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Background  Benign prostatic obstruction (BPO) due to benign prostatic hyperplasia (BPH) is a leading cause of morbidity in men over the age of 40. This study examined whether there was an association between body mass index (BMI) and pre-operative prostate volume and whether expression of two genes, alpha-2-macroglobulin ( A2M ) and transforming growth factor beta 3 ( TGFB3 ), was correlated with BMI, pre-operative prostate volume, and age at surgery.    Methods  Medical records of patients who underwent holmium enucleation of the prostate surgery for treatment of BPO were retrospectively reviewed. Surgical specimens were obtained from formalin-fixed paraffin-embedded blocks, and expression of the targeted genes was quantified using a real time PCR approach. Linear regression analysis was performed to assess association between BMI and prostate volume adjusting for demographic characteristics and co-morbidity. Spearman’s correlation was used to examine whether gene expression was correlated with BMI, prostate volume, and age at surgery.    Results  A total of 278 patients were identified, including 62.9% European Americans (n = 175) and 27.7% Hispanic Americans (n = 77). BMI was significantly correlated with prostate volume (Spearman’s  rho  = 0.123,  P  = 0.045). In linear regression analysis, BMI was positively associated with prostate volume ( β  = 0.01,  P  = 0.004), while hyperlipidemia was negatively associated with prostate volume ( β  = −0.08,  P  = 0.02). A trend for a positive association was also observed for diabetes ( β  = 0.07,  P  = 0.099). In the race/ethnicity stratified analysis, age at surgery showed a trend for significantly positive association with prostate volume in European Americans ( β  = 0.005,  P  = 0.08), but not in Hispanic Americans. Expression of the  A2M  gene in the stroma was negatively correlated with age at surgery ( P  = 0.006).  A2M  expression in the gland was positively correlated with prostate volume among older men (Age ≥ 70,  P  = 0.01) and overweight men (BMI 25–30,  P  = 0.04).  TGFB3  expression in the gland was positively correlated with BMI ( P  = 0.007) among older men.    Conclusions  This study demonstrated the positive correlation between BMI and prostate volume. Expression of  TGFB3  and  A2M  was correlated with BMI, prostate volume, and age at surgery.    Supplementary information   Supplementary information  accompanies this paper at 10.1186/s12894-020-00753-9.

bmc urology

Correlation between body mass index and prostate volume in benign prostatic hyperplasia patients undergoing holmium enucleation of the prostate surgery