Skip to main content

Advertisement

Log in

Benign prostatic hyperplasia: dietary and metabolic risk factors

  • Review
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Benign prostatic hyperplasia (BPH) is the most common nonmalignant condition of the prostate occurring in ageing men. Even though BPH is a major public health problem, causing high morbidity and substantial worsening in men’s quality of life, little is known about its risk factors. Several studies revealed that it is a multifactorial disease. Previous studies have documented family history, hormonal imbalance, and growth factors as etiological factors in the development of BPH. This review focuses on the dietary and metabolic risk factors including diabetes mellitus, hypertension, obesity, hyperinsulinemia, as well as dyslipidemia and their mechanisms in the pathogenesis of BPH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

BPH:

Benign prostatic hyperplasia

EPA:

Eicosapentaenoic acid

DHA:

Docosahexaenoic acid

DHT:

Dihydrotestosterone

LUTS:

Lower urinary tract symptoms

HIF:

Hypoxia inducible factor

VEGF:

Vascular endothelial growth factor

FGF:

Fibroblast growth factors

IL:

Interleukin

BMI:

Body mass index

WHR:

Waist-to-hip ratio

SHR:

Spontaneously hypertensive rats

PSA:

Prostate specific antigen

IHD:

Ischemic heart disease

IGF:

Insulin-like growth factor

LDL:

Low density lipoprotein

HDL:

High density lipoprotein

References

  1. Berry SJ, Coffey DS, Walsh PC et al (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474–479

    PubMed  CAS  Google Scholar 

  2. Ziada A, Rosenblum M, Crawford ED (1999) Benign prostatic hyperplasia: an overview. Urology 53(3):1–6

    Article  PubMed  CAS  Google Scholar 

  3. Barry JM (1990) Epidemiology and natural history of BPH. Urol Clin North Am 17(3):495–507

    PubMed  CAS  Google Scholar 

  4. Partin AW, Oesterling JE et al (1991) Influence of age and endocrine factors on the volume of benign prostatic hyperplasia. J Urol 145(2):405–409

    PubMed  CAS  Google Scholar 

  5. Sanda MG, Beaty TH, Stutzman RE et al (1994) Genetic susceptibility of benign prostatic hyperplasia. J Urol 152:115–119

    PubMed  CAS  Google Scholar 

  6. Golda R, Wolski Z, Wyszomirska-Golda M et al (2004) The presence and structure of circulating immune complexes in patients with prostate tumors. Med Sci Monit 10:CR123–CR127

    PubMed  Google Scholar 

  7. Sinowatz F, Amselgruber W, Plendl J et al (1995) Effects of hormones on the prostate in adult and aging men and animals. Microsc Res Tech 30:282–292

    Article  PubMed  CAS  Google Scholar 

  8. Griffiths K, Denis L, Turkes A et al (1998) Phytoestrogens and diseases of the prostate gland. Baillieres Clin Endocrinol Metab 12:625–647

    Article  PubMed  CAS  Google Scholar 

  9. Kolle S, Sinowatz F, Boie G et al (1999) Expression of growth hormone receptor in human prostatic carcinoma and hyperplasia. Int J Oncol 14:911–916

    PubMed  CAS  Google Scholar 

  10. Leav I, Merk FB, Lee KF (1999) Prolactin receptor expression in the developing human prostate and in hyperplastic, dysplastic, and neoplastic lesions. Am J Pathol 154:863–870

    PubMed  CAS  Google Scholar 

  11. Stattin P, Kaaks R, Riboli E et al (2001) Circulating insulin-like growth factor-I and benign prostatic hyperplasia—a prospective study. Scand J Urol Nephrol 35:122–126

    Article  PubMed  CAS  Google Scholar 

  12. Wang FL, Wang H, Qin WJ et al (2004) Expression and its significance of b-FGF in human benign prostatic hyperplasia and prostatic carcinoma tissues. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 20:203–205

