Elsevier

Urology

Volume 68, Issue 6, December 2006, Pages 1198-1205
Urology

Adult urology
Anthropometric and metabolic factors and risk of benign prostatic hyperplasia: A prospective cohort study of Air Force veterans

https://doi.org/10.1016/j.urology.2006.09.034Get rights and content

Abstract

Objectives

The relationship between anthropometric and metabolic factors and benign prostatic hyperplasia (BPH) is poorly understood. We investigated the associations of BPH with anthropometric and metabolic parameters in this prospective study of Vietnam War veterans.

Methods

A total of 1206 participants in the comparison arm of the Air Force Health Study with a median follow-up of 15.6 years were included in this study. The “Ranch Hand” group, occupationally exposed to herbicides, was excluded to eliminate any confounding from exposure to herbicides. BPH was determined by medical record review using the International Classification of Diseases and Related Problems, Ninth Revision. We used Cox proportional hazards regression models for the statistical analysis.

Results

The median age for BPH diagnosis was 58.6 years. On multivariate analyses, increasing age (relative risk [RR] 1.14, 95% confidence interval [CI] 1.12 to 1.17), height (RR 1.02, 95% CI 1.004 to 1.03), and fasting blood glucose (RR 1.004, 95% CI 1.001 to 1.007) were associated with increased risk. The effect of age varied with the duration of follow-up. A greater systolic blood pressure (RR 0.992, 95% CI 0.986 to 0.997) was associated with decreased risk of BPH. A dose-response effect was seen for age, height, and systolic blood pressure. No effect was seen for weight, body mass index, change in weight or body mass index, lipids, thyroid hormone status, or the metabolic syndrome.

Conclusions

The risk of BPH increased with increasing age, height, and fasting blood glucose levels. The risk was decreased with a greater systolic blood pressure. No relationship was seen between BPH and metabolic syndrome, weight, body mass index, lipid level, or thyroid hormone status.

Section snippets

Material and methods

The Air Force Health Study was a prospective study of Operation Ranch Hand veterans and a comparison group of other Air Force veterans designed to assess the effects of exposure to Agent Orange during the Vietnam War. Operation Ranch Hand veterans were involved in spraying herbicides (including Agent Orange) during the Vietnam War. Agent Orange and some other herbicides containing 2,4,5-trichlorophenoxyacetic acid were contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin). The

Results

The median follow-up period was 15.6 years (range 0 to 22.5). Participants who had not been diagnosed with BPH during the follow-up period were followed for a median of 21.7 years (range 0 to 22.5). The median time to BPH diagnosis was 14.1 years (range 0 to 21). The median age at BPH diagnosis was 58.6 years (interquartile range 53.9 to 63.8).

The descriptive characteristics of the veterans who were and were not diagnosed with BPH are presented in Table I. Those with BPH were older at baseline,

Comment

In this prospective, cohort study, increasing height and FBG were associated with an increased risk of being diagnosed with BPH and a greater SBP was associated with a decreased risk.

The strengths of our study were that it was prospective in nature, the duration of follow-up was longer than that for all previous studies, and the loss to follow-up was minimized. We also had data on the subjects’ height, weight, and BMI at the end of the Southeast Asia tour that enabled us to evaluate the effect

Conclusions

The risk of BPH increased with increased age, height, and FBG levels. The risk was decreased with a greater SBP. No relationship was seen between BPH and metabolic syndrome, weight, BMI, HDL, LDL, triglycerides, or thyroid hormone status.

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