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

Article information

Korean J Health Promot. 2015;15(4):202-208

Publication date (electronic) : 2015 December 19

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

Heeseung Son ¹, Byungseong Suh^,¹, Soogeun Kim ¹, Junpyo Myong ¹, Youil Shon ¹, Heeyun Kim ¹, Hanseur Jeong ¹

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 2015 September 25; Accepted 2015 November 05.

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

Table 2.

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

Table 3.

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

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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.

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

Values were presented as medians (interquartile range).

Calculated by t-test.

Calculated by Mann-Whitney test.

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.

Values were presented as mean±SD.

Log transformed values were used for analysis.

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.

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