Lipids, lipoproteins and the risk of benign prostatic hyperplasia in community-dwelling men

OBJECTIVE To examine the associations of serum lipids and lipoproteins with benign prostatic hyperplasia (BPH) in community-dwelling men. SUBJECTS AND METHODS This analysis was conducted within the Rancho Bernardo Study, a prospective, community-based cohort study. BPH was defined as a history of prostate surgery for other than cancer, or a medical diagnosis of BPH. Logistic regression modelling, with adjustments for age and stratification by diabetes diagnosis, was used to estimate the odds ratio (OR) of BPH associated with fasting serum concentrations of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and the triglyceride to HDL ratio. RESULTS Among 531 eligible participants, 259 (48%) reported BPH and 272 (52%) reported no BPH. Men with BPH, with a mean (range) age of 75.8 (76.1-80.1) years, were older than men without BPH , at 72.7 (72.4-74.0) years. There were no significant associations of total cholesterol (P trend, 0.52), HDL cholesterol (0.56), triglycerides (0.30), or triglyceride to HDL ratio (0.13) with the risk of BPH. In a subset analysis in men with diabetes, those in the highest tertile (> 133 mg/dL) of LDL cholesterol, compared with those in the lowest tertile (< 110 mg/dL), were four times more likely to have BPH (odds ratio 4.00, 95% confidence interval 1.27-12.63, P trend 0.02). These results were not explained by the use of statins. CONCLUSIONS In these community-dwelling men, higher serum LDL was associated with a greater risk of BPH among diabetics. These data suggest that diabetic men with increased LDL cholesterol are at greater risk of BPH. This observation is consistent with the concept that cardiac risk factors are involved with the pathogenesis of BPH.