title: Impact of metabolic syndrome on response to medical treatment of benign prostatic hyperplasia.
abstract: OBJECTIVE
  To investigate the effect of metabolic syndrome (MetS) on the response to medical therapy of benign prostatic hyperplasia (BPH) after a 3-month period of treatment.
  
  
  METHODS
  This was a cohort study of 100 patients, 47 with MetS and 53 without MetS, referred to either the primary care unit or referral hospital with BPH who had moderate lower urinary tract symptoms of prostate involvement and were candidates for medical treatment. Our main outcome was response to medical treatment with prazosin 1 mg twice a day and finasteride 5 mg daily in patients with BPH on the basis of International Prostate Symptom Score (IPSS). Multivariate analysis of covariance was used to compare BPH treatment response in patients with and without MetS before and after receiving treatment.
  
  
  RESULTS
  The mean volume of the prostate was significantly higher in MetS patients than in patients without MetS (57 ± 32.65 mL compared with 46.00 ± 20.19 mL, p=0.036). The control group demonstrated an 11-unit reduction in IPSS, whereas those with MetS showed a reduction in the symptom score of only 6 units (p<0.001). Regarding the components of MetS separately, triglyceride (p<0.001), fasting blood sugar (p=0.001), and waist circumference (p=0.028) significantly affected the clinical progression of BPH. The observational nature of this study may be a limitation in comparison with an interventional study.
  
  
  CONCLUSIONS
  The results of the present study showed that MetS can negatively affect the response to medical treatment of BPH. Therefore, it is necessary to consider MetS in selecting patients with BPH for drug therapy.
authors.affiliation: Department of Urology, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Cyrus
authors.affiliation: Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, and Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Kabir
authors.affiliation: Department of Urology, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Goodarzi
authors.affiliation: Department of Endocrinology, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Talaei
authors.affiliation: Asadabad Health and Treatment Network, Hamedan University of Medical Sciences, Hamadan, and Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Moradi
authors.affiliation: Department of Statistics, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rafiee
authors.affiliation: Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Moghimi
authors.affiliation: Arak University of Medical Sciences, Arak, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Shahbazi
authors.affiliation: Arak University of Medical Sciences, Arak, Iran.
authors.forename: Elaheh
authors.initials: E
authors.lastname: Farmani
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D018120:Finasteride / Q000627:therapeutic use*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D018579:Patient Selection; D011224:Prazosin / Q000627:therapeutic use*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D064804:Urological Agents / Q000627:therapeutic use*
chemical_list: D064804:Urological Agents; D018120:Finasteride; D011224:Prazosin
keywords: Finasteride; Lower urinary tract symptoms; Metabolic syndrome X; Prazosin; Prostatic hyperplasia