association of Obesity-Related Hemodilution of Prostate-Specific Antigen, Dihydrotestosterone, and Testosterone. Prostate 2017; 77:466-470. [PMID: 27990661 DOI: 10.1002/pros.23285] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 11/11/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Prostate-specific antigen (PSA) hemodilution is the leading theory for lower PSA values in obese men. However, testosterone and dihydrotestosterone (DHT), which are necessary for PSA production, are reduced in obese men. We assessed the relationship of body mass index (BMI) and PSA, taking into consideration the effect of testosterone and DHT. METHODS Among 8,122 participants in Reduction by Dutasteride of Prostate Cancer Events (REDUCE), complete data were available for 7,275. BMI was categorized as normal (<25 kg/m2 ), overweight (25-29.9 kg/m2 ), obese (30-34.9 kg/m2 ), or moderate + severely obese (≥35 kg/m2 ). Associations between BMI, testosterone, and DHT and the outcome variable of PSA were examined using linear regression. RESULTS There were 1,964 (27.0%) normal weight, 3,826 (52.6%) overweight, 1,200 (16.5%) obese, and 285 (3.9%) moderately + severely obese patients. With increasing BMI, there was a progressive decrease in PSA (P = 0.02), increase in prostate volume (P < 0.001), and decrease in both testosterone (P < 0.001) and DHT (P < 0.001). Using linear regression, increasing BMI was associated with decreasing serum PSA values. Furthermore, BMI remained inversely associated with PSA after individually adjusting for testosterone and DHT, as well as when adjusting for testosterone and DHT in the same model. Decreased androgen levels accounted for only 19% of the lower PSA in men with higher BMI. CONCLUSIONS Only a fraction of lower PSA in obese men could be attributed to testosterone and DHT levels. The remaining factors explaining lower PSA are unaccounted for, presumably secondary to hemodilution associated with increased plasma volume in obese men. Prostate 77:466-470, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Lauren E Howard
- Duke University Medical Center, Durham, North Carolina
- Durham Veterans Affairs Medical Center, Durham, North Carolina
| | | | | | | | - Stephen J Freedland
- Durham Veterans Affairs Medical Center, Durham, North Carolina
- Cedars-Sinai Medical Center, Los Angeles, California
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Early Effect of Bariatric Surgery on Urogenital Function in Morbidly Obese Men. J Sex Med 2017; 14:205-214. [DOI: 10.1016/j.jsxm.2016.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 11/20/2022]
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Vidal AC, Freedland SJ. Obesity and Prostate Cancer: A Focused Update on Active Surveillance, Race, and Molecular Subtyping. Eur Urol 2016; 72:78-83. [PMID: 27771128 DOI: 10.1016/j.eururo.2016.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 10/08/2016] [Indexed: 12/21/2022]
Abstract
CONTEXT In 2012, we published a detailed review on obesity and prostate cancer. Since then, new studies have brought further understanding regarding the role of obesity in selecting active surveillance candidates, and differing associations between obesity and prostate cancer as a function of race and molecular subtype of prostate cancer. OBJECTIVE To review new manuscripts on these new concepts for which there were limited data before 2012. EVIDENCE ACQUISITION A PubMed search from July 2012 to March 2016 was performed using the terms "prostate cancer" and "obesity". Of 450 articles, we included 15 related to these three topics. EVIDENCE SYNTHESIS Among men on active surveillance or candidates for active surveillance, multiple studies suggest that the risk of upgrading is higher for obese men. No study has shown long-term oncologic differences, and the risk of prostate cancer mortality remains low. One study suggested that the link between obesity and prostate cancer risk is stronger among black men; however, other studies found that obesity is correlated with aggressive disease regardless of race. Two studies found that the associations between obesity and prostate cancer (ie, fewer low-grade cancers and yet more aggressive cancers) was limited to men with TMPRSS2-ERG-positive tumors. CONCLUSIONS The past 4 yr has seen much new work on the obesity-prostate cancer link. If confirmed in other studies, these findings provide novel insights into not only the link between obesity and prostate cancer but also prostate cancer biology in general. PATIENT SUMMARY While their outcomes may be slightly worse, obese men with localized prostate cancer should not be discouraged from active surveillance. Early studies suggest there may be subtypes of patients in whom obesity is more strongly linked to aggressive disease.
