scholarly journals The association of new-onset diabetes mellitus and medical therapy for benign prostatic hyperplasia: A population-based study

2021 ◽  
Vol 15 (8) ◽  
pp. 240-6
Author(s):  
Jeannette Johnstone ◽  
Avril Lusty ◽  
Mina Tohidi ◽  
Marlo Whitehead ◽  
Joan Tranmer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Medical Management ◽  
Population Based ◽  
Prostatic Hyperplasia ◽  
Increased Risk ◽  
New Diagnosis ◽  
New Onset Diabetes Mellitus ◽  
New Onset

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.

scholarly journals Medical management of benign prostatic hyperplasia: Results from a population-based study

2016 ◽  
Vol 10 (1-2) ◽  
pp. 55 ◽  
Author(s):  
Mohamed Bishr ◽  
Katharina Boehm ◽  
Vincent Trudeau ◽  
Zhe Tian ◽  
Paolo Dell’Oglio ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Medical Treatment ◽  
Medical Management ◽  
Population Based ◽  
Prostatic Hyperplasia ◽  
Categorical Variables ◽  
Chi Square ◽  
Alpha Blockers

<p><strong>Introduction:</strong> In men with bothersome lower urinary tract symptoms (LUTS), medical treatment usually represents the first line. We examined the patterns of medical management of benign prostatic hyperplasia (BPH) in the Montreal metropolitan area, within the context of a case control study focusing on incident prostate cancer.</p><p><strong>Methods</strong>: Cases were 1933 men with incident prostate cancer. Population controls included 1994 age-matched men. In-person interviews collected sociodemographic characteristics and medical history, including BPH diagnosis, its duration, and type of medical treatment received. Baseline characteristics were compared by the chi-square likelihood test for categorical variables and by the students t-test for continuously coded variables.</p><p><strong>Results:</strong> Overall, 1120 participants had history of BPH, of those 53.7% received medical treatment for BPH. Individuals with medically treated BPH, compared to individuals with medically untreated BPH, were older at index date [mean: 66.9 vs. 64.9 years, p˂0.001] and at diagnosis of BPH [mean: 62.3 vs. 60.3 years, p˂0.001]. They also had a longer duration of BPH-history [mean: 4.7 vs. 4.0 years, p=0.02]. Regarding medical treatment, monotherapy was more often used than combination therapy [87.6% vs. 12.4%, p˂0.001]. Alpha-blockers (69.9%) were most commonly used as monotherapy, followed by 5alpha-reductase inhibitors (5ARIs) (26.6%). Alpha-blockers plus 5ARIs were the most common combination therapy (97.3%).</p><p><strong>Conclusions:</strong> Despite evidence from randomized, controlled trials for better efficacy with use of combination therapy, monotherapy consisting of alpha-blockers or 5ARI, in that order, is most frequently used. Additionally, 5ARI use was more common than previously reported (27% vs. 15%).</p>

1143 Risk Factors for Pancreatic Cancer in New-Onset Diabetes Mellitus: A Population Based Study

2016 ◽  
Vol 150 (4) ◽  
pp. S233
Author(s):  
Emad Mansoor ◽  
Keyur P. Parikh ◽  
Chang H. Kim ◽  
Brooke Glessing ◽  
Amitabh Chak ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Pancreatic Cancer ◽  
Population Based ◽  
Population Based Study ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset

scholarly journals Increased risk of subsequent benign prostatic hyperplasia in non-Helicobacter pylori-infected peptic ulcer patients: a population-based cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Chu-Wen Fang ◽  
Chun-Hao Chen ◽  
Kun-Hung Shen ◽  
Wen-Chi Yang ◽  
Chih-Hsin Muo ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Benign Prostatic Hyperplasia ◽  
Vagus Nerve ◽  
Gastrointestinal Disease ◽  
Cox Model ◽  
Population Based ◽  
Prostatic Hyperplasia ◽  
Increased Risk ◽  
Stratified Analysis

AbstractThe vagus nerve plays an essential role in homeostasis and inflammation. Clinically, peptic ulcer patients without helicobacter pylori (HP) infection may provide a population for studying the effect of vagal hyperactivity. There were interests in the association of gastrointestinal disease and urogenital disorders. Herein, we try to investigate subsequent risk of benign prostatic hyperplasia (BPH) in non-HP infected peptic ulcer patients. We identified 17,672 peptic ulcer admission male patients newly diagnosed in 1998–2007 from Taiwan Health Insurance Database, and 17,672 male comparison without peptic ulcer, frequency matched by age, and index-year. We assessed subsequent incidence of BPH in each cohort by the end of 2013, and then compared the risk of developing BPH between individuals with and without peptic ulcer. In addition, peptic ulcer patients underwent surgery were also examined. There were 2954 peptic ulcer patients and 2291 comparisons noted with the occurrence of BPH (25.35 and 16.70 per 1000 person-years, respectively). Compared to comparisons, peptic ulcer patients had a 1.45- and 1.26-fold BPH risk in multivariable Cox model and Fine and Gray model (95% CI 1.37–1.54 and 1.19–1.34). In age-stratified analysis, the highest risk of BPH was in 45–59 years (interaction p < 0.05). Regarding surgery types, peptic ulcer patients who underwent simple suture surgery (i.e.: with integrated vagus nerve) had a significant higher BPH risk than comparison (HR 1.50 and 95% CI 1.33–1.74; SHR 1.26 and 95% CI 1.07–1.48), while patients underwent truncal vagotomy/pyloroplasty showed a lower incidence of BPH. In this study, non-HP-infected male peptic ulcer patients were found to have an increased risk of subsequent BPH. Indicating that there might be a role of vagus nerve. Based on the limitations of retrospective nature, further studies are required.

