Inflammatory Blood Markers May Signal Severity of BPH Symptoms, New Study Finds

The findings, published in the Journal of Inflammation Research, highlight the potential of simple blood indices such as the neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), and systemic immune-inflammatory index (SII) as non-invasive tools for evaluating disease severity.

LUTS linked with BPH are frequently observed in aging men and, if left unchecked, can lead to serious health complications. While early detection and timely intervention are key to managing BPH effectively, there remains a lack of reliable and accessible indicators to assess symptom severity. The present study, led by Yifan Wu and colleagues from the Department of Urology, aimed to bridge this gap by investigating the predictive value of immune-inflammatory indices derived from routine blood tests.

The cross-sectional analysis included 698 male patients diagnosed with BPH/LUTS at a tertiary care hospital. Participants were categorized into two groups—mild and moderate-to-severe—based on their International Prostate Symptom Score (IPSS). Researchers then evaluated the association between symptom severity and levels of NLR, SIRI, and SII through binary logistic regression analysis.

The study revealed the following findings:

• A strong positive correlation was observed between elevated immune-inflammatory indices and increased severity of LUTS.
• After adjusting for potential confounding factors, patients in the highest quartile of NLR had 6.20 times higher odds of experiencing moderate-to-severe symptoms compared to those in the lowest quartile.
• For SIRI, the odds ratio for symptom severity in the highest quartile was 7.49.
• For SII, patients in the highest quartile had an odds ratio of 7.85 for developing more severe LUTS.
• Subgroup analyses based on age, diet, physical activity, existing health conditions, and lifestyle habits supported the consistency of these findings.
• All three markers—NLR, SIRI, and SII—remained significantly associated with symptom severity across most subgroups.
• Among smokers, SIRI demonstrated a particularly strong association with worsening LUTS.

The authors emphasized that the use of immune-inflammatory biomarkers is a practical and cost-effective approach for clinicians to monitor disease progression and tailor interventions in patients with BPH. They also explored potential mechanisms linking systemic inflammation to prostatic enlargement and urinary symptoms, adding a theoretical dimension to their clinical findings.

However, the study's limitations warrant cautious interpretation. Due to its single-center and cross-sectional design, it restricts the ability to draw causal inferences. Additionally, certain variables, such as socioeconomic status and prostate volume, were not adjusted for, and multiple comparisons were not corrected, which may introduce bias or false-positive results.

Despite these limitations, the study offers valuable insights and lays the groundwork for future research. The authors advocate for large-scale, multicenter prospective studies to validate their findings and further investigate the clinical utility of these markers in diverse populations.

The authors concluded, "Elevated levels of NLR, SIRI, and SII appear to be strongly associated with the severity of LUTS in men with BPH. These readily accessible markers may serve as useful tools in identifying high-risk patients and enhancing early intervention strategies in urological practice."

Reference:

Wu Y, Sheng J, Liu X, Huang Y, Zhang Y, Feng N. The Relationship Between Immune-Inflammatory Indexes and the Severity of Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: A Cross-Sectional Study at a Tertiary Hospital in China. J Inflamm Res. 2025;18:8509-8523https://doi.org/10.2147/JIR.S523193