Association between Diabetes Mellitus and Hypertension in Benign Prostatic Hyperplasia Patients

Introduction: Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms are highly prevalent in the aging male. Similarly, the prevalence of metabolic syndrome is increasing worldwide, with mounting evidence that these two common conditions share more than age as a predisposing factor. The objective of this study was to determine if medical management of BPH is associated with an increased risk of new-onset diabetes mellitus (DM) in routine care. Methods: This population-based, retrospective cohort study expands on a parent study of linked administrative databases identifying patients diagnosed and treated for BPH between 2005 and 2015. The primary outcome of this secondary analysis was a new diagnosis of DM after the index date of BPH diagnosis. Covariates included age, dyslipidemia, hypertension, and vascular diseases. A Cox proportional hazards regression model was used for inferential statistical analysis. Results: A total 129 223 men were identified with a BPH diagnosis and no prior history of DM. Of those men, 6390 (5%) were exposed to 5-alpha-reductase inhibitor (5-ARI), 39 592 (31%) exposed to alpha-blocker (AB), and 30 545 (24%) exposed to combination therapy. Compared to those men with no BPH medication use, those exposed to drugs had an increased risk of new DM. Men treated with combination therapy of 5-ARI and AB (hazard ratio [HR] 1.30, 95% confidence interval [CI] 1.25–1.35), 5-ARI monotherapy (HR 1.25, 95% CI 1.17–1.34), or AB monotherapy (HR 1.17, 95% CI 1.13–1.22) all were at higher risk of new DM diagnosis after adjusting for important covariates. When calculating the risk of a new diabetes diagnosis measured from the start of drug exposure, men treated with 5-ARIs had an increased risk of DM compared to AB monotherapy as the reference, with HR 1.12 (95% CI 1.03–1.21) for 5-ARI monotherapy and HR 1.20 (95% CI 1.14–1.25) for combination therapy. Conclusions: In this large, long-term, retrospective study of men with a BPH diagnosis in routine practice, the risk of a new diagnosis of DM was greater in patients receiving medical management compared to controls. This modest but significant increased risk was highest in men treated with any 5-ARIs, in combination as well as monotherapy, compared to the ABs.

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The Impact of Diabetes Type 2 in the Pathogenesis of Benign Prostatic Hyperplasia: A Review

Advances in Urology ◽

10.1155/2009/818965 ◽

2009 ◽

Vol 2009 ◽

pp. 1-3 ◽

Cited By ~ 8

Author(s):

K. Stamatiou ◽

M. Lardas ◽

E. Kostakos ◽

V. Koutsonasios ◽

E. Michail

Keyword(s):

Diabetes Mellitus ◽

Benign Prostatic Hyperplasia ◽

Diabetes Mellitus Type 2 ◽

Diabetes Type 2 ◽

Prostatic Hyperplasia ◽

Diabetes Mellitus Type ◽

Search Terms ◽

Relationship Of ◽

The Impact

Introduction. Clinical observation of larger prostate glands in men with diabetes mellitus type 2 led some investigators to hypothesize that an association between these two conditions exists. In fact, both diseases are very common in men as they age and seem to be sharing similar epidemiologic features. Several studies examining the above hypothesis were yielded.Aim. The purpose of this paper is to summarize the existing literature focusing on the coexistence of BPH and diabetes mellitus type 2 and to elucidate whether or not an association among these conditions exists.Methods. We identified studies published from 1990 onwards by searching the MEDLINE database of the National Library of Medicine. Initial search terms werebenign prostatic hyperplasia, epidemiology, andrisk factor,combined withdiet hyperinsulinemia, and diabetes mellitus type 2.Results. Diabetes mellitus type 2 and hyperinsulinemia are quite common conditions and often coexist with BPH. There are several studies (observational, epidemiological, and experimental) examining the association between them in literature.Conclusion. Evidence suggests that an association between BPH and diabetes through a common pathogenic mechanism is possible. The specific pathway interfering in the development of both conditions is still poorly investigated; thus, the exact relationship of BPH to diabetes remains unclear.