scholarly journals Fall-related Injuries in Older Adults and Medications Prescribed within 30 Days Prior to the Injury

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 790-791
Author(s):  
Yu Ming ◽  
Aleksandra Zecevic ◽  
Susan Hunter ◽  
Richard Booth ◽  
Andrew Johnson ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Benign Prostatic Hyperplasia ◽  
Population Based ◽  
Convincing Evidence ◽  
Prostatic Hyperplasia ◽  
Public Health Care ◽  
Case Group ◽  
Increased Risk ◽  
Risk Of Fall

Abstract Fall-related injuries in older adults have serious consequences both for individuals and the public health care system. The purpose of this study was to identify medication classes prescribed within 30 days prior to the injury that were associated with fall-related injuries in older adults. This population-based, case-control study used secondary administrative health care data in Ontario, Canada. The cases were older adults, aged 66 years and older, who visited an emergency department for a fall-related injury. Controls were extracted from the Registered Person Database, and matched by same age, sex and residence area. Medication classes prescribed to both groups were recorded and logistic regression was conducted to examine the association between medications and fall-related injury. The case group included 255,270 older adults who experienced a fall-related injury over the five-year period (2010-2014). After adjustment for sex, age group, residence area, income level and number of medications prescribed, psychotropic medications (i.e., opioids, anti-epileptics, anti-Parkinson’s drugs, and antidepressants), drugs for treatment of constipation, infection and benign prostatic hyperplasia, antithrombotic agents, statins and bronchodilators were identified to be related to increased risk of fall-related injuries. In addition to medications already on the list of fall-risk increasing drugs or FRIDs, this study uncovered that drugs for benign prostatic hyperplasia, cephalosporins, biphosphates and bronchodilators increased the risk of fall-related injury in older adults. Well-designed prospective cohort studies considering prescription indication and drug-drug interactions are needed to provide more convincing evidence on medications that may be associated with increased risks of fall-related injury in older adults.

303 - Prevalence and Risk Factors for New Onset Diabetes Mellitus after Sentinel Episode of Acute Pancreatitis: A Population Based Study

2018 ◽  
Vol 154 (6) ◽  
pp. S-73
Author(s):  
Allyson Richardson ◽  
Emad Mansoor ◽  
Mohannad Abou Saleh ◽  
David Ngendahimana ◽  
Kevin Harris ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Acute Pancreatitis ◽  
Population Based ◽  
Population Based Study ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset

scholarly journals Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: population based cohort study

BMJ ◽  
2019 ◽  
pp. l1204 ◽  
Author(s):  
Li Wei ◽  
Edward Chia-Cheng Lai ◽  
Yea-Huei Kao-Yang ◽  
Brian R Walker ◽  
Thomas M MacDonald ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Propensity Score ◽  
Confidence Interval ◽  
Population Based ◽  
Prostatic Hyperplasia ◽  
Onset Type ◽  
Reductase Inhibitors ◽  
New Onset

AbstractObjectiveTo investigate the incidence of new onset type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors (dutasteride or finasteride) for long term treatment of benign prostatic hyperplasia.DesignPopulation based cohort study.SettingUK Clinical Practice Research Datalink (CPRD; 2003-14) and Taiwanese National Health Insurance Research Database (NHIRD; 2002-12).ParticipantsMen in the CPRD who received dutasteride (n=8231), finasteride (n=30 774), or tamsulosin (n=16 270) were evaluated. Propensity score matching (2:1; dutasteride to finasteride or tamsulosin) produced cohorts of 2090, 3445, and 4018, respectively. In the NHIRD, initial numbers were 1251 (dutasteride), 4194 (finasteride), and 86 263 (tamsulosin), reducing to 1251, 2445, and 2502, respectively, after propensity score matching.Main outcomes measureIncident type 2 diabetes using a Cox proportional hazard model.ResultsIn the CPRD, 2081 new onset type 2 diabetes events (368 dutasteride, 1207 finasteride, and 506 tamsulosin) were recorded during a mean follow-up time of 5.2 years (SD 3.1 years). The event rate per 10 000 person years was 76.2 (95% confidence interval 68.4 to 84.0) for dutasteride, 76.6 (72.3 to 80.9) for finasteride, and 60.3 (55.1 to 65.5) for tamsulosin. There was a modest increased risk of type 2 diabetes for dutasteride (adjusted hazard ratio 1.32, 95% confidence interval 1.08 to 1.61) and finasteride (1.26, 1.10 to 1.45) compared with tamsulosin. Results for the NHIRD were consistent with the findings for the CPRD (adjusted hazard ratio 1.34, 95% confidence interval 1.17 to 1.54 for dutasteride, and 1.49, 1.38 to 1.61 for finasteride compared with tamsulosin). Propensity score matched analyses showed similar results.ConclusionsThe risk of developing new onset type 2 diabetes appears to be higher in men with benign prostatic hyperplasia exposed to 5α-reductase inhibitors than in men receiving tamsulosin, but did not differ between men receiving dutasteride and those receiving finasteride. Additional monitoring might be required for men starting these drugs, particularly in those with other risk factors for type 2 diabetes.

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