Men who have a high body mass index (BMI), larger waist circumference, and increased serum leptin levels had a positive association with increased prostate growth or benign prostatic hyperplasia, according to a recent study.  The study published in the International Neurourology Journal involved 571 Korean men who underwent urological examinations, including serum prostate specific antigen measurement and transrectal ultrasonography.

“This research points out like other studies the negative influence obesity has on raising the risk of benign prostatic hyperplasia or BPH,” stated Dr. Samadi. “BPH is a common condition particularly in older men but it can cause problems with urinary tract symptoms lowering the quality of life for these men. It points out once again why achieving and then maintaining a healthy body weight is such an important aspect of keeping the prostate healthy and disease free.”

In this new study, besides the previously mentioned testing, the study participants also completed the International Prostate Symptom Score questionnaire.  Results from the research showed that waist circumference had a statistically significant linear correlation with incremental increases in prostate volume.  Also found was men with high abdominal obesity, determined by their body mass index, waist circumference, body fat, and visceral fat composition had significant association of the presence of high-volume benign prostatic hyperplasia.  In addition, the highest quartile of serum leptin and adiponectin levels were significantly correlated with high-volume BPH compared to the lowest quartile of levels.

“Research like this is so important in revealing what is driving BPH in obese men,” said Dr. Samadi. “The researchers are saying that what appears to be the reason why obesity is linked to BPH is the fact that obesity leads to insulin resistance.  Insulin resistance means the chronic elevation of insulin which is associated with increased levels of insulin-like growth factor-1 or IGF-1.  They believe that too much circulating insulin can stimulate the formation of a tumor by influencing IGF-1 synthesis along with activating insulin and IGF-1 receptors which have been found in cancer cells.”

Dr. Samadi went on to add, “Excess fat tissue doesn’t just sit there.  Having excess body fat can influence levels of hormones like insulin which affects immune function and inflammation. Fat tissue activity creates an environment that encourages cell growth and discourages cell death which is the perfect situation for cancer to begin.”

Another explanation the study gave for increased BPH in obese men was the involvement of chronic inflammation and oxidative stress.   When there are these inflammatory changes occurring in body tissue this may provide an environment promoting abnormal or quick growth of a tumor.

The role of leptin and adiponectin and enlargement of the prostate was determined to be that leptin and adiponectin, both adipokines which are cell signaling proteins secreted by adipose or fat tissue, play a key role in regulating body weight.  Leptin promotes increase in cell number or proliferation and it also has both proinflammatory and angiogenic effects that could result in carcinogenesis. 

“My goal as a urologist is to understand the effect of obesity on the urological health of a man,” explained Dr. Samadi. “The connection between obesity and the negative consequences it can have on increasing pressure on the bladder and prostate, makes it all the more important for me to talk to any obese man I see about taking steps to reduce his body weight.  Even modest weight loss improves factors associated with cancer risk, like insulin sensitivity and inflammation. I want them to know obesity is reversible.  We can talk about adding in physical activity and making lifestyle changes that can have a huge difference in men with BPH.   Together, I can help them achieve a healthier body weight and lead a healthier life.”

Patients newly diagnosed with benign prostatic hyperplasia can contact world renowned prostate cancer surgeon and urologic oncologist Dr. David Samadi at 212-365-5000 for a free phone consultation.  To learn more about prostate cancer, visit ProstateCancer911.com.