A polygenic risk score (PGS) for BPH has been developed that is associated with lower urinary tract symptoms, prostate volume, and risk of surgical intervention for BPH. Potentially modifiable risk factors such as physical activity, obesity, and sleep disturbance, as well as psychosocial factors such as anxiety/depression have also been associated lower urinary tract symptoms (LUTS), but it is unknown if these factors can modulate the inherited risk of BPH/LUTS.
Diagnosis of BPH was compared with lifestyle factors such as obesity and International Physical Activity Questionnaire (IPAQ) activity level and with diagnoses of other known risk factors including diabetes, OSA, depression, anxiety in univariate and multivariate analyses. Rate of BPH was compared between IPAQ activity group and PGS-BPH, adjusted for age and genetic background.
33,807 out of 228,470 male participants from the UK Biobank were diagnosed with BPH. Diagnoses of type 2 diabetes, anxiety, depression, and OSA were significantly associated with BPH (Table 1). BMI was similar in men with and without BPH (mean 27). In univariate and multivariate analysis, moderate (multivariate OR 0.95 [0.92-0.99; p=0.02] and high (OR 0.92 [0.89-0.96; p=4.65E-05]) IPAQ activity levels were associated with lower risk of BPH. Higher activity levels slightly moderated inherited genetic risk of BPH (PGS-BPH; Figure 1).
In this large cohort study from the UK Biobank, higher levels of physical activity are associated with a decreased risk of BPH diagnosis, and higher activity levels appear to modestly influence the genetic predisposition for BPH. This study provides evidence that at least moderate physical activity should be encouraged as part of men’s health.
