ABSTRACT
The study was aimed to the evaluation of the effect of the components of the metabolic syndrome (obesity, insulin resistance (IR)) and androgen deficiency on the clinical course of lower urinary tract symptoms against the background of benign prostatic hyperplasia (LUTS/BPH) and nocturia, as well as on some of the parameters of BPH (prostate volume, residual urine volume, total prostate-specific antigen (PSA) blood level). The comprehensive survey of 160 men with LUTS/BPH (mean age 56.7 ± 3.3 years) was performed; based on the results of survey, three comparison groups were formed: Group 1 (n = 70)--patients with isolated obesity; Group 2 (n = 36)--patients with obesity and insulin resistance; and Group 3 (n = 54)--patients with obesity, insulin resistance and androgen deficiency. The control group consisted of 30 patients with LUTS/BPH without these metabolic and hormonal disorders. In patients with LUTS/BPH and obesity, higher frequency of nocturia compared with the control group was revealed (63.7% vs 23.3%; P < 0.05), as well as the relationship between the waist circumference and free testosterone level (n = 160; r = -0.322; P = 0.005) and waist circumference and total prostate volume (n = 160; r = 0.121; P = 0.005). In patients of Group 2, significant positive correlation between waist circumference and blood insulin level was identified (n = 36; r = 0.461; P = 0.005). Patients with obesity, insulin resistance and androgen deficiency had the highest average prostate volume and residual urine volume compared with those of other groups (P < 0.05). Thus, obesity, insulin resistance, androgen deficiency are associated pathological conditions, greatly aggravating the clinical course of LUTS/BPH due to adverse impact on the BPH parameters, acting both together and separately. The most severe LUTS/BPH were associated with the presence of all three of the above systemic disorders.
