Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
J Korean Med Sci. 2020 Jun 8;35(22):e164. doi: 10.3346/jkms.2020.35.e164.
Nonalcoholic fatty liver disease (NAFLD) is associated with a wide spectrum of metabolic abnormalities. This study aimed to evaluate whether NAFLD is associated with benign prostatic hyperplasia (BPH) independent of other risk factors.
A total of 3,508 subjects who underwent prostate and hepatic ultrasonography were enrolled. NAFLD was diagnosed and graded by ultrasonographic findings. BPH was defined by total prostate volume.
The prevalence of BPH was significantly increased according to NAFLD severity ( < 0.001). The multivariate analysis showed that NAFLD was associated with a 22% increase in the risk of BPH (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.02-1.45). In non-obese subjects, NAFLD was associated with a 41% increase in the risk of BPH (OR, 1.41; 95% CI, 1.14-1.73), and an incremental increase in the risk of BPH according to NAFLD severity was pronounced (adjusted OR [95% CI], 1.32 [1.05-1.68] for mild NAFLD, 1.55 [1.15-2.10] for moderate to severe NAFLD vs. no NAFLD, P for trend = 0.004). However, in the obese population, the association of NAFLD in the risk of BPH was insignificant ( = 0.208).
NAFLD is associated with an increased risk of BPH regardless of metabolic syndrome, especially in non-obese subjects. An incrementally increased risk of BPH according to NAFLD severity is prominent in non-obese subjects with NAFLD. Thus, physicians caring for non-obese patients with NAFLD may consider assessing the risk of BPH and associated urologic conditions.
非酒精性脂肪性肝病（NAFLD）与广泛的代谢异常有关。本研究旨在评估NAFLD 是否与其他危险因素无关，与良性前列腺增生（BPH）有关。
共纳入 3508 例接受前列腺和肝脏超声检查的受试者。通过超声检查结果诊断和分级 NAFLD。BPH 定义为总前列腺体积。
根据 NAFLD 严重程度，BPH 的患病率显著增加（<0.001）。多变量分析显示，NAFLD 与 BPH 风险增加 22%相关（比值比 [OR]，1.22；95%置信区间 [CI]，1.02-1.45）。在非肥胖受试者中，NAFLD 与 BPH 风险增加 41%相关（OR，1.41；95%CI，1.14-1.73），并且根据 NAFLD 严重程度，BPH 的风险呈递增趋势（调整后的 OR [95%CI]，轻度 NAFLD 为 1.32 [1.05-1.68]，中重度 NAFLD 为 1.55 [1.15-2.10] vs. 无 NAFLD，趋势检验 P=0.004）。然而，在肥胖人群中，NAFLD 与 BPH 风险的关联无统计学意义（=0.208）。
无论代谢综合征如何，NAFLD 与 BPH 风险增加相关，尤其是在非肥胖人群中。在非肥胖的 NAFLD 患者中，NAFLD 严重程度与 BPH 风险呈递增趋势。因此，照顾非肥胖的 NAFLD 患者的医生可能需要考虑评估 BPH 及相关泌尿科疾病的风险。
