Introduction: Benign prostatic hyperplasia is a common condition among men that leads to bothersome lower urinary tract symptoms (LUTS). Several attempts have been made to identify modifiable and non-modifiable risk factors for development of BPH, though few large population cohorts have been examined for associations. The UK Biobank (UKB) is one of the largest prospective population-based cohort studies in the world, comprising >500,000 participants. In this study, we aim to identify factors associated with prevalence and incidence of BPH in the UKB.
Methods: A total of 214,515 male participants from the UKB were included. The primary outcome was ICD10 diagnosis of BPH (N40). Associations of candidate risk factors for BPH, including ICD-10 diagnosis codes, blood assays, body mass index (BMI), activity as measured by metabolic equivalent task (MET), alcohol, and smoking were examined in both a prevalence and incidence cohort. All models were adjusted for age at recruitment and top 10 principal components.
Results: Men with BPH (n=24,585) were more likely to also be diagnosed with diabetes, sleep apnea, anxiety, depression, hypertension, hyperlipidemia, and coronary artery disease compared to men without BPH (n=189,930). Men with BPH also had higher BMI, body fat percentage, higher waist circumference, lower vigorous and total METs, and were more likely to report alcohol use once or more per week. Reported smoking and cannabis use was not associated with BPH diagnosis. Similar findings were seen in an incidence cohort of 9,197 men with BPH and 189,930 controls.
Conclusions: In a large prospective population-based cohort, anxiety, depression, obesity, metabolic syndrome, alcohol use, and lower levels of exercise are associated with the diagnosis of BPH. Assessment and management of these comorbid conditions should be considered in management of patients with BPH.
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