Abstract
OBJECTIVE:
To examine the association of components of the metabolic syndrome with lower urinary tract symptoms (LUTS), which often result from prostate enlargement and heightened tone of prostate and bladder smooth muscle.
DESIGN:
Third National Health and Examination Survey (NHANES III), from which LUTS cases and controls were selected.
SUBJECTS:
A total of 2372 men aged 60+ y who participated in NHANES III. LUTS cases were men with at least three of these four symptoms: nocturia, incomplete bladder emptying, weak stream, and hesitancy, and who never had noncancer prostate surgery. Controls were men without any of the symptoms and who never had noncancer prostate surgery.
MEASUREMENTS:
As part of NHANES III, an oral glucose tolerance test was carried out, glycosylated hemoglobin, HDL and LDL cholesterol, and triglycerides were measured, and history of diabetes mellitus and hypertension were assessed. Logistic regression was used to calculate odds ratios (ORs) after applying sampling weights.
RESULTS:
History of diabetes (OR 1.67; 95% confidence interval (CI) 0.72–3.86) and hypertension (OR 1.76; 95% CI 1.20–2.59) appeared to be positively associated with LUTS. The odds of LUTS increased with increasing glycosylated hemoglobin (P-trend=0.005). No statistically significant associations between fasting or 2-h glucose or fasting insulin and LUTS were observed. However, men classified as having three or more components of the metabolic syndrome had an increased odds of LUTS (OR=1.80; 95% CI 1.11–2.94).
CONCLUSION:
These findings support the role for metabolic perturbations in the etiology of LUTS.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Hammarsten J, Hogstedt B, Holthuis N, Mellstrom D . Components of the metabolic syndrome-risk factors for the development of benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 1998; 1: 157–162.
Joseph MA, Harlow SD, Wei JT, Sarma AV, Dunn RL, Taylor JMG, James SA, Cooney KA, Doerr KM, Montie JE, Schottenfeld D . Risk factors for lower urinary tract symptoms in a population-based sample of African-American men. Am J Epidemiol 2003; 157: 906–914.
Barry MJ, Fowler Jr FJ, O'Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, Cockett AT . The American Urological Association Symptom Index for benign prostatic hyperplasia. The measurement committee of the American Urological Association. J Urol 1992; 148: 1549–1557.
National Center for Health Statistics. Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–94. Series 1: Programs and collection procedures. Vital Health Stat 1994; 1: 1–407.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–419.
Brown CD, Higgins M, Donato KA, Rohde FC, Garrison R, Obarzanek E, Ernst ND, Horan M . Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res 2000; 8: 605–619.
Gunter EW, Lewis BG, Koncikowski SM . Laboratory procedures used for the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994. Centers for Disease Control and Prevention: Hyattsville, MD; 1996.
Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB . The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 2003; 163: 427–436.
Shah BV, Barnwell BG, Bieler GS . SUDAAN user's manual: software for analysis of correlated data. Research Triangle Institute: Research Triangle Park, NC; 1995.
Rohrmann S, Smit E, Giovannucci E, Platz EA . Associations of obesity with lower urinary tract symptoms and noncancer prostate surgery in the Third National Health and Nutrition Examination Survey. Am J Epidemiol 2004; 159: 390–397.
Dahle SE, Chokkalingam AP, Gao YT, Deng J, Stanczyk FZ, Hsing AW . Body size and serum levels of insulin and leptin in relation to the risk of benign prostatic hyperplasia. J Urol 2002; 168: 599–604.
Liu K, Stamler J, Stamler R, Cooper R, Shekelle RB, Schoenberger JA, Berkson DM, Lindberg HA, Marquardt J, Stevens E, Tokich T . Methodological problems in characterizing an individual's plasma glucose level. J Chronic Dis 1982; 35: 475–485.
Khaw K-T, Wareham N, Luben R, Bingham S, Oakes S, Welch A, Day N . Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk). BMJ 2001; 322: 15–18.
Hammarsten J, Hogstedt B . Clinical, anthropometric, metabolic and insulin profile of men with fast annual growth rates of benign prostatic hyperplasia. Blood Press 1999; 8: 29–36.
Roberts RO, Jacobson DJ, Girman CJ, Rhodes T, Klee GG, Lieber MM, Jacobsen SJ . Insulin-like growth factor I, insulin-like growth factor binding protein 3, and urologic measures of benign prostatic hyperplasia. Am J Epidemiol 2003; 157: 784–791.
Chokkalingam AP, Gao YT, Deng J, Stanczyk FZ, Sesterhenn IA, Mostofi FK, Fraumeni Jr JF, Hsing AW . Insulin-like growth factors and risk of benign prostatic hyperplasia. Prostate 2002; 52: 98–105.
