The impacts of metabolic syndrome and lifestyle on the prevalence of benign prostatic hyperplasia requiring treatment: historical cohort study of 130 454 men

Objective: To investigate the influences of lifestyle and metabolic syndrome (MetS) on the prevalence of benign prostatic hyperplasia (BPH) requiring treatment using a large historical cohort. Patients and methods: This study included 130 454 men selected from the National Health Information Database of the National Health Insurance Service in South Korea. Men were divided into the two groups according to the presence of MetS. A generalised estimating equation was used to assess the predictors of BPH requiring treatment after adjusting for other variables. Results: The prevalence of BPH requiring treatment was significantly higher in men with MetS, except in men aged <50 years. Multivariable analysis showed that MetS was associated with higher prevalence of BPH requiring treatment regardless of age, and that a low income was associated with a lower prevalence in men aged ≥60 years. Alcohol consumption was negatively associated with the prevalence of BPH requiring treatment in all age groups, except in men aged <50 years. Amongst the MetS components, low high-density lipoprotein cholesterol (HDL-C) levels showed the strongest association with the prevalence of BPH requiring treatment in all age categories, although all MetS components were correlated with an increased prevalence of BPH requiring treatment, particularly in men aged ≥50 years. Conclusion: MetS and its components, particularly low HDL-C levels, were strongly correlated with an increased prevalence of BPH requiring treatment. In addition, moderate alcohol intake and elderly men from lower socioeconomic strata were associated with a decreased prevalence of BPH requiring treatment in our cohort. © 2018 The Authors BJU International