Prostate growth in men with benign prostatic hyperplasia (BPH) is increased in the presence of the metabolic syndrome, according to a study that supports a causative role for hyperinsulinemia.


Researchers at the Numune Education and ResearchHospital in Ankara, Turkey, prospectively studied 78 BPH patients with lower urinary tract symptoms. They divided subjects into two groups according to the presence or absence of metabolic syndrome, which the investigators defined based on the National Cholesterol Education Program’s Third Adult Treatment Panel.

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Subjects with metabolic syndrome had significantly higher median body weight, BMI, serum glucose, serum triglyceride, and PSA levels, but lower serum HDL levels than men without the syndrome. The men with metabolic syndrome had a median annual growth rate in total prostate (TP) volume and transition zone (TZ) volume of 1.0 and 1.25 mL, respectively, the investigators reported in European Urology (2006;Epub ahead print).


The rates for men without the syndrome were 0.64 and 0.93. Moreover, median serum insulin levels were significantly higher in the metabolic syndrome group than in the men without the syndrome. Thirty men (78.9%) in metabolic syndrome group were hyperinsulemic (greater than 20 µIU/mL), compared with only seven patients (17.5%) in the other group. Both annual TP and TZ growth rates correlated significantly with serum insulin levels.


Metabolic syndrome, the investigators noted, is a constellation of multiple metabolic and CVD risk factors, at the center of which is insulin resistance and compensatory hyperinsulemia, which are etiologic links between metabolic syndrome and elevated BPH risk. The researchers say their data suggest that hyperinsulemia is a systemic causal factor in the development of BPH.