Serum cholesterol and risk of lower urinary tract symptoms progression: Results from the Reduction by Dutasteride of Prostate Cancer Events study

• Published in: International journal of urology Vol. 24; no. 2; pp. 151 - 156
• Main Authors: Feng, Tom, Howard, Lauren E, Vidal, Adriana C, Moreira, Daniel M, Castro‐Santamaria, Ramiro, Andriole, Gerald L, Freedland, Stephen J
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.02.2017
• Subjects: Benign; benign prostatic hyperplasia; Cholesterol; Dyslipidemia; Hyperplasia; lipids; Low density lipoprotein; lower urinary tract symptoms; Prostate cancer; Statistical analysis; Surgery; Urinary tract; Urogenital system; cholesterol; lipids; lower urinary tract symptoms; benign prostatic hyperplasia
• ISSN: 0919-8172; 1442-2042; 1442-2042
• DOI: 10.1111/iju.13265

Objective To determine if cholesterol is a risk factor for the development of lower urinary tract symptoms in asymptomatic men. Methods A post‐hoc analysis of the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study was carried out in 2323 men with baseline International Prostate Symptom Score <8 and not taking benign prostatic hyperplasia or cholesterol medications. Cox proportion models were used to test the association between cholesterol, high‐density lipoprotein, low‐density lipoprotein and the cholesterol : high‐density lipoprotein ratio with incident lower urinary tract symptoms, defined as first report of medical treatment, surgery or two reports of an International Prostate Symptom Score >14. Results A total of 253 men (10.9%) developed incident lower urinary tract symptoms. On crude analysis, higher high‐density lipoprotein was associated with a decreased lower urinary tract symptoms risk (hazard ratio 0.89, P = 0.024), whereas total cholesterol and low‐density lipoprotein showed no association. After multivariable adjustment, the association between high‐density lipoprotein and incident lower urinary tract symptoms remained significant (hazard ratio 0.89, P = 0.044), whereas no association was observed for low‐density lipoprotein (P = 0.611). There was a trend for higher cholesterol to be linked with higher lower urinary tract symptoms risk, though this was not statistically significant (hazard ratio 1.04, P = 0.054). A higher cholesterol : high‐density lipoprotein ratio was associated with increased lower urinary tract symptoms risk on crude (hazard ratio 1.11, P = 0.016) and adjusted models (hazard ratio 1.12, P = 0.012). Conclusions Among asymptomatic men participating in the REDUCE study, higher cholesterol was associated with increased incident lower urinary tract symptoms risk, though the association was not significant. A higher cholesterol : high‐density lipoprotein ratio was associated with increased incident lower urinary tract symptoms, whereas higher high‐density lipoprotein was protective. These findings suggest dyslipidemia might play a role in lower urinary tract symptoms progression.