Associations Between Diabetes and Clinical Markers of Benign Prostatic Hyperplasia Among Community-Dwelling Black and White Men

  1. Aruna V. Sarma, PHD12,
  2. James P. Burke, PHD3,
  3. Debra J. Jacobson, MS4,
  4. Michaela E. McGree, BS4,
  5. Jennifer St. Sauver, PHD5,
  6. Cynthia J. Girman, DRPH56,
  7. Michael M. Lieber, MD7,
  8. William Herman, MD, PHD8,
  9. Jill Macoska, PHD1,
  10. James E. Montie, MD1 and
  11. Steven J. Jacobsen, MD, PHD9
  1. 1Department of Urology, University of Michigan, Ann Arbor, Michigan
  2. 2Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
  3. 3Ingenix, Eden Prarie, Minnesota
  4. 4Division of Biostatistics, Mayo Clinic, Rochester, Minnesota
  5. 5Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
  6. 6Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania
  7. 7Department of Urology, Mayo Clinic, Rochester, Minnesota
  8. 8Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
  9. 9Southern California Permanente Medical Group, Pasadena, California
  1. Address correspondence and reprint requests to Dr. Aruna V. Sarma, Department of Urology, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0759. E-mail: asarma{at}umich.edu

Abstract

OBJECTIVE—The aim of this study was to examine associations between diabetes and clinical markers of benign prostatic hyperplasia (BPH) in community-dwelling white and black men aged 40–79 years.

RESEARCH DESIGN AND METHODS—Data from the Olmsted County Study of Urinary Symptoms and Health Status and the Flint Men's Health Study were combined for a total study sample of 2,484 men. Severity of lower urinary tract symptoms (LUTS), peak urinary flow rates, prostate volume, and serum prostate-specific antigen (PSA) levels were examined by self-reported physician-diagnosed diabetes.

RESULTS—Overall, 170 men (6.8%) reported a history of diabetes. Increased irritative LUTS and specifically nocturia were positively associated with diabetes. These patterns were consistent across race and persisted after adjustment for age, BMI, and various indicators of socioeconomic status. Furthermore, the relationship between irritative LUTS and diabetes was greater in black men. No significant associations were observed between diabetes and prostate volume, PSA level, and peak urinary flow rate.

CONCLUSIONS—Our multiethnic community-based study demonstrates positive associations between diabetes and irritative LUTS and nocturia. Moreover, the association between irritative LUTS and diabetes is increased in black men. There was no strong evidence for an association between diabetes and BPH across measures more specific to BPH (i.e., prostate volume, PSA, and peak urinary flow rate). Taken together, our findings suggest that the presence of diabetes may be less related to prostate growth and more related to the dynamic components of lower urinary tract function. Further evaluations of the association between diabetes and BPH and related racial variations are warranted.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 10 December 2007. DOI: 10.2337/dc07-1148.

    C.J.G. holds stock in Amgen and Genentech.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted November 30, 2007.
    • Received June 18, 2007.
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  1. Published online before print December 10, 2007, doi: 10.2337/dc07-1148 Diabetes Care March 2008 vol. 31 no. 3 476-482
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