Association between metabolic syndrome and risk of benign prostatic hyperplasia: a prospective cohort study of 163 975 participants.

Background: Previous studies have identified metabolic syndrome (MetS) as a risk factor for benign prostatic hyperplasia (BPH). However, large-scale evidence remains to be established. This study aims to examine the association between MetS and the risk of incident BPH using large-scale cohort data, as well as the underlying biological mechanisms.

Methods: We used prospective cohort data from the UK Biobank, including 163 975 male participants. We applied Cox proportional hazards models to estimate the risk of BPH associated with MetS, adjusting for sociodemographic and lifestyle factors. A mediation analysis was conducted to investigate the potential mediating role of various biomarkers.

Results: The median follow-up period was 13.40 years, during which 6614 participants (12.03%) with MetS developed BPH. The presence of MetS was associated with an increased risk of BPH (hazard ratio = 1.07; 95% confidence interval = 1.03-1.10). Further analysis showed that longer follow-up duration, individual MetS components (elevated waist circumference, elevated triglycerides, elevated blood pressure, elevated glycated haemoglobin, and reduced high-density lipoprotein cholesterol), and the cumulative number of components were all significantly associated with an increased risk of BPH. Mediation analysis indicated that inflammation, erythrocyte-related biomarkers, liver function, and renal function partially mediated these associations.

Conclusions: MetS is a significant risk factor for the incident BPH. Inflammation, erythrocyte-related biomarkers, liver and renal function partially mediate this relationship. Early detection and intervention in MetS may help reduce the risk of developing BPH.