Why metabolic syndrome may trigger benign prostatic hyperplasia

The term metabolic syndrome and benign prostatic hyperplasia (BPH) may not synonymously go together, but according to recent studies, there does appear to be a link between them.

Metabolic syndrome is a condition made up of a cluster of familiar health problems. If a person has obesity, elevated blood pressure and blood lipid levels, and high blood glucose, they have metabolic syndrome. These health problems are risk factors placing a person at an increased risk for type 2 diabetes and cardiovascular disease. The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning.

About one in three American adults have metabolic syndrome

BPH is an enlargement of the prostate gland that is typically found among older men past the age of 50. As the prostate begins to grow in size, it will start to press against and squeeze the urethra in addition to causing the wall of the bladder to become thicker because of the pressure. This can lead to frustrating urinary symptoms, such as a frequent or urgent need to urinate or pain during urination.

Concerns with metabolic syndrome

It has been widely acknowledged by physicians that metabolic syndrome is a major health concern. The combination of obesity, high blood glucose, unhealthy lipid levels and high blood pressure, all at the same time, makes a person a ticking time bomb for significant health risks.

As a person ages, the likelihood of developing metabolic syndrome increases. About one in three American adults have metabolic syndrome. For men, it has been estimated that more than half of all men over the age of 60 have it.

BPH has similar numbers – up to 60% of men in their sixties and up to 80-90% of men in their seventies and eighties have enlargement of their prostate gland.

Men (and women) who have metabolic syndrome are five times more likely to be diagnosed with type 2 diabetes and three times more likely to develop cardiovascular disease than a person who does not have it.

Studies linking metabolic syndrome to BPH

Over the past few years there have been numerous studies showing a link between men with metabolic syndrome and an elevated risk for BPH.

Men can adopt lifestyle behaviors to help reduce their risk of developing metabolic syndrome

A 2017 study published in the Journal of Urology looked at men with central obesity and insulin resistance and their propensity to increase the risk of metabolic and cardiovascular diseases. It also looked at how metabolic syndrome may lead to BPH. It emphasized that clinicians should recognize the impact of metabolic syndrome in men with lower urinary tract symptoms associated with BPH and to use appropriate medical therapy to alter or slow the progression of BPH to help these men avoid developing unnecessary morbidities and mortalities from metabolic syndrome.

Another study conducted in 2014 in the journal BJU International reviewed eight studies involving 5,403 men with BPH. The researchers found that up to one-quarter of the men had metabolic syndrome. The men with metabolic syndrome had larger prostates than the men without it.

Researchers of a 2014 study in Urology reported a link between metabolic syndrome and BPH. They found that men with BPH and who also had metabolic syndrome had an 80% increased risk of the symptoms associated with BPH of urinary urgency and frequency, incontinence, and pain during urination.

Why is there a link between the two?

Each study had their own conclusions as to why there appears to be an association between BPH and metabolic syndrome. One possibility is that metabolic syndrome, which is known to affect the part of the nervous system that controls the involuntary functions of the body’s internal organs, could be interfering with the muscle contractions needed for normal urination.

There are numerous studies showing a link between men with metabolic syndrome and an elevated risk for BPH

Author of the BJU International study found a common thread among men with enlarged prostates who had low levels of high-density lipoprotein (HDL) cholesterol. HDL is considered “good” cholesterol that helps remove unhealthy low-density lipoprotein (LDL) cholesterol from the body. Studies have found high levels of LDL cholesterol can promote growth and inflammation of prostate cells in a test tube.

How men can lower their risk of developing metabolic syndrome

More research is needed before medical experts can say for certain if metabolic syndrome causes or worsens BPH and it is also not known if reversing metabolic syndrome would help prevent BHP or relieve its symptoms.

In the meantime, there are certain lifestyle behaviors all men can adopt to help reduce their risk of developing metabolic syndrome – what’s good for the heart is good for the prostate:

• Get in regular exercise. Start off by taking daily walks on a routine basis or other forms of exercise to keep off excess weight, lower blood pressure, and reduce blood glucose. These same regular physical activities can also lower the risk for developing BPH symptoms by about 30%.
• Eat a healthy diet. While there is no specific dietary plan to reduce the risk of BPH, there are steps a man can take to lessen the likelihood of metabolic syndrome. The American Heart Association recommends following a heart healthy plan to include whole grains, fruits, vegetables, and fish to lower the risk of metabolic syndrome.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital. He is a medical contributor for the Fox News Channel's Medical A-Team. Follow Dr. Samadi on Twitter, Instagram, Pinterest, SamadiMD.com, davidsamadiwiki, davidsamadibio and Facebook