Association between dynamic abdominal obesity (DAO) and benign prostatic hyperplasia (lower urinary tract symptoms): evidence from the China Health and Retirement Longitudinal Study (CHARLS).

OBJECTIVE

This study aimed to elucidate the relationship between dynamic abdominal obesity (DAO) and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) among middle-aged and elderly Chinese adults from the dimensions of cross-sectional and longitudinal analyses.

METHODS AND MATERIALS: We used cross-sectional data from the 2011 China Health and Retirement Longitudinal Study (CHARLS). Logistic regression was performed to examine the association between D/AO and prevalent BPH/LUTS, with subgroup analyses to assess potential effect modification. We further established a prospective cohort using CHARLS data from 2011 to 2018. Kaplan‑Meier curves and log‑rank tests were used to compare cumulative BPH/LUTS incidence across D/AO subgroups. Cox regression and BMI‑stratified analyses were then applied to investigate the effect of D/AO on the long-term risk of BPH/LUTS.

RESULTS

This study ultimately included 5,849 participants in the baseline cross-sectional study, among whom 571 self-reported having BPH/LUTS. In adjusted logistic regression models, only participants with both dynapenia and abdominal obesity (D/AO) had a significantly higher risk of prevalent BPH/LUTS (OR = 1.677, 95% CI: 1.012-2.686, P = 0.037). Subgroup analysis revealed that the association was more evident in participants with primary school education or below (OR = 1.874, 95% CI: 1.044-3.226, P = 0.028), and those with BMI ≥ 24.0 kg/m² (OR = 2.111, 95% CI: 1.069-4.040, P = 0.027). In adjusted Cox models, only participants with abdominal obesity without dynapenia (ND/AO) had an increased risk of incident BPH/LUTS (HR = 1.337, 95% CI: 1.091-1.638, P = 0.005). Stratified BMI analysis revealed that the association between DAO subtypes and the risk of BPH/LUTS onset exhibited significant stratified differences, with an interaction P value of 0.037.

CONCLUSION

In cross-sectional analyses, DAO was identified as a potential risk factor for prevalent BPH/LUTS among middle-aged and elderly Chinese adults. In cohort analyses, however, obesity without low muscle strength appeared to increase the long-term risk of developing BPH/LUTS, and this association was modified by BMI.