Abstract

Background: A high fat diet is associated with risk of benign prostatic hyperplasia (BPH). However, whether hyperlipidemia is associated with BPH remains unclear. This population-based cohort study elucidated whether hyperlipidemia is associated with an increased risk of BPH. Methods: We used a new-exposure design and analyzed data retrieved from the Taiwan National Health Insurance Database between January 1, 2000 and December 31, 2013. The cohort of men with newly diagnosed hyperlipidemia and the age- and index-date-matched (1:3) nonhyperlipidemia cohort were tracked for incidence of BPH during a 1- to 14-year follow-up. Diagnosis of BPH using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, and the occurrence of BPH diagnosis plus the use of alpha-blockers or 5-alpha reductase inhibitors or receipt of transurethral resection of the prostate were the primary and secondary endpoints, respectively. The confounders in this study were diabetes mellitus, hypertension, coronary heart disease, obesity, liver cirrhosis, nonsteroidal anti-inflammatory drugs, metformin, aspirin, and number of urologist visits. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a multivariate Cox proportional hazards regression model adjusted for the propensity score. Results: A total of 35 860 subjects (aged 40-99 years)—including the hyperlipidemia cohort (n = 8,965) and nonhyperlipidemia cohort (n = 26 895)—were identified. Our data revealed that the hyperlipidemia cohort had significantly higher incidences of developing BPH (24.6% vs 12.3%, P < 0.001) and treated BPH (13% vs 5.7%, P < 0.001) compared with the nonhyperlipidemia cohort. The risk of developing BPH in the hyperlipidemia cohort was significantly higher than that in the nonhyperlipidemia cohort (HR = 1.73, 95% CI = 1.63-1.83, P < 0.001) after adjustment for the propensity score. Conclusions: Hyperlipidemia is associated with an increased risk of clinical BPH.

Original languageEnglish
Pages (from-to)113-120
Number of pages8
JournalProstate
Volume78
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

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Prostatic Hyperplasia
Hyperlipidemias
Propensity Score
5-alpha Reductase Inhibitors
Confidence Intervals
Transurethral Resection of Prostate
Metformin
Incidence
National Health Programs
High Fat Diet
International Classification of Diseases
Taiwan
Proportional Hazards Models
Liver Cirrhosis
Aspirin
Coronary Disease
Diabetes Mellitus
Cohort Studies
Anti-Inflammatory Agents
Obesity

Keywords

  • hyperlipidemia
  • hyperplasia
  • lipid
  • prostate

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Hyperlipidemia is associated with an increased risk of clinical benign prostatic hyperplasia. / Shih, Hung Jen; Huang, Chun Jen; Lin, Jui An; Kao, Ming Chang; Fan, Yen Chun; Tsai, Pei Shan.

In: Prostate, Vol. 78, No. 2, 01.02.2018, p. 113-120.

Research output: Contribution to journalArticle

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title = "Hyperlipidemia is associated with an increased risk of clinical benign prostatic hyperplasia",
abstract = "Background: A high fat diet is associated with risk of benign prostatic hyperplasia (BPH). However, whether hyperlipidemia is associated with BPH remains unclear. This population-based cohort study elucidated whether hyperlipidemia is associated with an increased risk of BPH. Methods: We used a new-exposure design and analyzed data retrieved from the Taiwan National Health Insurance Database between January 1, 2000 and December 31, 2013. The cohort of men with newly diagnosed hyperlipidemia and the age- and index-date-matched (1:3) nonhyperlipidemia cohort were tracked for incidence of BPH during a 1- to 14-year follow-up. Diagnosis of BPH using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, and the occurrence of BPH diagnosis plus the use of alpha-blockers or 5-alpha reductase inhibitors or receipt of transurethral resection of the prostate were the primary and secondary endpoints, respectively. The confounders in this study were diabetes mellitus, hypertension, coronary heart disease, obesity, liver cirrhosis, nonsteroidal anti-inflammatory drugs, metformin, aspirin, and number of urologist visits. Hazard ratios (HRs) and 95{\%} confidence intervals (CIs) were estimated using a multivariate Cox proportional hazards regression model adjusted for the propensity score. Results: A total of 35 860 subjects (aged 40-99 years)—including the hyperlipidemia cohort (n = 8,965) and nonhyperlipidemia cohort (n = 26 895)—were identified. Our data revealed that the hyperlipidemia cohort had significantly higher incidences of developing BPH (24.6{\%} vs 12.3{\%}, P < 0.001) and treated BPH (13{\%} vs 5.7{\%}, P < 0.001) compared with the nonhyperlipidemia cohort. The risk of developing BPH in the hyperlipidemia cohort was significantly higher than that in the nonhyperlipidemia cohort (HR = 1.73, 95{\%} CI = 1.63-1.83, P < 0.001) after adjustment for the propensity score. Conclusions: Hyperlipidemia is associated with an increased risk of clinical BPH.",
keywords = "hyperlipidemia, hyperplasia, lipid, prostate",
author = "Shih, {Hung Jen} and Huang, {Chun Jen} and Lin, {Jui An} and Kao, {Ming Chang} and Fan, {Yen Chun} and Tsai, {Pei Shan}",
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T1 - Hyperlipidemia is associated with an increased risk of clinical benign prostatic hyperplasia

