Hyperinsulinaemia as a risk factor for developing benign prostatic hyperplasia

Area of Science:

• Urology
• Endocrinology
• Metabolic Syndrome

Background:

• Benign prostatic hyperplasia (BPH) is a common condition in aging men.
• The transition zone (TZ) volume is a key indicator of BPH, but total prostate volume is often used as a surrogate.
• Hyperinsulinaemia, a condition of excess insulin, is suspected to play a role in BPH development.

Purpose of the Study:

• To validate total prostate gland volume as a measure of transition zone (TZ) volume in BPH.
• To investigate the causal relationship between hyperinsulinaemia and the development of BPH.

Main Methods:

• Studied 307 men with lower urinary tract symptoms.
• Validated total prostate volume against TZ volume in 114 patients using ultrasound.
• Analyzed BPH risk factors, including metabolic disease, metabolic syndrome components, and fasting plasma insulin levels, in relation to annual BPH growth rate.

Main Results:

• Total prostate volume strongly correlated with TZ volume (validity coefficient r.s. = 0.97).
• Faster BPH growth rates were observed in men with metabolic disease, non-insulin-dependent diabetes mellitus (NIDDM), hypertension, obesity, and dyslipidaemia.
• Higher fasting plasma insulin levels were significantly associated with increased annual BPH growth rate and total prostate volume.

Conclusions:

• Total prostate gland volume is a valid indicator of BPH.
• Findings support hyperinsulinaemia as a causal factor in BPH development.
• Suggests a potential link between hyperinsulinaemia and increased sympathetic nerve activity in BPH.