The Prevalence and Association of Metabolic Syndrome With Benign Prostatic Enlargement Among Men Treated at Kenyatta National Hospital

Abstract

Background: Metabolic syndrome, a conglomeration of metabolic derangements associated with central adiposity and insulin resistance, is thought to result in development of Benign Prostate Enlargement (BPE). We sought to establish the prevalence of metabolic syndrome in BPE and its association with BPE in order to elaborate on the cause of BPE among African populations. Methodology: Using a cross sectional study design, 97 men seeking treatment for BPE at a Kenyan hospital were recruited through consecutive sampling approach. Exposure variables included age, lower urinary tract symptoms (LUTS), PSA levels and prostate ultrasound findings. The international prostate symptoms score (IPSS) provided a standard assessment of the severity of LUTS associated with BPE and were categorized into moderate and severe. The outcome, occurrence of metabolic syndrome, was diagnosed using any three of the following features: - waist circumference, blood pressure reading, fasting blood sugar and lipid profile above the normal laboratory ranges. Chi square test was used for hypothesis testing. Results: The mean age of study participants was 69.5 years. Proportion of patients with moderate LUTS was 22.7% compared to severe in 77.3%. Mean PSA level was 5.44ng/ml with 38.1% of men having elevated PSA. Mean prostate size was 74.3gms. Mean fasting blood sugar was 8.21mmols/l. Mean waist circumference was 39.1 inches with high waist circumference occurring in 36.1% of participants. The mean of HDL was 57mg/dl with 30.9% having low HDL. The mean triglyceride level was 104.7mg/dl with elevated levels found in 7.2%. Hypertension was prevalent in 50.5%. The prevalence of metabolic syndrome was 33% (CI 24 - 42). Men with severe LUTs had high odds of having metabolic syndrome (OR 4 (CI 1 – 22.6), p value=.038) compared to those with moderate LUTS. Conclusion: The prevalence of metabolic syndrome among African populations is increasing. From our findings, there is a correlation of metabolic Syndrome and BPE. With paucity of data on association between metabolic syndrome and BPE in the African continent, this study provides a new insight which will greatly help to improve management protocols of care in patients with BPE.