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Affiliation(s)
- Adriana C Vidal
- Department of Surgery, Cedars-Sinai Medical Center and Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA.
| | - Stephen J Freedland
- Department of Surgery, Cedars-Sinai Medical Center and Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
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30
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Influence of Age and Obesity on 5α-Reductase 2 Gene Expression. CURRENT BLADDER DYSFUNCTION REPORTS 2016. [DOI: 10.1007/s11884-016-0361-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Park J, Lee DG, Suh B, Cho SY, Chang IH, Paick SH, Lee HL. Establishment of Reference Ranges for Prostate Volume and Annual Prostate Volume Change Rate in Korean Adult Men: Analyses of a Nationwide Screening Population. J Korean Med Sci 2015; 30:1136-42. [PMID: 26240492 PMCID: PMC4520945 DOI: 10.3346/jkms.2015.30.8.1136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 05/27/2015] [Indexed: 11/20/2022] Open
Abstract
We aimed to determine normal reference ranges for prostate volume (PV) and annual PV change rate in a Korean nationwide screening population. Data from men who underwent a routine health check-up were collected from 13 university hospitals. The cohort comprised men aged ≥40 yr who had undergone 2 or more serial transrectal ultrasonographies. Men with initial PV>100 mL; serum PSA level>10 ng/mL; PV reduction>20% compared with initial PV, or who had history of prostate cancer or prostate surgery, were excluded. Linear regression and mixed effects regression analyses were used to predict mean PV and longitudinal change in PV over time. A total of 2,967 men formed the study cohort. Age, body mass index (BMI), and serum prostate-specific antigen (PSA) level were found to be significant predictors of PV. A predicted PV table, with a 95% confidence interval (CIs), was developed after adjusting for these 3 variables. Annual PV change rate was 0.51 mL/year (95% CI, 0.47-0.55). Annual PV change rate according to age was 0.68 mL/year, 0.84 mL/year, 1.09 mL/year, and 0.50 mL/year for subjects in their 40s, 50s, 60s, and ≥70 yr, respectively. Predicted annual PV change rate differed depending on age, BMI, serum PSA level and baseline PV. From a nationwide screening database, we established age-, PSA-, and BMI-specific reference ranges for PV and annual PV change rate in Korean men. Our newly established reference ranges for PV and annual PV change rate will be valuable in interpreting PV data in Korean men.
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Affiliation(s)
- Jinsung Park
- Department of Urology, Eulji University Hospital, Daejeon, Korea
| | - Dong-Gi Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Beomseok Suh
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sung Yong Cho
- Department of Urology, Boramae Medical Center, Seoul, Korea
| | - In Ho Chang
- Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sung Hyun Paick
- Department of Urology, Konkuk University Hospital, Seoul, Korea
| | - Hyung-Lae Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
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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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Russo GI, Castelli T, Urzì D, Privitera S, La Vignera S, Condorelli RA, Calogero AE, Favilla V, Cimino S, Morgia G. Emerging links between non-neurogenic lower urinary tract symptoms secondary to benign prostatic obstruction, metabolic syndrome and its components: A systematic review. Int J Urol 2015; 22:982-90. [DOI: 10.1111/iju.12877] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/16/2015] [Indexed: 01/20/2023]
Affiliation(s)
| | | | - Daniele Urzì
- Department of Urology; University of Catania; Catania Italy
| | | | - Sandro La Vignera
- Department of Clinical and Experimental Medicine; University of Catania; Catania Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine; University of Catania; Catania Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine; University of Catania; Catania Italy
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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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35
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Bechis SK, Otsetov AG, Ge R, Wang Z, Vangel MG, Wu CL, Tabatabaei S, Olumi AF. Age and Obesity Promote Methylation and Suppression of 5α-Reductase 2: Implications for Personalized Therapy of Benign Prostatic Hyperplasia. J Urol 2015; 194:1031-7. [PMID: 25916673 DOI: 10.1016/j.juro.2015.04.079] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2015] [Indexed: 01/24/2023]
Abstract
PURPOSE In men with symptomatic benign prostatic hyperplasia 5α-reductase inhibitors are a main modality of treatment. More than 30% of men do not respond to the therapeutic effects of 5α-reductase inhibitors. We have found that a third of adult prostate samples do not express 5α-reductase type 2 secondary to epigenetic modifications. We evaluated whether 5α-reductase type 2 expression in benign prostatic hyperplasia specimens from symptomatic men was linked to methylation of the 5α-reductase type 2 gene promoter. We also identified associations with age, obesity, cardiac risk factors and prostate specific antigen. MATERIALS AND METHODS Prostate samples from men undergoing transurethral prostate resection were used. We determined 5α-reductase type 2 protein expression and gene promoter methylation status by common assays. Clinical variables included age, body mass index, hypertension, hyperlipidemia, diabetes, prostate specific antigen and prostate volume. Univariate and multivariate statistical analyses were performed followed by stepwise logistic regression modeling. RESULTS Body mass index and age significantly correlated with methylation of the 5α-reductase type 2 gene promoter (p <0.05) whereas prostate volume, prostate specific antigen or benign prostatic hyperplasia medication did not correlate. Methylation highly correlated with 5α-reductase protein expression (p <0.0001). In a predictive model increasing age and body mass index significantly predicted methylation status and protein expression (p <0.01). CONCLUSIONS Increasing age and body mass index correlate with increased 5α-reductase type 2 gene promoter methylation and decreased protein expression in men with symptomatic benign prostatic hyperplasia. These results highlight the interplay among age, obesity and gene regulation. Our findings suggest an individualized epigenetic signature for symptomatic benign prostatic hyperplasia, which may be important to choose appropriate personalized treatment options.
