Association between Insulin Resistance and Benign Prostatic Hyperplasia in Healthy Middle-aged Korean Men

Heeseung Son; Byungseong Suh; Soogeun Kim; Junpyo Myong; Youil Shon; Heeyun Kim; Hanseur Jeong

doi:10.15384/kjhp.2015.15.4.202

Korean J Health Promot > Volume 15(4); 2015 > Article

Son, Suh, Kim, Myong, Shon, Kim, and Jeong: Association between Insulin Resistance and Benign Prostatic Hyperplasia in Healthy Middle-aged Korean Men

Original Article

Korean Journal of Health Promotion 2015;15(4):202-208.

Published online: December 19, 2015

DOI: https://doi.org/10.15384/kjhp.2015.15.4.202

Association between Insulin Resistance and Benign Prostatic Hyperplasia in Healthy Middle-aged Korean Men

Heeseung Son¹, Byungseong Suh¹, Soogeun Kim¹, Junpyo Myong¹, Youil Shon¹, Heeyun Kim¹, Hanseur Jeong¹

¹Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Medical Center of Sungkyunkwan University School of Medicine, Seoul, Korea

²Department of Occupational & Environmental Medicine, Seoul Mary's Hospital, The Catholic University School of Medicine, Seoul, Korea

￭ Corresponding author：Byungseong Suh, MD, PhD Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Medical Center of Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
Tel: +82-2-2001-1863, Fax: +82-2-2001-2748 E-mail: byungseong.suh@samsung.com

Received September 25, 2015 Accepted November 05, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background

We examined the association between insulin resistance assessed by homeostatic model assessment-insulin resistance (HOMA-IR) and benign prostatic hyperplasia (BPH) in healthy middle-aged male subjects.

Methods

A cross-sectional study included 1,727 male subjects, aged 40-59 year, free of medication history for BPH who received a transrectal ultrasonography and completed a structured questionnaire in 2011. Multiple logistic regression analysis was performed to evaluate the relationships of HOMA-IR with BPH across the tertile of HOMA-IR.

Results

The prevalence of BPH was 24.4% (421 out of 1,727). It was increased across HOMA-IR tertiles in crude and age-adjusted models. In a multivariable-adjusted model after adjusting potential confounders such as age, body mass index (BMI), triglyceride, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), alcohol consumption, smoking, exercise and meat consumption, odds ratios (95% confidence intervals, CIs) of BPH for 2nd tertile and 3rd tertile compared to 1st tertile were 1.76 (1.31-2.35), and 1.83 (1.34-2.48), respectively.

Conclusions

In middle-aged, healthy men, higher HOMA-IR was significantly associated with higher prevalence of BPH, supporting insulin resistance as an independent risk factor for BPH.

Keywords: Insulin resistance, Benign prostatic hyperplasia, Middle-aged

Figure 1.

Flow for the selection of study subjects.

Table 1.

Baseline characteristics of study participants by the presence of BPH

	Overall	Normal	BPH	P
Number	1,727	1,306 (75.6%)	421 (24.4%)
Age, y^a	45.6±4.3	45.6±4.4	45.6±4.2	0.949^c
BMI, kg/m^2a	22.72±1.56	22.67±1.59	22.90±1.46	0.006^c
WC, cm^a	81.9±4.5	81.6±4.6	82.7±4.1	＜0.001^c
Systolic BP, mmHg^a	112.4±10.1	111.6±10.0	114.8±10.0	＜0.001^c
Diastolic BP, mmHg^a	72.4±8.1	71.6±8.1	74.6±7.8	＜0.001
Glucose, mg/dL^b	96 (91-102)	96 (91-101)	99 (94-105)	＜0.001^d
Fasting insulin, mIU/L^b	3.87 (2.67-5.41)	3.76 (2.56-5.33)	4.30 (3.03-5.69)	＜0.001^d
HOMA-IR^b	0.93 (0.62-1.33)	0.89 (0.59-1.30)	1.04 (0.74-1.44)	＜0.001^d
Triglyceride, mg/dL^b	112 (83-154)	111 (81-155)	113 (87-153)	0.276^d
Total cholesterol, mg/dL^a	202.3±32.3	202.4±32.5	202.2±31.7	0.900^c
HDL-C, mg/dL^a	56.0±13.1	56.0±12.9	55.9±13.8	0.872^c
LDL-C, mg/dL^a	128.0±29.4	128.4±29.7	126.8±28.7	0.343^c
PSA, ng/mL^b	0.88 (0.63-1.24)	0.83 (0.59-1.17)	1.06 (0.79-1.43)	＜0.001^d
Alcohol use^a				0.976^e
Normal	55.6%	55.7%	55.6%
High risk	44.4%	44.3%	44.4%
Smoking^a				0.441^e
Non and ex-smoker	54.4%	53.9%	56.1%
Current smoker	45.6%	46.1%	43.9%
Regular exercise^a				0.073^e
≥ 5 times/week	48.9%	50.2%	45.1%
＜5 times/week	51.1%	49.8%	54.9%
Meat consumptiona				0.111^e
＜1 time/week	56.1%	57.1%	52.7%
1-2 times/week	37.0%	36.2%	39.4%
≥ 3 times/week	6.9%	6.7%	7.8%

