Castelli Risk Index and its association with benign prostatic hyperplasia: data from a nationwide Chinese cohort

the burden of benign prostatic hyperplasia (BPH) is rising with population aging, with emerging evidence implicating dyslipidemia in its pathogenesis. However, the association between Castelli Risk Indices (CRI-I and CRI-II) and BPH remains unclear. This study investigated this relationship in a middle-aged and elderly Chinese cohort.

this cross-sectional study included 4,974 male participants from the China Health and Retirement Longitudinal Study (2015). Multivariable logistic regression and restricted cubic spline models were used to assess the independent and dose-response relationships between CRI-I/CRI-II and BPH, adjusted for potential confounders. Subgroup analyses and ROC curve analysis were performed to evaluate consistency and combined predictive ability.

each 1-unit increase in CRI-I and CRI-II was associated with a 10.9 % and 17.4 % elevated risk of BPH, respectively, showing significant linear dose-response relationships. These associations remained consistent across key subgroups, especially in individuals aged > 60 years, smokers, alcohol consumers, and non-hypertensive individuals. The combined CRI-I/CRI-II model demonstrated acceptable predictive ability for BPH.

elevated CRI-I and CRI-II levels are independently associated with increased BPH risk, suggesting their potential as accessible biomarkers for risk stratification and highlighting the role of dyslipidemia in BPH pathogenesis.