    PubMed  Google Scholar 

  13. Wolff JM, Fandel T, Borchers H et al (1998) Transforming growth factor-beta1 serum concentration in patients with prostatic cancer and benign prostatic hyperplasia. Br J Urol 81:403–405

    PubMed  CAS  Google Scholar 

  14. Suzuki S, Platz EA, Kawachi I et al (2002) Intakes of energy and macronutrients and the risk of benign prostatic hyperplasia. Am J Clin Nutr 75:689–697

    PubMed  CAS  Google Scholar 

  15. Gu F (1997) Changes in the prevalence of benign prostatic hyperplasia in China. Chin Med J 110:163–166

    PubMed  CAS  Google Scholar 

  16. Araki H, Watanabe H, Mishina T et al (1983) High-risk group for benign prostatic hypertrophy. Prostate 4:253–264

    Article  PubMed  CAS  Google Scholar 

  17. Denis L, Morton MS, Griffiths K (1999) Diet and its preventive role in prostatic disease. Eur Urol 35:377–387

    Article  PubMed  CAS  Google Scholar 

  18. Troisi RJ, Weiss ST, Parker DR et al (1991) Relation of obesity and diet to sympathetic nervous system activity. Hypertension 17:669–677

    PubMed  CAS  Google Scholar 

  19. Augustin LS, Franceschi S, Jenkins DJ (2002) Glycemic index in chronic disease: a review. Eur J Clin Nutr 56:1049–1071

    Article  PubMed  CAS  Google Scholar 

  20. Chokkalingam AP, Gao YT, Deng J (2002) Insulin-like growth factors and risk of benign prostatic hyperplasia. Prostate 52:98–105

    Article  PubMed  CAS  Google Scholar 

  21. Bostwick D (1996) Pathology of benign prostatic hyperplasia. In: Kirby R, McConnell J, Fitzpatrick J et al (eds) Textbook of benign prostatic hyperplasia. ISIS Medical Media, Ltd, Oxford, pp 91–104

    Google Scholar 

  22. Liang T, Liao S (1992) Inhibition of steroid 5α-reductase by specific aliphatic unsaturated fatty acids. Biochem J 285:557–562

    PubMed  CAS  Google Scholar 

  23. Weisser H, Krieg M (1998) Fatty acid composition of phospholipids in epithelium and stroma of human benign prostatic hyperplasia. Prostate 36:235–243

    Article  PubMed  CAS  Google Scholar 

  24. Boon TA, Van Venrooji GE, Eckhardt MD (2001) Effect of diabetes mellitus on lower urinary tract symptoms and dysfunction in patients with benign prostatic hyperplasia. Curr Urol Rep 2(4):297–301

    Article  PubMed  CAS  Google Scholar 

  25. Michel MC, Mehlburger L, Schumacher H et al (2000) Effect of diabetes on lower urinary tract symptoms in patients with benign prostatic hyperplasia. J Urol 163:1725–1729

    Article  PubMed  CAS  Google Scholar 

  26. Hammarsten J, Hogstedt B (2001) Hyperinsulinemia as a risk factor for developing benign prostatic hyperplasia. Eur Urol 39:151–158

    Article  PubMed  CAS  Google Scholar 

  27. Berger AP, Deibel M, Halpern EJ et al (2005) Vascular damage induced by type 2 diabetes mellitus as a risk factor for benign prostatic hyperplasia. Diabetologia 48:784–789

    Article  PubMed  CAS  Google Scholar 

  28. Ghafar MA, Puchner PJ, Anastasiadis AG et al (2002) Does the prostate vascular system contribute to the development of benign prostatic hyperplasia? Curr Urol Rep 3:292–296

    Article  PubMed  Google Scholar 

  29. Loran OB, Vishnevskii EL, Vishnevskii AE (1996) The role of detrusor hypoxia in the pathogenesis of urination disorders in patients with benign prostatic hyperplasia. Urol Nefrol 6:33–37

    Google Scholar 

  30. Berger AP, Kofler K, Bektic J et al (2003) Increased growth factor production in a human prostatic stromal cell culture model caused by hypoxia. Prostate 57:57–65