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Affiliation(s)
- Seth K Bechis
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexander G Otsetov
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rongbin Ge
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Zongwei Wang
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mark G Vangel
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Chin-Lee Wu
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shahin Tabatabaei
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Aria F Olumi
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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Xu T, Wang X, Xia L, Zhang X, Qin L, Zhong S, Shen Z. Robot-Assisted Prostatectomy in Obese Patients: How Influential Is Obesity on Operative Outcomes? J Endourol 2015; 29:198-208. [PMID: 25178054 DOI: 10.1089/end.2014.0354] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Tianyuan Xu
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xianjin Wang
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Leilei Xia
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaohua Zhang
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Liang Qin
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shan Zhong
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhoujun Shen
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Russo GI, Castelli T, Urzì D, Privitera S, Fragalà E, La Vignera S, Condorelli RA, Calogero AE, Favilla V, Cimino S, Morgia G. Connections between lower urinary tract symptoms related to benign prostatic enlargement and metabolic syndrome with its components: a systematic review and meta-analysis. Aging Male 2015; 18:207-16. [PMID: 26171768 DOI: 10.3109/13685538.2015.1062980] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A significant amount of epidemiological evidences have underlined an emerging link between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement a (BPE). We aimed to assess the connections between LUTS and MetS with its components. Meta-analysis were conducted to determine the mean differences (MD) and confidence intervals of IPSS total score, IPSS-voiding, IPSS-storage and prostate volume (PV) in patients with or without MetS. Ln(odds-ratio) were calculated to estimate the risk of having moderate-to-severe LUTS (IPSS ≥ 8). Nineteen studies were identified as eligible for this systematic review, with a total of 18,476 participants, including 5554 (30.06%) with and 12,922 (69.94%) without MetS. Pooled analysis did not demonstrate significant MD of IPSS, IPSS-voiding and IPSS-storage in men with or without MetS but PV was significantly different (MD = 2.18; p = 0.03). Presence of MetS was not significantly associated with moderate-to-severe LUTS (odds ratio = 1.13; p = 0.53) and only altered serum triglycerides and diabetes were associated with this risk. The association between MetS and LUTS/BPE remain unclear and further observational studies in a population with metabolic disorders should be conducted in order to address it's potential role in determining LUTS/BPE.
