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The relationship between metabolic syndrome, the predictors of BPH and the severity of LUTS

In a recent study, conducted at Beijing Shijitan Hospital, Zhao and colleagues examined the  relationship between metabolic syndrome (MetS), benign prostatic hyperplasia (BPH) and secondary lower urinary tract symptoms (LUTS).1

A total of 871 Chinese males with an International Prostate Symptom Score (IPSS) of >7 were recruited, of whom 530 were assessed in this study.1

Individuals defined as having MetS had at least three of the following1

  • Waist circumference ≥90 cm
  • Serum triglycerides ≥150 mg/dL
  • Serum high-density lipoprotein cholesterol <40 mg/dL
  • Blood pressure ≥130/85 mmHg
  • Fasting plasma glucose ≥100 mg/dL.

Predictors for clinical BPH included a total prostate volume (TPV) ≥31 cm3, maximum urinary flow rate <10.6 mL/s, serum prostate-specific antigen levels ≥1.6 ng/mL, post-void residual urine volume (PVR) ≥39 mL and ≥62 years of age.1


Metabolic syndrome was significantly associated with predictors of clinical BPH progression.1

An increasing number of MetS components was significantly associated with the percentage of subjects with ≥1 predictors of clinical BPH progression, including TPV and PVR alone (all parameters p<0.001).1


IPSS score, voiding category (ability to empty bladder) and storage (need to empty bladder) contributed to the categorisation of LUTS.1


Severity and frequency of LUTS was associated with metabolic syndrome, including voiding score.1

Although the study was performed at a single institution and produced hypotheses that require testing in future investigations, the researchers note that the link between MetS, BPH and LUTS may be modifiable by encouraging dietary changes and regular physical exercise.1

Reference list

  1. Zhao S, Chen C, Chen Z, Xia M, Tang J, Shao S, et al. Relationship between metabolic syndrome and predictors for clinical benign prostatic hyperplasia progression and International Prostate Symptom Score in patients with moderate to severe lower urinary tract symptoms. Urol J 2016; 13(3): 2717–2726.