Association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and early-onset benign prostatic hyperplasia: a cross-sectional analysis based on NHANES.

Background: The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR), a biomarker of lipid metabolism, has been used to predict cardiovascular disease incidence. However, its association with early-onset benign prostatic hyperplasia (BPH) remains unclear. This study aimed to investigate the relationship between NHHR and the risk of early-onset BPH.

Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) in the United States between 2005 and 2008. NHHR was calculated as the ratio of non-HDL-C to HDL-C. Weighted multivariable logistic regression models were used to assess the association after adjusting for potential confounders.

Results: A total of 530 participants were included, with a median onset age of 60 years. Participants were divided into early-onset and late-onset BPH groups based on the median age. The early-onset group had higher rates of current smoking, education level, poverty-income ratio (PIR), BMI, NHHR, and total cholesterol compared to the late-onset group. After full adjustment, elevated NHHR was significantly associated with increased odds of early-onset BPH (OR = 1.35; 95% CI 1.09-1.68; P = 0.010). Additionally, higher NHHR was associated with a younger age of BPH onset (exp(β) = 0.17; 95% CI 0.07-0.42; P < 0.001). Subgroup analysis showed that this association was observed in most subgroups.

Conclusion: Elevated NHHR is positively associated with early-onset BPH. Further prospective studies are needed to explore the role of lipid metabolism in prostate disease.