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Affiliation(s)
| | | | | | | | | | - Sandro La Vignera
- b Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine , University of Catania , Catania , Italy
| | - Rosita A Condorelli
- b Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine , University of Catania , Catania , Italy
| | - Aldo E Calogero
- b Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine , University of Catania , Catania , Italy
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Luke S, Addison B, Broughton K, Masters J, Stubbs R, Kennedy-Smith A. Effects of bariatric surgery on untreated lower urinary tract symptoms: a prospective multicentre cohort study. BJU Int 2014; 115:466-72. [DOI: 10.1111/bju.12943] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Serge Luke
- Department of Urology; Dunedin Hospital; Dunedin New Zealand
| | - Ben Addison
- Department of Urology; Auckland City Hospital; Auckland New Zealand
| | | | - Jonathan Masters
- Department of Urology; Auckland City Hospital; Auckland New Zealand
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Vidal AC, Howard LE, Moreira DM, Castro-Santamaria R, Andriole GL, Freedland SJ. Obesity increases the risk for high-grade prostate cancer: results from the REDUCE study. Cancer Epidemiol Biomarkers Prev 2014; 23:2936-42. [PMID: 25261967 DOI: 10.1158/1055-9965.epi-14-0795] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Studies suggest that obesity is associated with lower risk of prostate cancer but more aggressive cancers. As obesity lowers PSA levels, these observations may be influenced by detection bias. We examined the association between obesity and risk of low- and high-grade prostate cancer in REDUCE, in which biopsies were largely independent of PSA. METHODS The REDUCE study tested dutasteride for prostate cancer risk reduction in men with a PSA of 2.5 to 10.0 ng/mL and a negative biopsy. Study participants included 6,729 men who underwent at least one on-study biopsy. The association between baseline body mass index (BMI <25 kg/m(2) normal weight; 25-29.9 kg/m(2) overweight; and ≥30 kg/m(2) obese) and risk of high-grade (Gleason ≥7) or low-grade prostate cancer (Gleason <7) versus no prostate cancer was examined using multinomial logistic regression. RESULTS Overall, 1,739 men (27%) were normal weight, 3,384 (53%) overweight, and 1,304 (20%) were obese. Obesity was associated with lower risk of low-grade prostate cancer in both univariable (OR, 0.74; P = 0.001) and multivariable analyses (OR, 0.79; P = 0.01). In univariable analysis, obesity was not associated with high-grade prostate cancer (OR, 1.08; P = 0.50). However, in multivariable analysis, obesity was associated with increased risk of high-grade prostate cancer (OR, 1.28; P = 0.042). This analysis was not able to address how obesity may influence prostate cancer progression. CONCLUSIONS Obesity is associated with decreased risk of low-grade and increased risk of high-grade prostate cancer. These data provide further support to the hypothesis that obesity is associated with aggressive prostate cancer. IMPACT Obesity is linked with aggressive prostate cancer. Avoiding obesity may prevent the risk of developing high-grade prostate cancer.
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Affiliation(s)
- Adriana C Vidal
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina. Duke Prostate Center, Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina.
| | - Lauren E Howard
- Duke Prostate Center, Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina. Surgery Section, Durham VA Medical Center, Durham, North Carolina
| | | | - Ramiro Castro-Santamaria
- GlaxoSmithKline Inc., Metabolic Pathways and Cardiovascular R&D Unit, King of Prussia, Pennsylvania
| | - Gerald L Andriole
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Stephen J Freedland
- Duke Prostate Center, Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina. Surgery Section, Durham VA Medical Center, Durham, North Carolina. Department of Pathology, Duke University School of Medicine, Durham, North Carolina
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40
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Gacci M, Corona G, Vignozzi L, Salvi M, Serni S, De Nunzio C, Tubaro A, Oelke M, Carini M, Maggi M. Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis. BJU Int 2014; 115:24-31. [PMID: 24602293 DOI: 10.1111/bju.12728] [Citation(s) in RCA: 155] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To summarise and meta-analyse current literature on metabolic syndrome (MetS) and benign prostatic enlargement (BPE), focusing on all the components of MetS and their relationship with prostate volume, transitional zone volume, prostate-specific antigen and urinary symptoms, as evidence suggests an association between MetS and lower urinary tract symptoms (LUTS) due to BPE. METHODS An extensive PubMed and Scopus search was performed including the following keywords: 'metabolic syndrome', 'diabetes', 'hypertension', 'obesity' and 'dyslipidaemia' combined with 'lower urinary tract symptoms', 'benign prostatic enlargement', 'benign prostatic hyperplasia' and 'prostate'. RESULTS Of the retrieved articles, 82 were selected for detailed evaluation, and eight were included in this review. The eight studies enrolled 5403 patients, of which 1426 (26.4%) had MetS defined according to current classification. Patients with MetS had significantly higher total prostate volume when compared with those without MetS (+1.8 mL, 95% confidence interval [CI] 0.74-2.87; P < 0.001). Conversely, there were no differences between patients with or without MetS for International Prostate Symptom Score total or LUTS subdomain scores. Meta-regression analysis showed that differences in total prostate volume were significantly higher in older (adjusted r = 0.09; P = 0.02), obese patients (adjusted r = 0.26; P < 0.005) and low serum high-density lipoprotein cholesterol concentrations (adjusted r = -0.33; P < 0.001). CONCLUSIONS Our results underline the exacerbating role of MetS-induced metabolic derangements in the development of BPE. Obese, dyslipidaemic, and aged men have a higher risk of having MetS as a determinant of their prostate enlargement.