Abbreviations: BPH, benign prostatic hyperplasia; BMI, body mass index; WC, waist circumference; BP, blood pressure; HOMA-IR, homeostasis model of insulin resistance; HDL-C, high-density lipoprotein√cholesterol; LDL-C, low-density lipoprotein cholesterol; PSA, prostate specific antigen.

^a Values were presented as N (%) or mean±SD.

^b Values were presented as medians (interquartile range).

^c Calculated by t-test.

^d Calculated by Mann-Whitney test.

^e Calculated by chi-square test.

Table 2.

Baseline characteristics and prevalence of benign prostatic hyperplasia by HOMA-IR categories

	The 1^st tertile (n＝576)	The 2^nd tertile (n＝584)	The 3^rd tertile (n＝567)	P-trend
	HOMA-IR ≤ 0.72	0.72＜HOMA-IR ≤ 1.19	1.19＜HOMA-IR	P-trend
Age, y^a	45.8±4.5	45.7±4.4	45.1±4.0	0.011^c
BMI, kg/m^2a	22.12±1.74	22.80±1.45	23.26±1.25	＜0.001^c
WC, cm^a	80.0±4.8	82.1±4.2	83.6±3.7	＜0.001^c
Systolic BP, mmHg^a	110.1±10.0	113.1±9.9	114.0±10.0	＜0.001^c
Diastolic BP, mmHg^a	70.3±8.2	73.1±7.9	73.7±7.8	＜0.001^c
Triglyceride, mg/dL^b	102.0±57.8	128.1±59.7	158.8±113.5	＜0.001^c
Total cholesterol, mg/dL^a	197.9±30.7	202.7±31.4	206.4±34.2	＜0.001^c
HDL-C, mg/dL^a	59.2±13.6	56.4±12.9	52.3±12.0	＜0.001^c
LDL-C, mg/dL^a	124.4±28.9	128.3±28.7	131.3±30.4	＜0.001^c
PSA, ng/mL^b	1.02±0.57	1.05±0.59	0.95±0.52	0.025^c

Abbreviations: BMI, body mass index; WC, waist circumference; BP, blood pressure; HOMA-IR, homeostasis model of insulin resistance HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; PSA, prostate specific antigen; BPH, benign prostatic hyperplasia.

^a Values were presented as mean±SD.

^b Log transformed values were used for analysis.

^c Calculated by linear regression analyses for linear trend.

Table 3.

Odds ratios and 95% confidence intervals for the prevalence of benign prostatic hyperplasia in HOMA-IR and HOMA-IR categories^a

	Prevalence of BPH	Model 1	Model 2	Model 3
HOMA-IR (continuous variable)		1.28 (1.09-1.50)	1.28 (1.09-1.50)	1.25 (1.04-1.50)
The 1^st tertile (n＝576)	17.4%	1.00	1.00	1.00
The 2^nd tertile (n＝584)	27.4%	1.80 (1.36-2.38)	1.80 (1.36-2.38)	1.76 (1.31-2.35)
The 3^rd tertile (n＝567)	28.4%	1.89 (1.42-2.50)	1.89 (1.42-2.51)	1.83 (1.34-2.48)

Abbreviations: HOMA-IR, homeostasis model of insulin resistance; BPH, benign prostatic hyperplasia.

Model 1: crude.

Model 2: age-adjusted.

Model 3: age, triglyceride, HDL-cholesterol, LDL-cholesterol, BMI, exercise, alcohol consumption, smoking, meat consumption adjusted.

^a Values are presented as odds ratio and 95% confidence interval using logistic regression model.

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