Correlation between metabolic syndrome and lower urinary tract symptoms

Abstract

Middle-aged men often have lower urinary tract symptoms (LUTS) resulting from benign prostatic enlargment (BPE). The correlation between metabolic syndrome (MS) and BPE remain debatable. The aim of the present study is to investigate the impact of MS on LUTS in a middle-aged men receiving a health checkup. Males aged > 45 years who voluntary underwent a medical checkup were enrolled in this study. All participants were stratified into 2 groups by the presence of 3 or more risk factors of MS including elevated blood pressure, waist circumference (WC) , serum fasting glucose (SFG), high density lipoproteins cholesterol (HDL-C) and triglyceride (TG. Prostate volume (PV), determinated by TRUS, and PSA level were used for subrgroup analysis, including determination of total International Prostate Symptom Score (IPSS), with voiding and storage score, and quality of life (QOL) score.Three hundred fifty four men, with mean age 55.6 ± 9.72 years, were enrolled into the study. According to reporting criteria of MS, 108 (30.5%) had MS and formed the study group, whereas 246 (69.5%) MS-negative men formed a control group. Antrpometric, metabolic outcoms and percentage of hypertension were significantly higher in MS vs non-MS group. The MS-group had lower mean total IPSS (7.83 ± 6.63 vs 6.85 ± 6.25,p=0.05), lower severity of weak urinary stream (1.24 ± 1.60 vs 0.95 ± 1.50,p=0.021) and lower severity of IPSS grading (p 30 mL), total IPSS, storage score, voiding frequency, urgency and incomplete emptying were lower in the MS group (p 0.93 ng/mL) group men with MS had significantly lower IPSS, voiding score and less reporting of incomplete emptying and weak urinary stream. Men in the MS group were stratified into 3 groups according to the number of MS risk factors (3, 4 and 5) and their LUTS score was compared to that of non-MS group. The negative association between voiding score, storage score, severity of LUTS and MS became particularly pronounced as the number of MS factors increased. The odds ratio (OR) for moderate to severe LUTS was significantly lower in men with 3 (OR 0.61, 95% confidence interval (CI) 0.40-0.94) or 5 ( OR 0.32, 95% CI 0.11-0.95) MS risk factors. Men in the MS group were less likely to experience moderate to severe LUTS (OR 0.58, 95% CI 0.41- 0.83). We confirmed that MS had favorable effects in LUTS, including voiding and storage symptoms in healthy middle-aged men. This beneficial effect was most significant in men with enlarged prostate and/or high PSA level.