Hyperlipidemia is associated with an increased risk of clinical benign prostatic hyperplasia

• Published in: The Prostate Vol. 78; no. 2; pp. 113 - 120
• Main Authors: Shih, Hung‐Jen, Huang, Chun‐Jen, Lin, Jui‐An, Kao, Ming‐Chang, Fan, Yen‐Chun, Tsai, Pei‐Shan
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.02.2018
• Subjects: 5-alpha Reductase Inhibitors - therapeutic use; Adult; Aged; Anti-inflammatory agents; Aspirin; Benign; Cardiovascular disease; Cirrhosis; Confounding Factors (Epidemiology); Coronary artery disease; Data processing; Diabetes mellitus; Diagnosis; Genital diseases; Health risk assessment; Heart diseases; High fat diet; Humans; Hyperlipidemia; Hyperlipidemias - diagnosis; Hyperlipidemias - epidemiology; Hyperplasia; Incidence; Inflammation; lipid; Liver cirrhosis; Liver diseases; Male; Metformin; Middle Aged; Population studies; Proportional Hazards Models; Prostate; Prostate - pathology; Prostatic Hyperplasia - diagnosis; Prostatic Hyperplasia - epidemiology; Prostatic Hyperplasia - therapy; Reductase; Risk Factors; Statistics as Topic; Taiwan - epidemiology; Transurethral Resection of Prostate - methods; Transurethral Resection of Prostate - statistics & numerical data; hyperplasia; hyperlipidemia; prostate; lipid
• ISSN: 0270-4137; 1097-0045; 1097-0045
• DOI: 10.1002/pros.23451

Background A high fat diet is associated with risk of benign prostatic hyperplasia (BPH). However, whether hyperlipidemia is associated with BPH remains unclear. This population‐based cohort study elucidated whether hyperlipidemia is associated with an increased risk of BPH. Methods We used a new‐exposure design and analyzed data retrieved from the Taiwan National Health Insurance Database between January 1, 2000 and December 31, 2013. The cohort of men with newly diagnosed hyperlipidemia and the age‐ and index‐date‐matched (1:3) nonhyperlipidemia cohort were tracked for incidence of BPH during a 1‐ to 14‐year follow‐up. Diagnosis of BPH using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, and the occurrence of BPH diagnosis plus the use of alpha‐blockers or 5‐alpha reductase inhibitors or receipt of transurethral resection of the prostate were the primary and secondary endpoints, respectively. The confounders in this study were diabetes mellitus, hypertension, coronary heart disease, obesity, liver cirrhosis, nonsteroidal anti‐inflammatory drugs, metformin, aspirin, and number of urologist visits. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a multivariate Cox proportional hazards regression model adjusted for the propensity score. Results A total of 35 860 subjects (aged 40‐99 years)—including the hyperlipidemia cohort (n = 8,965) and nonhyperlipidemia cohort (n = 26 895)—were identified. Our data revealed that the hyperlipidemia cohort had significantly higher incidences of developing BPH (24.6% vs 12.3%, P < 0.001) and treated BPH (13% vs 5.7%, P < 0.001) compared with the nonhyperlipidemia cohort. The risk of developing BPH in the hyperlipidemia cohort was significantly higher than that in the nonhyperlipidemia cohort (HR = 1.73, 95% CI = 1.63‐1.83, P < 0.001) after adjustment for the propensity score. Conclusions Hyperlipidemia is associated with an increased risk of clinical BPH.