1. ¹Department of Urology, Skaraborg Hospital, Skövde, Sweden
2. ²Department of Urology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg, Sweden
3. ³Department of Clinical Sciences, Malmö General Hospital, Lund University, Malmö, Sweden
4. ⁴Department of Orthopedics, Malmö General Hospital, Lund University, Malmö, Sweden
5. ⁵Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
6. ⁶Department of Internal Medicine at the Sahlgrenska Academy, Center for Bone Research, Sahlgrenska University Hospital, Göteborg, Sweden
7. ⁷The Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
8. ⁸Department of Geriatrics at the Sahlgrenska Academy, Center for Bone Research, Sahlgrenska University Hospital, Göteborg, Sweden

Correspondence: Dr J Hammarsten, Department of Urology, Skaraborg Hospital, Skövde, Sweden, Leopardgatan 3, Verberg S-432 37, Sweden. E-mail: jan.hammarsten@telia.com

Received 1 May 2008; Revised 13 August 2008; Accepted 27 August 2008; Published online 30 September 2008.

Abstract

The aetiology of benign prostatic hyperplasia (BPH) remains unclear. The objective of the present study was to test the insulin, oestradiol and metabolic syndrome hypotheses as promoters of BPH. The design was a risk factor analysis of BPH in which the total prostate gland volume was related to endocrine and anthropometric factors. The participants studied were 184 representative men, aged 72–76 years, residing in Göteborg, Sweden. Using a multivariate analysis, BPH as measured by the total prostate gland volume correlated statistically significantly with fasting serum insulin (=0.200, P=0.028), free oestradiol (=0.233, P=0.008) and lean body mass (=0.257, P=0.034). Insulin and free oestradiol appear to be independent risk factors for BPH, confirming both the insulin and the oestradiol hypotheses. Our findings also seem to confirm the metabolic syndrome hypothesis. The metabolic syndrome and its major endocrine aberration, hyperinsulinaemia, are possible primary events in BPH.