Metabolic syndrome has inverse link with LUTS in Korean men

By Joanna Lyford, Senior medwireNews Reporter

The metabolic syndrome (MS) may be protective against lower urinary-tract symptoms (LUTS), a study of Korean middle-aged men has found.

The validity of the finding is strengthened by evidence of a dose–response, whereby the risk of the MS decreased as the number of MS components rose.

A team led by Won Jae Yang (Soonchunhyang University, Seoul, South Korea) undertook a retrospective analysis of 4076 Korean men aged 40–65 years who underwent a routine health assessment. The men’s mean age was 52.2 years and 18.5% were classified as having the MS, based on the presence of three or more of the syndrome’s components. Of the 756 men with the MS, 550 had three components and 206 had four or five.

Compared with men without the MS, those with MS were significantly older and had significantly larger prostate volumes on transrectal ultrasonography. Levels of prostate-specific antigen did not differ between the groups.

All men were assessed for LUTS and prostate symptoms. The mean total International Prostate Symptom Score (IPSS) and Quality of Life scores did not differ between men with and without the MS.

Of nine individual LUTS, only one – urinary frequency – differed significantly between the groups. Men without the MS scored significantly higher for frequency than those with the syndrome, at 1.31 versus 1.18 points on the IPSS.

The researchers undertook a pre-planned subgroup analysis, dichotomising the groups by prostate volume less than or greater than or equal to 28 mL. Among men with larger prostates, those with three MS components (including hypertension and hypertriglyceridaemia) were 34% less likely to have moderate-to-severe LUTS than were those without the MS, after adjusting for age.

Furthermore, men with the MS and four or five risk factors were 39% less likely to have moderate-to-severe LUTS versus men without the MS. Among men with smaller prostates (<28 mL), the odds of LUTS did not differ between men with and without the MS.

Writing in Urology, the researchers say that this is the fifth study to show a protective effect of the MS or obesity-related factors on LUTS in men. Notably, all these studies have been conducted in Asian men, whereas studies in Western populations have found conflicting results.

“Further studies with larger samples and long-term follow-up are warranted to clarify the association between MS and LUTS”, they conclude.

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