MP35-13 SERUM CHOLESTEROL AND RISK OF LOWER URINARY TRACT SYMPTOMS PROGRESSION: RESULTS FROM THE REDUCE STUDY

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation1 Apr 2016MP35-13 SERUM CHOLESTEROL AND RISK OF LOWER URINARY TRACT SYMPTOMS PROGRESSION: RESULTS FROM THE REDUCE STUDY Tom Feng, Lauren Howard, Adriana Vidal, Daniel Moreira, Ramiro Castro-Santamaria, Gerald Andriole, and Stephen Freedland Tom FengTom Feng More articles by this author , Lauren HowardLauren Howard More articles by this author , Adriana VidalAdriana Vidal More articles by this author , Daniel MoreiraDaniel Moreira More articles by this author , Ramiro Castro-SantamariaRamiro Castro-Santamaria More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , and Stephen FreedlandStephen Freedland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1605AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The role of serum cholesterol levels on lower urinary tract symptoms (LUTS) progression remains unclear. Our aim was to evaluate the association between serum cholesterol levels and incident LUTS using the REDUCE study. METHODS REDUCE was a 4-year, multi-center, randomized, double-blind, placebo-controlled study that followed biopsy-negative men with protocol-dictated biopsies testing dutasteride for prostate cancer risk reduction. Total serum cholesterol, LDL, and HDL levels were measured at baseline. During the 4 year study period, participants completed the International Prostate Symptom Score (IPSS) every 6 months. Exclusion criteria included men on BPH medical therapy, baseline IPSS≥8, or on statins. Incident LUTS was defined as the first report of medical treatment, surgery, or sustained clinically significant BPH symptoms defined as two reports of IPSS>14. Men who progressed within 30 days of study enrollment were also excluded. Cox proportional hazards analysis was used to test whether cholesterol, HDL, and LDL levels as well as the cholesterol:HDL ratio independently predicted time to incident LUTS. Secondary analyses were conducted to test for interactions between cholesterol and BMI, smoking, and diabetes. RESULTS Of the 2,323 men who met study enrollment criteria, 253 progressed to incident LUTS. On crude analysis, higher HDL was associated with a decreased risk of LUTS progression (HR 0.89, p=0.024) while total cholesterol and LDL showed no association. After multivariable adjustment, the association between HDL and incident LUTS remained significant (HR 0.89, p=0.044) while no association was observed for LDL (p=0.611). There was a trend for higher cholesterol to be associated with higher incident LUTS risk, though this did not reach statistical significance (HR 1.04, p=0.054). Higher cholesterol:HDL ratio was associated with increased risk of LUTS on crude (HR 1.11, p=0.016) and adjusted models (HR 1.12, p=0.012). There were no significant interactions between cholesterol and BMI, smoking, and diabetes (p>0.303). CONCLUSIONS Among men in REDUCE, higher cholesterol was associated with higher risk of incident LUTS, though the association was modest and of borderline statistical significance. Higher cholesterol to HDL ratio was significantly associated with increased incident LUTS while higher HDL was protective. If confirmed in future studies, these findings suggest cholesterol may play a role in LUTS progression and cholesterol reduction may be a target for LUTS prevention. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e485 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Tom Feng More articles by this author Lauren Howard More articles by this author Adriana Vidal More articles by this author Daniel Moreira More articles by this author Ramiro Castro-Santamaria More articles by this author Gerald Andriole More articles by this author Stephen Freedland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...