Number of patients 929 25,892 Risk factor/s Body mass index (≥26.8 vs. ＜24.4 kg/m2) Waist circumference 158 9,856 307 708 2,797 2,372 88 422 Type II DM Hypertension Waist circumference HDL-cholesterol Plasma fasting insulin Metabolic syndrome DM Type II DM Treated hypertension Obesity Dyslipidaemia Plasma fasting insulin Metabolic syndrome Body mass index (29-50 vs. 18-24 kg/m2) Waist-hip ratio (0.98-1.17 vs 0.73-0.90) Systolic blood pressure (133-183 vs. 78-114) Diastolic blood pressure (85-110 vs. 54-72) DM Body mass index (＞23.4 vs. ＜19.5 kg/m2) Waist-hip ratio (＞0.92 vs. ＜0.85%) Fasting insulin (＞9.7 vs. ＜5.8) Body mass index (≥30 vs. ＜25 kg/m2) Hypertension DM Body mass index (≥30 vs. ＜25 kg/m2) Metabolic syndrome Metabolic syndrome (specific definition)* Hypertension Body mass index (35-39 vs. ＜25 kg/m2) Waist-hip ratio (≥0.94 vs. ＜0.85%) DM Fasting insulin HDL-cholesterol LDL-cholesterol Body mass index (≥35 vs. ＜25 kg/m2) Fasting plasma glucose (＞104 vs. ＜90 ng/dl) TABLE 1. Summary of the most relevant reports that addressed the relationship between benign prostatic hyperplasia/lower urinary tract symptoms and the metabolic syndrome and/or its components: obesity, dyslipidemia, hypertension, and insulin resistance OR (95% Confidence Interval) 0.9 (0.6-1.4) 2.4 (1.4-4.0) 2.0 (1.5-2.7) Direct relationship Direct relationship Direct relationship Direct relationship Direct relationship Direct relationship 1.1 (1.0-1.1) Direct relationship Direct relationship Direct relationship Direct relationship Direct relationship Direct relationship 0.8 (0.5-1.2) 0.9 (0.6-1.5) 0.7 (0.4-1.1) 1.0 (0.6-1.6) 1.5 (0.8-2.7) 1.5 (0.7-2.6) 2.0 (1.1-3.8) 2.2 (1.2-4.1) 1.1 (0.8-1.7) 1.5 (1.1-2.1) 2.0 (1.4-2.9) 1.25 (0.7-2.2) 1.2 (0.8-1.7) 1.8 (1.1-2.9) 1.8 (1.2-2.6) 1.4 (1.1-1.9) 1.3 (1.2-1.5) 1.3 (1.1-1.5) Direct relationship Direct relationship Inverse relationship 3.5 (1.5-8.6) 2.0 (1.1-3.8) p-value - ＜.001 ＜.001 ＜.001 ＜.001 ＜.001 ＜.001 ＜.001 ＜.001 - ＜.001 ＜.001 ＜.001 ＜.001 ＜.001 ＜.001 - - 0.1 0.06 0.03 - - 0.3 - - - - - - - - - ＜.001 ＜.001 ＜.001 0.01 0.03 508 Author Seitter and Barrett-Connor [33] Giovannucci et al [8] Hammarsten and Högstedt [14] Michel et al [88] Hammarsten and Högstedt [4] Year 1992 1994 1998 2000 2001 Meigs et al [34] 2001 1,019 Dahle et al [9] 2002 502 Joseph et al [15] Rohrmann et al [85] Rohrmann et al [29] 2003 2004 2005 Seim et al [11] 2005 21,694 Nandeesha et al [23] 2006 Parson et al [10] 2006 Korean J Urol 2011;52:507-516 Abdollah et al Endpoint/s Prostatectomy for BPH Prostatectomy for BPH Frequent urinary symp- toms among men without prostatectomy Prostate gland volume Annual BPH growth rate LUTS Annual BPH growth rate LUTS LUTS LUTS LUTS LUTS BPH Moderate-severe LUTS Prostate gland volume