Metabolic Syndrome and Prostate Inflammation in Benign Prostate Hyperplasia
Raffaella Santi, Mauro Gacci, Linda Vignozzi, Marco Carini, Mario Maggi, Gabriella Nesi. University of Florence, Florence, Italy
Background: Features of metabolic syndrome (MetS), including hypertension, type 2 diabetes mellitus, abdominal obesity and dyslipidemia have all been associated with an increased risk of benign prostatic hyperplasia (BPH). Inflammation may also play a role in BPH and represents a common finding in prostate specimens for BPH. The aim of this study was to evaluate the possible association between components of MetS and the presence of an inflammatory infiltrate in prostate specimens from transurethral or open prostatectomy for BPH.
Design: In a series of 70 consecutive patients (mean age: 79.6 years; mean BMI: 26.5) MetS was defined according to NCEP-ATPIII criteria. All surgical specimens were weighed at the time of surgery. According to the standardized classification system of chronic prostatitis of NIH, the following parameters were assessed: prevalent anatomic location (stromal, periglandular, glandular), grade score (mild , moderate , severe ) and extent (focal [<10%], multifocal [10-50%], diffuse [>50%]) of the inflammatory infiltrate and the presence/absence of glandular disruption. Patients with moderate to severe inflammation (grade 2-3 or extent >10% or presence of glandular disruption) were compared to those with mild inflammation (grade 1 or extent <10% and absence of glandular disruption).
Results: Fifty-six (80%) prostates showed moderate to severe inflammation. NCEP-ATPIII-defined MetS was detected in 23 (32.9%) patients. The presence of MetS increased the occurrence of moderate to severe inflammation even after the adjustment for age (p=0.05). Among MetS components, low HDL-cholesterol and high triglyceride serum levels were the most important predictors of prostate inflammation (p=0.02 and p=0.022, respectively). Moreover, the weight of prostatic adenoma significantly correlated with the extent (p=0.026) and the anatomic location (p=0.017) of inflammatory infiltrate and with the presence of glandular disruption (p=0.008).
Conclusions: We highlighted a statistically significant relationship between both low HDL-cholesterol and high triglyceride serum levels with the presence of an inflammatory infiltrate in adenomatous prostatic tissue. Severe inflammation was also significantly associated with increase in prostate weight. These data indicate that metabolic syndrome may play a key role in the pathogenesis of BPH and underline the importance of assessing HDL in men with BPH.
Category: Genitourinary (including renal tumors)
Wednesday, March 21, 2012 1:00 PM
Poster Session VI # 161, Wednesday Afternoon