Metabolically healthy obesity is associated with increased risk of lower urinary tract symptoms secondary to benign prostatic hyperplasia: A cohort study of Chinese elderly males

Weinan Chen; Sailimai Man; Bo Wang; Gaohaer Kadeerhan; Xiaobo Huang

doi:10.1111/luts.12420

Metabolically healthy obesity is associated with increased risk of lower urinary tract symptoms secondary to benign prostatic hyperplasia: A cohort study of Chinese elderly males

Low Urin Tract Symptoms. 2022 May;14(3):170-177. doi: 10.1111/luts.12420. Epub 2021 Dec 9.

Authors

Weinan Chen^{1

2}, Sailimai Man^{3

4

5}, Bo Wang^{4

5}, Gaohaer Kadeerhan⁶, Xiaobo Huang^{1

2}

Affiliations

¹ Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China.
² The Institute of Applied Lithotripsy Technology, Peking University, Beijing, China.
³ Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
⁴ Meinian Institute of Health, Beijing, China.
⁵ Meinian Public Health Institute, School of Public Health, Peking University, Beijing, China.
⁶ National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.

PMID: 34882977
DOI: 10.1111/luts.12420

Abstract

Objectives: Obesity and metabolic status are both modifiable risk factors of lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH). However, the association between metabolically healthy obesity (MHO) and LUTS/BPH is largely unexplored. This study aimed to investigate the risk of LUTS/BPH among different metabolic syndrome-body mass index (MetS-BMI) phenotypes in a cohort of Chinese males.

Methods: A total of 3321 males from the China Health and Retirement Longitudinal Study (CHARLS) without history of LUTS/BPH at baseline were included into the analyses. Participants were categorized into six mutually exclusive groups according to presence or absence of MetS combined with BMI status: metabolically healthy normal weight/overweight/obesity (MHN/MHOW/MHO) and metabolically unhealthy normal weight/overweight/obesity (MUN/MUOW/MUO). Adjusted odds ratios (OR) and 95% CI of LUTS/BPH across MetS-BMI categories were estimated with multivariable logistic regression models.

Results: A total of 394 (11.86%) participants developed LUTS/BPH during the follow-up. After adjusting for age, educational level, smoking status, drinking status, and BMI change, the multivariable-adjusted OR (95% CI) for incident LUTS/BPH comparing MUO, MHO, MUOW, MHOW, and MUN with MHN were 1.99 (1.23-3.22), 2.04 (1.14-3.66), 1.61 (1.11-2.34), 1.45 (1.02-2.05), and 0.91 (0.54-1.56), respectively.

Conclusions: MHO and MHOW were risk populations of LUTS/BPH, suggesting that overweight and obesity can independently contribute to LUTS/BPH, even among metabolically healthy individuals. These findings emphasize metabolically healthy individuals may still benefit from maintaining normal body weight to prevent LUTS/BPH. Our findings also support that those recommendations for LUTS/BPH should highlight the importance of maintaining metabolic health across all BMI groups among Chinese males.

Keywords: lower urinary tract symptoms; metabolic syndrome; obesity; prostatic hyperplasia.

MeSH terms

Aged
China / epidemiology
Cohort Studies
Female
Humans
Longitudinal Studies
Lower Urinary Tract Symptoms* / epidemiology
Lower Urinary Tract Symptoms* / etiology
Male
Obesity / complications
Obesity / diagnosis
Obesity, Metabolically Benign* / complications
Obesity, Metabolically Benign* / epidemiology
Overweight / complications
Prostatic Hyperplasia* / complications
Risk Factors