title: Metabolic syndrome, inflammation and lower urinary tract symptoms: possible translational links.
abstract: BACKGROUND
  Epidemiological data suggest that lower urinary tract symptoms (LUTSs) may be associated with metabolic syndrome (MetS). Inflammation has been proposed as a candidate mechanism at the crossroad between these two clinical entities. The aim of this review article is to evaluate the role of MetS-induced inflammation in the pathogenesis and progression of LUTS.
  
  
  METHODS
  A systematic review was conducted using the keywords 'metabolic syndrome and lower urinary tract symptoms' within the title search engines including PubMed, Web of Science and the Cochrane Library for relevant research work published between 2000 and January 2015. The obtained literature was reviewed by the primary author (QH) and was assessed for eligibility and standard level of evidence.
  
  
  RESULTS
  Total of 52 articles met the eligibility criteria. On the basis of database search during the past 15 years and our systematic review of prospective and retrospective cohorts, case-control trials, observational studies and animal data identified a possible link between MetS-induced inflammation and LUTS including BPH, bladder outlet obstruction, overactive bladder, urinary incontinence and other possible urinary tract abnormalities.
  
  
  CONCLUSIONS
  There is convincing evidence to suggest that MetS and inflammation could be important contributors to LUTS in men, particularly in the development of BPH. However, the role of MetS-induced inflammation remains unclear in overactive bladder, urinary incontinence and etiology of LUTS progression.
authors.affiliation: Department of Urology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, OH, USA.|Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nephro-Urological Clinical Center, Second Hospital of Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Q
authors.initials: Q
authors.lastname: He
authors.affiliation: Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nephro-Urological Clinical Center, Second Hospital of Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: G
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: F
authors.initials: F
authors.lastname: Daneshgari
authors.affiliation: Department of Pathology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: G T
authors.initials: GT
authors.lastname: MacLennan
authors.affiliation: Department of Urology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: S
authors.initials: S
authors.lastname: Gupta
mesh_terms: D006801:Humans; D007249:Inflammation / Q000453:epidemiology* / Q000473:pathology; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000473:pathology; D011467:Prostate / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000453:epidemiology / Q000473:pathology; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology; D001743:Urinary Bladder / Q000473:pathology