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The Influencing Role of Diabetes Mellitus and Hypertension in the Establishment of Benign Prostatic Hyperplasia

Journal of Nobel Medical College ◽

10.3126/jonmc.v9i1.29543 ◽

2020 ◽

Vol 9 (1) ◽

pp. 56-60

Author(s):

Ram Sagar Shah ◽

Rabindra Tamang

Keyword(s):

Diabetes Mellitus ◽

Benign Prostatic Hyperplasia ◽

Positive Association ◽

Prostatic Hyperplasia ◽

Control Group ◽

Common Benign Tumor ◽

Institutional Review ◽

Age Related ◽

Included Patient ◽

Prevalent Disease

Background: Benign prostatic hyperplasia is regarded as non-malignant growth of prostatic tissueIt is the most common benign tumor in men, and the incidence is age related. In men aged more than 50 years, it is the fourth most prevalent disease. This study aim to determine the association of benign prostatic hyperplasia with diabetes mellitus and/or hypertension and this may help to bring out new dimensions in management of benign prostatic hyperplasia, hypertension and diabetes mellitus. Materials and Methods: Five hundred forty patients, diagnosed as benign enlargement of prostate with control group 270 at Urology out patient door between May 2018 to February 2019 with approval of Institutional review committee, were included. Patient with history of prostate cancer, neurogenic bladder, those who had undergone surgical intervention for prostate, not willing to take part in study were excluded. Results: Age range in cases and control were from 41–94 years. Diabetes was present in 14.63% of cases and 11.85% of controls. The positive association was established between prostatic hyperplasia and Diabetes (P-0.27). Hypertension was present in 37.96% of cases and 29.63% of controls (P-0.019). Diabetes and Hypertension were present in 56.48% in cases and 43.33% in control (P-0.000). Conclusion: Study suggests that benign prostatic hyperplasia is associated with diabetes mellitus and hypertension and may help to bring out new dimensions in management of benign prostatic hyperplasia.

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Urinary Tract Stones Risk Factors in Patients with Benign Prostatic Hyperplasia in West Java, Indonesia

Althea Medical Journal ◽

10.15850/amj.v8n2.2257 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Iman Surendroputro Tjahjodjati ◽

Bambang Sasongko Noegroho ◽

Aaron Tigor Sihombing

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Antihypertensive Drugs ◽

Prostatic Hyperplasia ◽

Fisher Exact Test ◽

Cross Sectional ◽

Exact Test ◽

Urinary Tract Stones

Background: Urinary tract stones are common in patients with benign prostatic hyperplasia (BPH); therefore, an imaging test is needed for patients who have risk factors for the formation of urinary tract stones. The purpose of this study was to explore the factors associated with the presence of urinary tract stones in patients with BPH as information to conduct imaging tests.Methods: A cross-sectional quantitative analytic study was conducted on medical records of patients with BPH, both with and without urinary tract stones, or patients with urinary tract stones registered at the Department of Urology, Dr. Hasan Sadikin General Hospital, Indonesia, from 2015 to 2018. Data on age, body mass index, hypertension, use of antihypertensive drugs, diabetes mellitus, and hyperuricemia were collected and analyzed using the Mann-Whitney, Chi-square, Fisher exact test, and multivariate logistic regression statistical test to compare variables between BPH with and without urinary tract stones.Results: In total, 235 BPH patients were registered, of whom 74 (31.5%) had urinary tract stones. The median age was 64 years old. There was a relationship between age (p=0.030), diabetes mellitus (p=0.043), and the occurrence of urinary tract stones in patients with BPH. The most dominant risk factor was diabetes mellitus (OR=3.000, 95%CI 1.03-8.69).Conclusions: Age and diabetes mellitus are the risk factors for urinary tract stones in patients with BPH. BPH patients with diabetes mellitus are at a 3-fold risk for urinary tract stones. Diabetes mellitus in BPH patients is an indication to conduct imaging tests.

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