AU - Shih, Hung Jen

AU - Huang, Chun Jen

AU - Lin, Jui An

AU - Kao, Ming Chang

AU - Fan, Yen Chun

AU - Tsai, Pei Shan

N1 - © 2017 Wiley Periodicals, Inc.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: A high fat diet is associated with risk of benign prostatic hyperplasia (BPH). However, whether hyperlipidemia is associated with BPH remains unclear. This population-based cohort study elucidated whether hyperlipidemia is associated with an increased risk of BPH. Methods: We used a new-exposure design and analyzed data retrieved from the Taiwan National Health Insurance Database between January 1, 2000 and December 31, 2013. The cohort of men with newly diagnosed hyperlipidemia and the age- and index-date-matched (1:3) nonhyperlipidemia cohort were tracked for incidence of BPH during a 1- to 14-year follow-up. Diagnosis of BPH using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, and the occurrence of BPH diagnosis plus the use of alpha-blockers or 5-alpha reductase inhibitors or receipt of transurethral resection of the prostate were the primary and secondary endpoints, respectively. The confounders in this study were diabetes mellitus, hypertension, coronary heart disease, obesity, liver cirrhosis, nonsteroidal anti-inflammatory drugs, metformin, aspirin, and number of urologist visits. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a multivariate Cox proportional hazards regression model adjusted for the propensity score. Results: A total of 35 860 subjects (aged 40-99 years)—including the hyperlipidemia cohort (n = 8,965) and nonhyperlipidemia cohort (n = 26 895)—were identified. Our data revealed that the hyperlipidemia cohort had significantly higher incidences of developing BPH (24.6% vs 12.3%, P < 0.001) and treated BPH (13% vs 5.7%, P < 0.001) compared with the nonhyperlipidemia cohort. The risk of developing BPH in the hyperlipidemia cohort was significantly higher than that in the nonhyperlipidemia cohort (HR = 1.73, 95% CI = 1.63-1.83, P < 0.001) after adjustment for the propensity score. Conclusions: Hyperlipidemia is associated with an increased risk of clinical BPH.

AB - Background: A high fat diet is associated with risk of benign prostatic hyperplasia (BPH). However, whether hyperlipidemia is associated with BPH remains unclear. This population-based cohort study elucidated whether hyperlipidemia is associated with an increased risk of BPH. Methods: We used a new-exposure design and analyzed data retrieved from the Taiwan National Health Insurance Database between January 1, 2000 and December 31, 2013. The cohort of men with newly diagnosed hyperlipidemia and the age- and index-date-matched (1:3) nonhyperlipidemia cohort were tracked for incidence of BPH during a 1- to 14-year follow-up. Diagnosis of BPH using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, and the occurrence of BPH diagnosis plus the use of alpha-blockers or 5-alpha reductase inhibitors or receipt of transurethral resection of the prostate were the primary and secondary endpoints, respectively. The confounders in this study were diabetes mellitus, hypertension, coronary heart disease, obesity, liver cirrhosis, nonsteroidal anti-inflammatory drugs, metformin, aspirin, and number of urologist visits. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a multivariate Cox proportional hazards regression model adjusted for the propensity score. Results: A total of 35 860 subjects (aged 40-99 years)—including the hyperlipidemia cohort (n = 8,965) and nonhyperlipidemia cohort (n = 26 895)—were identified. Our data revealed that the hyperlipidemia cohort had significantly higher incidences of developing BPH (24.6% vs 12.3%, P < 0.001) and treated BPH (13% vs 5.7%, P < 0.001) compared with the nonhyperlipidemia cohort. The risk of developing BPH in the hyperlipidemia cohort was significantly higher than that in the nonhyperlipidemia cohort (HR = 1.73, 95% CI = 1.63-1.83, P < 0.001) after adjustment for the propensity score. Conclusions: Hyperlipidemia is associated with an increased risk of clinical BPH.

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KW - hyperplasia

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