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Relationship between non-alcoholic fatty liver disease and benign prostatic hyperplasia/lower urinary tract symptoms: new insights from an Italian cross-sectional study

World Journal of Urology volume 33, pages 743–751 (2015)Cite this article

A Letter to the Editor to this article was published on 13 January 2015

Abstract

Purpose

To investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) assessed by the fatty liver index (FLI), in lower urinary tract symptoms (LUTS) patients and to estimate its ability in predicting LUTS.

Methods

We performed a cross-sectional analysis of 448 consecutive patients affected by LUTS. LUTS were evaluated using the IPSS questionnaire and metabolic syndrome (MetS) criteria (by International Diabetes Federation). FLI, prostate volume (PV), serum prostate-specific antigen, total testosterone (TT) and homeostasis model assessment (HOMA) index were evaluated. A value of FLI ≥40 was set to predict NAFLD. Patients were divided into Group A (FLI <40) and Group B (FLI ≥40). Odds ratios (OR) for having moderate–severe LUTS were calculated. Logistic regression model was fitted adjusting for confounding factors.

Results

Group B showed higher prevalence of MetS, IR, moderate–severe LUTS and ED, higher IPSS, IPSS-storage, IPSS-voiding, total prostate volume, insulin, HOMA and lower TT and IIEF-5. Univariate logistic regression analysis demonstrated that continuous FLI (OR = 1.03, p < 0.05) and FLI ≥40 (OR = 2.41, p < 0.01) significantly increase the risk of moderate–severe LUTS. Continuous FLI (OR = 1.12, p < 0.01) and FLI ≥40 (OR = 5.39, p < 0.01) were independent predictors of moderate–severe LUTS at the multivariate logistic regression analysis, after adjusting for confounding factors. Subjects with MetS and FLI ≥40 had 2.0-fold the risk of moderate–severe LUTS (OR = 2.10, p < 0.01).

Conclusions

Non-alcoholic fatty liver disease (NAFLD) subjects have higher risk of LUTS. The presence of FLI ≥40 can be used to predict subjects at high risk of LUTS.

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Conflict of interest

Each author declares no conflict of interest.

Ethical standard

All participants provided written informed consent before enrollment, and the study was conducted in accordance with regulatory standards of Good Clinical Practice and the Declaration of Helsinki (1996). The study was approved by our Institutional Research Ethics Committee.

Author information

Affiliations

  1. Department of Urology, School of Medicine Policlinico Hospital, University of Catania, Catania, Italy

    Giorgio Ivan Russo, Sebastiano Cimino, Eugenia Fragalà, Salvatore Privitera, Mario Chisari, Tommaso Castelli, Vincenzo Favilla & Giuseppe Morgia

  2. Section of Endocrinology, Andrology, and Internal Medicine, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy

    Sandro La Vignera, Rosita Condorelli & Aldo E. Calogero

Authors
  1. Giorgio Ivan Russo
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  2. Sebastiano Cimino
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  3. Eugenia Fragalà
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  5. Sandro La Vignera
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  7. Aldo E. Calogero
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  8. Mario Chisari
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  9. Tommaso Castelli
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  10. Vincenzo Favilla
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  11. Giuseppe Morgia
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Correspondence to Giorgio Ivan Russo.

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Russo, G.I., Cimino, S., Fragalà, E. et al. Relationship between non-alcoholic fatty liver disease and benign prostatic hyperplasia/lower urinary tract symptoms: new insights from an Italian cross-sectional study. World J Urol 33, 743–751 (2015). https://doi.org/10.1007/s00345-014-1392-4

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Keywords

  • LUTS
  • Insulin resistance
  • BPH
  • HOMA
  • IPSS
  • Metabolic syndrome
  • NAFLD