title: Association between Benign Prostatic Hyperplasia and Neutrophil-Lymphocyte Ratio, an Indicator of Inflammation and Metabolic Syndrome.
abstract: OBJECTIVE
  There is a large body of evidence of clinical studies regarding the relation between metabolic syndrome (MetS) and benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS) in men. A possible link between inflammation and these 2 clinical entities has also been proposed. Here, we aimed at evaluating the role of neutrophil-lymphocyte ratio (NLR), an indicator of inflammation and MetS, in the pathogenesis of LUTS and other BPH-related parameters.
  
  
  METHODS
  We evaluated 244 patients with benign prostate hyperplasia admitted to our outpatient clinic between January 2014 and June 2015. NLR was calculated from the peripheral blood sample for all patients. Patients' anthropometric characteristics, serum lipid levels, waist circumferences, total prostate-specific antigen (PSA) and testosterone values, prostate volumes, max values and International Prostate Symptom Score (IPSS) were recorded. All statistical analyses were conducted by SPSS version 17.0 package program, and p value <0.05 was chosen as the criterion for statistical significance.
  
  
  RESULTS
  There was statistical significance between NLR and patients with severe IPSS score (>20) and over age 60 years (p = 0.02). Patients younger than 60 years had statistical significance between NLR and PSA <2.5 ng/dl (p = 0.004). When body mass index was selected, there was statistical significance between prostate volume <35 ml (p = 0.009) and age >60 years (p = 0.028). If 60 years of age was selected as cut-off value, there is statistical significance between age and severe IPSS, and in terms of mild erectile dysfunction, PSA >2.5 ng/dl, and prostate volume >35 ml.
  
  
  CONCLUSIONS
  We found positive correlation between NLR and severe symptoms and progression of BPH. In this manner, anti-inflammatory therapy could contribute to the medical treatment of BPH. Higher NLR may be a candidate marker for severity of symptoms in BPH patients.
authors.affiliation: Department of Urology, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Kutan
authors.initials: K
authors.lastname: Ozer
authors.forename: Mustafa Ozan
authors.initials: MO
authors.lastname: Horsanali
authors.forename: Sacit Nuri
authors.initials: SN
authors.lastname: Gorgel
authors.forename: Burcu Ozalp
authors.initials: BO
authors.lastname: Horsanali
authors.forename: Emin
authors.initials: E
authors.lastname: Ozbek
mesh_terms: D000368:Aged; D000886:Anthropometry; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019540:Area Under Curve; D015992:Body Mass Index; D007172:Erectile Dysfunction / Q000150:complications; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D059411:Lower Urinary Tract Symptoms / Q000209:etiology; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000503:physiopathology; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology*; D010045:Outpatients; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000503:physiopathology; D012372:ROC Curve; D013739:Testosterone / Q000097:blood
chemical_list: D000893:Anti-Inflammatory Agents; D008055:Lipids; D013739:Testosterone; D017430:Prostate-Specific Antigen
keywords: Benign prostate hyperplasia; Lower urinary tract symptoms; Metabolic syndrome; Neutrophil-lymphocyte ratio