Metabolic Syndrome (MetS) has been frequently associated with an overall inflammation status, called metaflammation, including atherosclerosis and non-alcholic steatohepatitis (NASH), In this study we aimed to evaluate the relationship between intra-prostatic inflammation and NASH in a cohort of patients affected by BPH. Between January 2012 and January 2016, 132 consecutive patients with BPH-related lower urinary tract symptoms (LUTS) who underwent transurethral resection of the prostate were prospectively enrolled. The presence of NASH was evaluated using the NASH score: 1.18*MetS (yes=1)+0.45*Diabetes (yes=2)+0.15*fasting serum insulin +0.04*serum AST 0.94*(AST/ALT) 2.89. A cut-off of 1.05 was set to predict NASH (AUC: 0.82). Prostate samples were anlaysized for the evaluation of inflammation and this was classified accordindg to Irani score (score from 0 to 6). Patients with viral hepatitis or alcohol steatohepatitis were excluded. A final cohort of 132 patients were included. The median age was 70.8 (interquartile range (IQR) 64.6573.97), the median IPSS was 24.0 (IQR; 20.025.75) and the median prostate volume was 50.5 (IQR: 40.072.25). The prevalence of patients affected by MetS alone was 56.8% (76/132), by NASH in 56.8% (76/132) and by severe intraprostatic inflammation (Irani ≥4) in while by the both disease in 27.3% (36/132). When considering patients with Irani score ≥4, we observed significant increase of NASH score (−0.45 vs −1.01; P<0.01). The age-adjusted linear regression analysis demonstrated that waist circumference (r=0.35; P<0.01), fasting glucose (r=0.32; P<0.01), LDL (r=0.15; P<0.05), tryglycerides (r=0.42; P<0.01) and Irani score (r=0.12; P<0.05) were associated with increase in NASH score. The age adjuested logistic regression analysis revealed that Irani score ≥4 (OR: 3.06; P<0.05) was an independent risk factor of NASH. Further, the combination between MetS and NASH was significantly associated with severe intra-prostatic inflammation (OR: 10.8; P<0.01) while vs MetS as single alteration. Patients with BPH are more frequently associated with a parallel liver inflammation. These findings can be explained by the metaflammation condition, associated with metabolic aberration. Further studies should be conducted with the scope to revert or prevent prostate related inflammation.
20 - 23 May 2017
European Society of Endocrinology