    Article  PubMed  CAS  Google Scholar 

  31. Palmer LA, Semenza GL, Stoler MH et al (1998) Hypoxia induces type II NOS gene expression in pulmonary artery endothelial cells via HIF-1. Am J Physiol 274:212–219

    Google Scholar 

  32. Dahle ES, Chokkalingam AP, Gao Y-T et al (2002) Body size and serum levels of insulin and leptin in relation to the risk of benign prostatic hyperplasia. J Urol 168:599–604

    Google Scholar 

  33. Hammarsten J, Hogstedt B (1999) Clinical, anthropometric, metabolic and insulin profile of men with fast annual growth rates of benign prostatic hyperplasia. Blood Press 8:29–36

    Article  PubMed  CAS  Google Scholar 

  34. Giovannucci E, Rimm EB, Chute CG et al (1994) Obesity and benign prostatic hyperplasia. Am J Epidemiol 140(11):989–1002

    PubMed  CAS  Google Scholar 

  35. Furukawa S, Fujita T, Shimabukuro M (2004) Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 114:1752–1761

    PubMed  CAS  Google Scholar 

  36. Nickel JC, Downey J, Young I et al (1999) Asymptomatic inflammation and/or infection in benign prostatic hyperplasia. BJU Int 84:976–981

    Article  PubMed  CAS  Google Scholar 

  37. Di Silverio F, Gentile V, De Matteis A (2003) Distribution of inflammation, pre-malignant lesions, incidental carcinoma in histologically confirmed benign prostatic hyperplasia: a retrospective analysis. Eur Urol 43:164–175

    Article  PubMed  Google Scholar 

  38. Ivleva AI, Sivkov AV (2000) Treatment of arterial hypertension in patients with benign prostatic hyperplasia. Urologia 1:6–11

    Google Scholar 

  39. Steers WD, Clemow DB, Persson K et al (1999) The spontaneously hypertensive rat: insight into the pathogenesis of irritative symptoms in benign prostatic hyperplasia and young anxious males. Exp Physiol 84(1):137–147

    PubMed  CAS  Google Scholar 

  40. Guo LJ, Zhang XH, Li PJ et al (2005) Association study between benign prostatic hyperplasia and primary hypertension. Zhonghua Wai Ke Za Zhi 43(2):108–111

    PubMed  Google Scholar 

  41. Guthrie RM, Siegel RL (1999) A multicenter, community-based study of doxazin in the treatment of concomitant hypertension and symptomatic benign prostatic hyperplasia: the hypertension and BPH intervention trial. Clin Ther 21(10):1732–1748

    Article  PubMed  CAS  Google Scholar 

  42. Steers WD, Clemow DB, Persson K et al (1999) The spontaneously hypertensive rats: insight into the pathogenesis of irritative symptoms in benign prostatic hyperplasia and young anxious males. Exp Physiol 84:137–147

    PubMed  CAS  Google Scholar 

  43. Lujan M, Ferruelo A, Paez A et al (2004) Prostate apoptosis after doxazin treatment in the spontaneous hypertensive rat model. BJU Int 93(3):410–414

    Article  PubMed  CAS  Google Scholar 

  44. Achari R, Hosmane B, Bonacci E et al (2000) The relationship between terazosin dose and blood pressure response in hypertensive patients. J Clin Pharmacol 40:1166–1172

    PubMed  CAS  Google Scholar 

  45. Esler M, Rumantir M, Kaye D (2001) Sympathetic nerve biology in essential hypertension. Clin Exp Pharmacol Physiol 28:986–989

    Article  PubMed  CAS  Google Scholar 

  46. Guo LJ, Zhang XH, Li PJ et al (2005) Impact of hypertension on angiogenesis in the tissues of benign prostatic hyperplasia. Zhonghua Yi Xue Za Zhi 85(9):606–609

    PubMed  CAS  Google Scholar 

  47. Weisman KM, Larijani GE, Goldstein MR et al (2000) Relationship between benign prostatic hyperplasia and history of coronary artery disease in elderly men. Pharmacotherapy 20(4):383–386