Stattin P, Kaaks R, Riboli E, Ferrari P, Dechaud H, Hallmans G . Circulating insulin-like growth factor-i and benign prostatic hyperplasia—a prospective study. Scand J Urol Nephrol 2001; 35: 122–126.
Scherrer U, Sartori C . Insulin as a vascular and sympathoexcitatory hormone: implications for blood pressure regulation, insulin sensitivity, and cardiovascular morbidity. Circulation 1997; 96: 4104–4113.
Michel MC, Mehlburger L, Schumacher H, Bressel HU, Goepel M . Effect of diabetes on lower urinary tract symptoms in patients with benign prostatic hyperplasia. J Urol 2000; 163: 1725–1729.
Sechi LA, Catena C, Zingaro L, De Carli S, Bartoli E . Hypertension and abnormalities of carbohydrate metabolism possible role of the sympathetic nervous system. Am J Hypertens 1997; 10: 678–682.
Landsberg L . Role of the sympathetic adrenal system in the pathogenesis of the insulin resistance syndrome. Ann N Y Acad Sci 1999; 892: 84–90.
Haffner SM . Sex hormones, obesity, fat distribution, type 2 diabetes and insulin resistance: epidemiological and clinical correlation. Int J Obes Relat Metab Disord 2000; 24 (Suppl 2): S56–S58.
Abate N, Haffner SM, Garg A, Peshock RM, Grundy SM . Sex steroid hormones, upper body obesity, and insulin resistance. J Clin Endocrinol Metab 2002; 87: 4522–4527.
Gann PH, Hennekens CH, Longcope C, Verhoek-Oftedahl W, Grodstein F, Stampfer MJ . A prospective study of plasma hormone levels, nonhormonal factors, and development of benign prostatic hyperplasia. Prostate 1995; 26: 40–49.
Krieg M, Nass R, Tunn S . Effect of aging on endogenous level of 5 alpha-dihydrotestosterone, testosterone, estradiol, and estrone in epithelium and stroma of normal and hyperplastic human prostate. J Clin Endocrinol Metab 1993; 77: 375–381.
Hautanen A . Synthesis and regulation of sex hormone-binding globulin in obesity. Int J Obes Relat Metab Disord 2000; 24 (Suppl 2): S64–S70.
Platz EA, Kawachi I, Rimm EB, Longcope C, Stampfer MJ, Willett WC, Giovannucci E . Plasma steroid hormones, surgery for benign prostatic hyperplasia, and severe lower urinary tract symptoms. Prostate Cancer Prostatic Dis 1999; 2: 285–289.
World Health Organization. Diabetes mellitus: report of a who study group. WHO: Geneva, Switzerland; 1995. WHO Technical Report Series 727.
Vinik AI, Maser RE, Mitchell BD, Freeman R . Diabetic autonomic neuropathy. Diabetes Care 2003; 26: 1553–1579.
Nightingale SL . From the food and drug administration. JAMA 1992; 268: 1390.
Food and Drug Administration. Electronic orange book: approved drug products with therapeutic equivalence evaluations http://www.accessdata.fda.gov/scripts/cder/ob/docs/tempaidet.cfm?Appl_No=020180&TABLE1=Rx.
Terazosin now indicated for benign prostatic hyperplasia. Am J Hosp Pharm 1994; 51: 25.
Andersson KE . Storage and voiding symptoms: pathophysiologic aspects. Urology 2003; 62 (5 Suppl 2): 3–10.
Acknowledgements
Dr Rohrmann is supported by the Fund for Research and Progress in Urology, Johns Hopkins Medical Institutions.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rohrmann, S., Smit, E., Giovannucci, E. et al. Association between markers of the metabolic syndrome and lower urinary tract symptoms in the Third National Health and Nutrition Examination Survey (NHANES III). Int J Obes 29, 310–316 (2005). https://doi.org/10.1038/sj.ijo.0802881
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0802881
Keywords
This article is cited by
-
Sleep-related disorders and lower urinary tract symptoms in middle-aged and elderly males: a cross-sectional study based on NHANES 2005–2008
Sleep and Breathing (2024)
-
SKA-31-induced activation of small-conductance calcium-activated potassium channels decreased modulation of detrusor smooth muscle function in a rat model of obesity
Journal of Bioenergetics and Biomembranes (2022)
-
INPP4B protects from metabolic syndrome and associated disorders
Communications Biology (2021)
-
Obesity, metabolic health, and urological disorders in adults: a nationwide population-based study
Scientific Reports (2021)
-
Attenuated regulatory function of the small-conductance Ca2+-activated K+ channel in detrusor smooth muscle cells excitability in an obese rat model
International Urology and Nephrology (2020)