title: Serum cholesterol and risk of lower urinary tract symptoms progression: Results from the Reduction by Dutasteride of Prostate Cancer Events study.
abstract: To determine if cholesterol is a risk factor for the development of lower urinary tract symptoms in asymptomatic men.
  
  
  
  A post-hoc analysis of the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study was carried out in 2323 men with baseline International Prostate Symptom Score <8 and not taking benign prostatic hyperplasia or cholesterol medications. Cox proportion models were used to test the association between cholesterol, high-density lipoprotein, low-density lipoprotein and the cholesterol : high-density lipoprotein ratio with incident lower urinary tract symptoms, defined as first report of medical treatment, surgery or two reports of an International Prostate Symptom Score >14.
  
  
  
  A total of 253 men (10.9%) developed incident lower urinary tract symptoms. On crude analysis, higher high-density lipoprotein was associated with a decreased lower urinary tract symptoms risk (hazard ratio 0.89, P = 0.024), whereas total cholesterol and low-density lipoprotein showed no association. After multivariable adjustment, the association between high-density lipoprotein and incident lower urinary tract symptoms remained significant (hazard ratio 0.89, P = 0.044), whereas no association was observed for low-density lipoprotein (P = 0.611). There was a trend for higher cholesterol to be linked with higher lower urinary tract symptoms risk, though this was not statistically significant (hazard ratio 1.04, P = 0.054). A higher cholesterol : high-density lipoprotein ratio was associated with increased lower urinary tract symptoms risk on crude (hazard ratio 1.11, P = 0.016) and adjusted models (hazard ratio 1.12, P = 0.012).
  
  
  
  Among asymptomatic men participating in the REDUCE study, higher cholesterol was associated with increased incident lower urinary tract symptoms risk, though the association was not significant. A higher cholesterol : high-density lipoprotein ratio was associated with increased incident lower urinary tract symptoms, whereas higher high-density lipoprotein was protective. These findings suggest dyslipidemia might play a role in lower urinary tract symptoms progression.
authors.affiliation: Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Tom
authors.initials: T
authors.lastname: Feng
authors.affiliation: Surgery Section, Durham VA Medical Center, Durham, North Carolina, USA.|Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Howard
authors.affiliation: Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Adriana C
authors.initials: AC
authors.lastname: Vidal
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Moreira
authors.affiliation: Research and Development, GlaxoSmithKline, King of Prussia, Pennsylvania, USA.
authors.forename: Ramiro
authors.initials: R
authors.lastname: Castro-Santamaria
authors.affiliation: Washington University School of Medicine in St. Louis, St. Louis, Missouri.
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Andriole
authors.affiliation: Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Surgery Section, Durham VA Medical Center, Durham, North Carolina, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Freedland
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood*; D066264:Datasets as Topic; D018450:Disease Progression; D000068538:Dutasteride / Q000627:therapeutic use; D050171:Dyslipidemias / Q000097:blood* / Q000150:complications; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D011471:Prostatic Neoplasms / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D058891:5-alpha Reductase Inhibitors; D002784:Cholesterol; D000068538:Dutasteride
keywords: benign prostatic hyperplasia; cholesterol; lipids; lower urinary tract symptoms