title: Metabolic syndrome and lower urinary tract symptoms in patients with benign prostatic enlargement: a possible link to storage symptoms.
abstract: OBJECTIVE
  To evaluate the association between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) in patients with benign prostatic enlargement (BPE).
  
  
  METHODS
  From 2009 onward, a consecutive series of patients with LUTS-BPE were enrolled. Patients were evaluated using the International Prostate Symptom Score (IPSS) and ultrasonographic prostate volume. Body mass index, waist circumference, and blood pressure were measured. Blood samples were collected for prostate-specific antigen levels, fasting glucose levels, triglyceride levels, high-density lipoprotein levels, and testosterone levels. MetS was defined according to Adult Treatment Panel III (ATP III). The risk of detecting LUTS as a function of MetS was evaluated using the logistic regression analysis.
  
  
  RESULTS
  A total of 431 patients were enrolled with a median age and prostate-specific antigen level of 67 years (61-73 years) and 3 ng/mL (2.2-4.3 ng/mL), respectively; median body mass index was 27 kg/m2 (25-29 kg/m(2)); median testosterone was 3.9 ng/mL (3.1-4.7 ng/mL); median IPSS was 8 (4-14), median prostate volume was 43 mL (35-56 mL). One hundred three of 431 patients (23.8%) presented with a MetS. Patients with MetS presented a higher IPSS storage subscore (4; interquartile range, 2-7 vs 3; interquartile range 1-7; P = .002). On multivariate analysis, the presence of MetS was associated with an increased risk of an IPSS storage subscore ≥4 (odds ratio, 1.782; 95% confidence interval, 1.045-3.042; P = .030).
  
  
  CONCLUSIONS
  In our single-center study, MetS is associated with an increased risk of storage symptoms in patients with BPE. Although these results should be confirmed, and the pathophysiology is yet to be understood, it can be assumed that MetS and its metabolic components should be considered as possible factors involved in LUTS-BPE pathogenesis.
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University "La Sapienza", Roma, Italy. Electronic address: cosimodenunzio@virgilio.it.
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.affiliation: Department of Urology, Ospedale Padre Pio Da Pietrelcina, Vasto, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cindolo
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Firenze, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Gacci
authors.affiliation: Department of Urology, Ospedale Padre Pio Da Pietrelcina, Vasto, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pellegrini
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Firenze, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Carini
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University "La Sapienza", Roma, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Lombardo
authors.affiliation: Department of Urology, Policlinico Umberto I, Roma, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Franco
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University "La Sapienza", Roma, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D016015:Logistic Models; D059411:Lower Urinary Tract Symptoms / Q000150:complications*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D015999:Multivariate Analysis; D011467:Prostate / Q000000981:diagnostic imaging; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000150:complications*; D012307:Risk Factors; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography; D055105:Waist Circumference
chemical_list: D008075:Lipoproteins, HDL; D013739:Testosterone; D017430:Prostate-Specific Antigen