title: Relationship between non-alcoholic fatty liver disease and benign prostatic hyperplasia/lower urinary tract symptoms: new insights from an Italian cross-sectional study.
abstract: OBJECTIVE
  To investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) assessed by the fatty liver index (FLI), in lower urinary tract symptoms (LUTS) patients and to estimate its ability in predicting LUTS.
  
  
  METHODS
  We performed a cross-sectional analysis of 448 consecutive patients affected by LUTS. LUTS were evaluated using the IPSS questionnaire and metabolic syndrome (MetS) criteria (by International Diabetes Federation). FLI, prostate volume (PV), serum prostate-specific antigen, total testosterone (TT) and homeostasis model assessment (HOMA) index were evaluated. A value of FLI ≥40 was set to predict NAFLD. Patients were divided into Group A (FLI <40) and Group B (FLI ≥40). Odds ratios (OR) for having moderate-severe LUTS were calculated. Logistic regression model was fitted adjusting for confounding factors.
  
  
  RESULTS
  Group B showed higher prevalence of MetS, IR, moderate-severe LUTS and ED, higher IPSS, IPSS-storage, IPSS-voiding, total prostate volume, insulin, HOMA and lower TT and IIEF-5. Univariate logistic regression analysis demonstrated that continuous FLI (OR = 1.03, p < 0.05) and FLI ≥40 (OR = 2.41, p < 0.01) significantly increase the risk of moderate-severe LUTS. Continuous FLI (OR = 1.12, p < 0.01) and FLI ≥40 (OR = 5.39, p < 0.01) were independent predictors of moderate-severe LUTS at the multivariate logistic regression analysis, after adjusting for confounding factors. Subjects with MetS and FLI ≥40 had 2.0-fold the risk of moderate-severe LUTS (OR = 2.10, p < 0.01).
  
  
  CONCLUSIONS
  Non-alcoholic fatty liver disease (NAFLD) subjects have higher risk of LUTS. The presence of FLI ≥40 can be used to predict subjects at high risk of LUTS.
authors.affiliation: Department of Urology, School of Medicine Policlinico Hospital, University of Catania, Catania, Italy, giorgioivan@virgilio.it.
authors.forename: Giorgio Ivan
authors.initials: GI
authors.lastname: Russo
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cimino
authors.forename: Eugenia
authors.initials: E
authors.lastname: Fragalà
authors.forename: Salvatore
authors.initials: S
authors.lastname: Privitera
authors.forename: Sandro
authors.initials: S
authors.lastname: La Vignera
authors.forename: Rosita
authors.initials: R
authors.lastname: Condorelli
authors.forename: Aldo E
authors.initials: AE
authors.lastname: Calogero
authors.forename: Mario
authors.initials: M
authors.lastname: Chisari
authors.forename: Tommaso
authors.initials: T
authors.lastname: Castelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Favilla
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011470:Prostatic Hyperplasia / Q000150:complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors