title: Benign Prostatic Hyperplasia, Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease: Is Metaflammation the Link?
abstract: The prevalence of prostatic inflammation (PI) is very frequent in patients affected by benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). To investigate the relationship between prostatic inflammation (PI) and the presence of MetS and non-alcoholic fatty liver disease (NAFLD) in a cohort of patients affected by BPH/LUTS.
  
  
  
  We conducted a prospective study from January 2012 to June 2014 on 264 consecutive patients, who underwent transurethral resection of the prostate for bladder outlet obstruction. Metabolic syndrome (MetS) has been defined according to the International Diabetes Federation (IDF). Prior to surgery, each patient has been evaluated for the presence of MetS and NAFLD. All surgical specimens were investigated for the presence of an inflammatory infiltrate, according to the Irani score.
  
  
  
  The prevalence of patients affected by MetS alone was 13.8% (32/232), 13.8% (32/232) by NAFLD alone, and 42.7% (99/232) by both diseases. The rate of subjects affected by MetS + NAFLD and severe PI was significantly greater than those with only one metabolic alteration (75.8% vs. 24.2%, P < 0.01). The multivariate logistic regression analysis revealed that FLI was independently associated with high PI (Irani score ≥ 4) (odds ratio [OR]: 1.04; P < 0.01). Further, the combination between MetS and NAFLD was associated severe PI (OR: 4.5; P < 0.01) while not MetS as a single alteration.
  
  
  
  Patients with BPH/LUTS and metabolic aberration exhibited grater PI. The coexistence of MetS and NAFLD exerted a greater detrimental effect on prostate gland by increasing severity of inflammation. Prostate 76:1528-1535, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, University of Catania, Catania, Italy. giorgioivan@virgilio.it.
authors.forename: Giorgio Ivan
authors.initials: GI
authors.lastname: Russo
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cimino
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Castelli
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Favilla
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Gacci
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Carini
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Italy.
authors.forename: Rosita A
authors.initials: RA
authors.lastname: Condorelli
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: La Vignera
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Italy.
authors.forename: Aldo E
authors.initials: AE
authors.lastname: Calogero
authors.affiliation: Department of G. F. Ingrassia, Section of Anatomic Pathology, University of Catania, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Motta
authors.affiliation: Department of G. F. Ingrassia, Section of Anatomic Pathology, University of Catania, Italy.
authors.forename: Lidia
authors.initials: L
authors.lastname: Puzzo
authors.affiliation: Department of G. F. Ingrassia, Section of Anatomic Pathology, University of Catania, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Caltabiano
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
mesh_terms: D000368:Aged; D006801:Humans; D007249:Inflammation / Q000453:epidemiology*; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000453:epidemiology*; D016017:Odds Ratio; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology / Q000601:surgery; D011470:Prostatic Hyperplasia / Q000453:epidemiology* / Q000473:pathology; D011472:Prostatitis / Q000453:epidemiology* / Q000473:pathology; D001748:Urinary Bladder Neck Obstruction / Q000601:surgery
keywords: LUTS; benign prostatic hyperplasia; inflammation; metabolic syndrome; non-alcholic fatty liver disease; prostate