    Article  PubMed  CAS  Google Scholar 

  48. Aliaev IuG, Fiev DN, Kopvlov FIu et al (2005) Treatment of benign prostatic hyperplasia in patients with ischemic heart disease. Urologia 1:12–18

    Google Scholar 

  49. Berger AP, Bartsch G, Deibl M et al (2006) Atherosclerosis as a risk factor for benign prostatic hyperplasia. BJU Int 98(5):1038–1042

    Article  PubMed  Google Scholar 

  50. Azadzoi KM, Tarcan T, Siroky MB et al (1999) Atherosclerosis-induced chronic ischemia causes bladder fibrosis and non-compliance in the rabbit. J Urol 161:1626–1635

    Article  PubMed  CAS  Google Scholar 

  51. Reaven GM (1988) Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 37(12):1595–1607

    Article  PubMed  CAS  Google Scholar 

  52. Li L, Yang G, Li Q et al (2006) High fat and lipid induced insulin resistance in rats: the comparison of glucose metabolism, plasma resistin and adiponectin levels. Ann Nutr Metab 50(6):499–505

    Article  PubMed  CAS  Google Scholar 

  53. Reaven GM (1992) The role of insulin resistance and hyperinsulinemia in coronary heart disease. Metabolism 41:16–19

    Article  PubMed  CAS  Google Scholar 

  54. Nandeesha H, Koner BC, Dorairajan LN et al (2006) Hyperinsulinemia and dyslipidemia in non diabetic benign prostatic hyperplasia. Clin Chim Acta 370:89–93

    Article  PubMed  CAS  Google Scholar 

  55. Morgan DA, Balon TW, Ginsberg BH et al (1993) Nonuniform regional sympathetic nerve responses to hyperinsulinemia in rats. Am J Physiol 264:R423–R427

    PubMed  CAS  Google Scholar 

  56. Hautanen A (2000) Synthesis and regulation of sex hormone-binding globulin in obesity. Int J Obes Relat Metab Disord 24:S64

    Article  PubMed  CAS  Google Scholar 

  57. Peehl DM, Cohen P, Rosenfeld RG (1996) The role of insulin-like growth factors in prostate biology. J Androl 17:2–4

    PubMed  CAS  Google Scholar 

  58. Stattin P, Kaaks R, Riboli E et al (2001) Circulating insulin-like growth factor -1 and benign prostatic hyperplasia: a prospective study. Scand J Urol Nephrol 35:122

    Article  PubMed  CAS  Google Scholar 

  59. Lee E, Park MS, Shin C (1997) A high-risk group for prostatism: a population-based epidemiological study in Korea. Br J Urol 79:736–741

    PubMed  CAS  Google Scholar 

  60. Li PJ, Zhang XH, Guo LJ et al (2005) Correlation of benign prostatic hyperplasia with hyperlipemia. Zhonghua Wai Ke Za Zhi 43(6):387–389

    PubMed  CAS  Google Scholar 

  61. Bagatell CJ, Knopp RH, Vale WW et al (1992) Physiologic testosterone levels in normal men suppress HDL-cholesterol levels. Ann Int Med 116:967–973

    PubMed  CAS  Google Scholar 

  62. Kondo A, Li J, Manabe M et al (2003) Relationship between high-density lipoprotein-cholesterol and malondialdehyde-modified low-density lipoprotein concentrations. J Atheroscler Thromb 10:72–78

    PubMed  CAS  Google Scholar 

  63. Sakai M, Kobori S, Miyazaki A et al (2000) Macrophage proliferation in atherosclerosis. Curr Opin Lipidol 11(5):503–509

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H. Nandeesha.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nandeesha, H. Benign prostatic hyperplasia: dietary and metabolic risk factors. Int Urol Nephrol 40, 649–656 (2008). https://doi.org/10.1007/s11255-008-9333-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-008-9333-z

Keywords

Navigation