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Affiliation(s)
- Mauro Gacci
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
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41
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Blankstein U, Chughtai B, Elterman DS. Relationship Between the Metabolic Syndrome and BPH-Related Voiding Dysfunction. CURRENT BLADDER DYSFUNCTION REPORTS 2014. [DOI: 10.1007/s11884-014-0230-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Patel ND, Parsons JK. Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction. Indian J Urol 2014; 30:170-6. [PMID: 24744516 PMCID: PMC3989819 DOI: 10.4103/0970-1591.126900] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium. BPH may compress the urethra and result in anatomic bladder outlet obstruction (BOO); BOO may present as lower urinary tract symptoms (LUTS), infections, retention and other adverse events. BPH and BOO have a significant impact on the health of older men and health-care costs. As the world population ages, the incidence and prevalence of BPH and LUTS have increased rapidly. Although non-modifiable risk factors – including age, genetics and geography – play significant roles in the etiology of BPH and BOO, recent data have revealed modifiable risk factors that present new opportunities for treatment and prevention, including sex steroid hormones, the metabolic syndrome and cardiovascular disease, obesity, diabetes, diet, physical activity and inflammation. We review the natural history, definitions and key risk factors of BPH and BOO in epidemiological studies.
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Affiliation(s)
- Nishant D Patel
- Department of Urology, Moores UCSD Cancer Center, University of California, San Diego, and Section of Surgery, VA San, USA
| | - J Kellogg Parsons
- Department of Urology, Moores UCSD Cancer Center, University of California, San Diego, and Section of Surgery, VA San, USA
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43
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Mondul AM, Giovannucci E, Platz EA. A prospective study of obesity, and the incidence and progression of lower urinary tract symptoms. J Urol 2014; 191:715-21. [PMID: 24076306 PMCID: PMC4164218 DOI: 10.1016/j.juro.2013.08.110] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE We prospectively evaluated the association between adiposity and the risk of lower urinary tract symptoms incidence and progression in the Health Professionals Followup Study (HPFS). MATERIALS AND METHODS At baseline participants reported current height and weight, and weight at age 21 years. A year later they reported waist and hip circumferences, and every 2 years thereafter they reported weight. Participants periodically completed the International Prostate Symptom Score (I-PSS) and reported surgery or medication use for lower urinary tract symptoms. We used Cox proportional hazards regression to estimate the multivariable adjusted association between adiposity and lower urinary tract symptoms incidence and progression. The incidence analytical cohort of 18,055 men had no lower urinary tract symptoms at baseline. A total of 6,461 men entered the progression analytical cohort when they first experienced lower urinary tract symptoms. RESULTS The risk of lower urinary tract symptoms in 4,088 cases increased with increasing body mass index (35 kg/m(2) or greater vs 23 to less than 25 HR 1.61, 95% CI 1.31-1.99), waist circumference (greater than 42 inches vs 33 or less HR 1.39, 95% CI 1.19-1.63) and weight gain since age 21 years (50 pounds or greater vs stable weight HR 1.31, 95% CI 1.17-1.46, each p trend <0.0001). The risk of lower urinary tract symptom progression in 1,691 cases increased with body mass index (35 kg/m(2) or greater vs 23 to less than 25 HR 1.44, 95% CI 1.04-2.00, p trend <0.0001), weight gain since age 21 years (50 pounds or greater vs stable weight HR 1.35, 95% CI 1.14-1.60, p trend <0.0001) and waist circumference (greater than 42 inches vs 33 or less HR 1.32, 95% CI 0.95-1.85, p trend 0.005). CONCLUSIONS Men with higher total and abdominal adiposity and those who gained weight were more likely to have lower urinary tract symptoms develop or progress. Our findings support the notion that obesity may be an important target for lower urinary tract symptom prevention and intervention.
