Risk Factors for Male Lower Urinary Tract Symptoms: The Role of Metabolic Syndrome and Androgenetic Alopecia in a Latin American Population

Abstract

To evaluate the association of male lower urinary tract symptoms (LUTS) with metabolic syndrome (MetS) and androgenetic alopecia in a Latin American population. We enrolled 907 patients for prospective evaluation at a single institution. LUTS were evaluated with the International Prostate Symptom Score (IPSS). Subjects were evaluated with respect to hypertension, diabetes, dyslipidemia, previous cardiovascular events, body mass index (BMI), waist and hip circumference, and a laboratorial investigation including prostate-specific antigen (PSA), C-reactive protein (CRP), and gonadal steroids. Alopecia was classified according to the Norwood-Hamilton scale. Mean patient age was 61.0 years; 57.5% of subjects had moderate/severe LUTS; MetS was present in 17.2% of subjects and 53.9% were classified as bald. Age, hypertension, diabetes, dyslipidemia, alopecia, previous cardiovascular event, and elevated waist-to-hip ratio (WHR) were associated with moderate/severe LUTS and with storage symptoms (P<.05). On multivariable analysis, age (odds ratio [OR] 2.30, 95% confidence interval [CI] 1.63-3.25), cardiovascular events (OR 1.73, 95% CI 1.07-2.78), and WHR (OR 1.65, 95% CI 1.13-2.40) were independent predictors for LUTS. For storage symptoms, age (OR 1.80, 95% CI 1.28-2.54), cardiovascular event (OR 2.07, 95% CI 1.27-3.39), WHR (OR 1.54, 95% CI 1.06-2.25), and MetS (OR 1.70, 95% CI 1.01-2.86) were independent risk factors. Age and cardiovascular event were the only independent predictors for voiding symptoms. Components of the MetS were strongly associated with moderate and severe LUTS. WHR and cardiovascular events were independent predictors of voiding and storage symptoms, and MetS was an independent predictor of storage symptoms. Alopecia was not an independent predictor of LUTS.