The comparison of GLUT-4 and nNOS expression in diabetic and non-diabetic patients with BPH/LUTS

The aim of this study was to compare glucose transporter-4 (GLUT-4) and neuronal nitric oxide synthase (nNOS) expression in diabetic and non-diabetic patients who underwent TUR-P or transvesical prostatectomy with the diagnosis of BPH.

Thirty diabetic patients with an average age of 58 and 30 non-diabetic patients with that of 56 were included in the study. T-PSA, IPSS, Q max value and prostate volume were compared between the two groups. The stromal and glandular staining scores of GLUT-4 and nNOS expression were compared. Student's t test and Mann-Whitney U test were used for statistical analysis.

There was no statistically significant difference in terms of age, IPSS, Qmax and PSA. Patients with diabetes had larger prostate volumes (p = 0.02). Mean GLUT-4 glandular total scores in diabetic and non-diabetic patients were 3.36 ± 1.21 and 2.1 ± 1.39, respectively, whereas stromal total scores were 3.63 ± 1.12 and 2.46 ± 1.33, and they were both statistically significant (p = 0.028 and p = 0.032, respectively). Glandular total nNOS scores in diabetic and non-diabetic patients were 4.53 ± 1.0 and 2.80 ± 1.12, while stromal total scores were 1.76 ± 1,0 and 2.30 ± 1.08 and they were found to be statistically significant (p = 0.0001 and p = 0.037, respectively).

GLUT-4 expression was found higher in prostatic tissue of the patients with diabetes mellitus. The expression value of nNOS was higher in the glandular area in diabetic patients, while stromal area expression score was higher in non-diabetic patients. Although our findings indicate important results, carefully designed further studies are needed to better comprehend the role of GLUT-4 and NOS pathways in BPH/LUTS pathophysiology.