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Affiliation(s)
- Alison M Mondul
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health and Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Edward Giovannucci
- Departments of Nutrition and Epidemiology, Harvard School of Public Health and Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health and Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
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44
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Associations of obesity, physical activity and diet with benign prostatic hyperplasia and lower urinary tract symptoms. Curr Opin Urol 2014; 24:10-4. [DOI: 10.1097/mou.0000000000000004] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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45
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Mosli HA, Mosli HH, Bokhari AA. The effect of obesity and components of metabolic syndrome on urinary and sexual functions in Saudi men. Res Rep Urol 2013; 5:91-7. [PMID: 24400240 PMCID: PMC3826943 DOI: 10.2147/rru.s43925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Objective To establish a possible association between obesity, measured by waist circumference (WC) and body mass index (BMI), and voiding and sexual functions in a random cohort of Saudi men. Materials and methods An outpatient men’s health clinic was set up at King Abdulaziz University Hospital in Jeddah, Saudi Arabia and men were invited to discuss their sexual and urinary functions. The data collected included age, WC, weight, height, blood pressure, history of diabetes, hypertension, and smoking. The International Prostate Symptom Score (IPSS) and the International Inventory of Erectile Function (IIEF-5) questionnaire were used to assess urinary tract symptoms and sexual function, respectively. Serum testosterone, prostate-specific antigen and cholesterol levels were measured and documented. Data were analyzed using the Statistical Package for the Social Sciences. Results We recruited 113 participants. The mean WC and BMI of the men were 104 ± 14.599 cm and 29.706 kg/m2, respectively. Thirty-seven men (32.7%) had an IPSS ≥ 8 points. Sexual disorders were reported in 19 men; 16 men had erectile dysfunction, while three had premature ejaculation. Of the whole cohort, 37 men were diabetic, of which 15 (40.5%) had an IPSS ≥ 8 and 13 (35%) were either overweight or obese. Conclusion Increased WC and BMI were associated with diabetes mellitus and large percentages of voiding and sexual disorders.
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Affiliation(s)
- Hisham A Mosli
- Department of Urology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Hala H Mosli
- Department of Internal Medicine (Endocrinology), King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Akram A Bokhari
- Department of Urology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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Mosli HA, Mosli HH. Influence of body mass index on Benign Prostatic Hyperplasia-related complications in patients undergoing prostatectomy. SPRINGERPLUS 2013; 2:537. [PMID: 25674400 PMCID: PMC4320153 DOI: 10.1186/2193-1801-2-537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 10/11/2013] [Indexed: 11/23/2022]
Abstract
Objectives To examine the link between increased body mass index and benign prostatic hyperplasia (BPH) related complications, namely: acute urinary retention (AUR), Bladder stones and Bladder diverticula. Material and methods Patients: We reviewed the medical records of BPH patients who underwent prostatectomy over three years period from 2010–2012. Prostatectomy was either done in the gold standard transurethral resection of the prostate (TURP) or using green light laser selective photo-vaporization (PVP). Age, PSA, Prostate Volume (PV) as measured by ultrasonography, patients’ weight & height, BPH related complications mainly AUR, bladder stones, and bladder diverticula were all taken in account. The BMI was calculated as weight in kg divided by square height in meters. The BMI was divided in 4 categories according to WHO classification: underweight if BMI ≤18.50 kg/m2; normal weight if BMI = 18.50-24.9 kg/m2; overweight: BMI ≥25 kg/m2; and obese BMI if ≥30 kg/m2. Statistical analysis: done using the SPSS package version 16. Chi-square test was used for comparison between groups where p-value was considered significant if <0.05 and ANOVA test was used for comparison between multiple variables. Results 197 patients were included in this study, of those 95(48%) underwent TURP and 102(52%) underwent PVP. The two groups were found to be similar in mean age and PSA, and significantly different in prostate volume and operating room (O.R.) time. Conclusions Although the mean weight for patients undergoing prostatectomy in this study was in the overweight range, yet only 59/197(30%) patients with increased BMI presented with AUR. In this particular cohort of patients undergoing prostatectomy there was no significant differences in the development of AUR, bladder stone and diverticulum formation between patients with increased BMI (overweight and obese) and those with normal BMI. Further studies are recommended to explore the influence of increased BMI on BPH-related complications.
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Affiliation(s)
- Hisham A Mosli
- Department of Urology, King Abdulaziz University, PO Box 80215, Jeddah, 21589 Saudi Arabia
| | - Hala H Mosli
- Department of Medicine (Endocrinology), King Abdulaziz University, PO Box 80215, Jeddah, 21589 Saudi Arabia
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