Correlation between body mass index and prostate volume in benign prostatic hyperplasia patients undergoing holmium enucleation of the prostate surgery

Ken Batai,Kieran A Hynes,Karleen M Meiklejohn,Michael Phung,Erika R Bracamonte,Robert Bell,Aye Lwin,Elinora Price,Joel T Funk

doi:10.1186/s12894-020-00753-9

Abstract

BackgroundBenign prostatic obstruction (BPO) due to benign prostatic hyperplasia (BPH) is a leading cause of morbidity in men over the age of 40. This study examined whether there was an association between body mass index (BMI) and pre-operative prostate volume and whether expression of two genes, alpha-2-macroglobulin (A2M) and transforming growth factor beta 3 (TGFB3), was correlated with BMI, pre-operative prostate volume, and age at surgery.MethodsMedical records of patients who underwent holmium enucleation of the prostate surgery for treatment of BPO were retrospectively reviewed. Surgical specimens were obtained from formalin-fixed paraffin-embedded blocks, and expression of the targeted genes was quantified using a real time PCR approach. Linear regression analysis was performed to assess association between BMI and prostate volume adjusting for demographic characteristics and co-morbidity. Spearman’s correlation was used to examine whether gene expression was correlated with BMI, prostate volume, and age at surgery.ResultsA total of 278 patients were identified, including 62.9% European Americans (n = 175) and 27.7% Hispanic Americans (n = 77). BMI was significantly correlated with prostate volume (Spearman’s rho = 0.123, P = 0.045). In linear regression analysis, BMI was positively associated with prostate volume (β = 0.01, P = 0.004), while hyperlipidemia was negatively associated with prostate volume (β = −0.08, P = 0.02). A trend for a positive association was also observed for diabetes (β = 0.07, P = 0.099). In the race/ethnicity stratified analysis, age at surgery showed a trend for significantly positive association with prostate volume in European Americans (β = 0.005, P = 0.08), but not in Hispanic Americans. Expression of the A2M gene in the stroma was negatively correlated with age at surgery (P = 0.006). A2M expression in the gland was positively correlated with prostate volume among older men (Age ≥ 70, P = 0.01) and overweight men (BMI 25–30, P = 0.04). TGFB3 expression in the gland was positively correlated with BMI (P = 0.007) among older men.ConclusionsThis study demonstrated the positive correlation between BMI and prostate volume. Expression of TGFB3 and A2M was correlated with BMI, prostate volume, and age at surgery.

Highlights

Benign prostatic obstruction (BPO) due to benign prostatic hyperplasia (BPH) is a leading cause of morbidity in men over the age of 40
Prostate tissue samples To prepare the surgical specimens for gene expression analysis, hematoxylin and eosin (H&E) slides associated with formalin-fixed paraffin-embedded (FFPE) tissue samples underwent a review by board certified genitourinary pathologists to identify different architectural and cellular components on the slides
body mass index (BMI) was significantly correlated with pre-operative prostate volume (Spearman’s rho = 0.123, P = 0.045, Fig. 1)

Summary

Introduction

Benign prostatic obstruction (BPO) due to benign prostatic hyperplasia (BPH) is a leading cause of morbidity in men over the age of 40. Benign prostatic obstruction (BPO) due to benign prostatic hypertrophy (BPH), enlargement of the prostate gland, is a leading cause of morbidity in men over the age of 40. Patients with BPO/BPH are treated with medical therapy consisting of alpha-adrenergic antagonists, 5-alpha-reductase inhibitors or surgery. BPO/BPH progression is not fully studies [3, 4], and there is a shortage of literature to guide the decisions surrounding when to intervene with definitive surgical therapy in order to avoid adverse outcomes as well as a limited understanding of which patients progress in their disease and why

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