Rising Chronic Disease Burden Elevates Risk of BPH and lower urinary tract symptoms among men: Study

A new study published in Nature Scientific Reports showed that benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) were more likely to occur in people with chronic diseases.

The growth of the prostate's stromal and epithelial cells is the hallmark of benign prostatic hyperplasia (BPH), which is linked to an elevated risk in older men. Chronic inflammation may influence the incidence and intensity of lower urinary tract symptoms (LUTS) as well as encourage the onset and progression of BPH.

As the population ages, the majority of senior citizens may have one or more chronic illnesses. Multiple comorbidities, which are defined as the coexistence of two or more chronic diseases, are linked to higher rates of outpatient visits, longer hospital stays, more severe cognitive impairment, higher health care costs, higher burdens of brain pathology, lower quality of life, and higher mortality rates than a single chronic disease. Therefore, using cross-sectional and longitudinal research, Zhigang Hu and colleagues investigated the relationships between the number and class of chronic illnesses and the risk of lower urinary tract symptoms indicative of benign prostatic hyperplasia (LUTS/BPH).

A total of 5,197 males aged 45 and older who participated in the China Health and Retirement Longitudinal Study (CHARLS) 2011 and had a 7-year follow-up were included in this study. We used latent class analysis, generalized additive analysis, and causal mediation analysis to multidimensionally examine the connections between LUTS/BPH and multimorbidity.

Four kinds of morbidity were discovered using latent class analysis: dominant chronic lung illnesses (class 2, N = 152), many chronic diseases (class 3, N = 387), dominant cardiac diseases or hazards (class 4, N = 498), and minimum or least common diseases (class 1, N = 4160, reference).

The risk of LUTS/BPH rose in a dose-dependent manner with the number of chronic conditions in both the cross-sectional and cohort investigations. 3 more classes seemed to have substantially higher risks of LUTS/BPH than class 1 in all multivariable-adjusted studies.

In the cross-sectional research, class 3's risk of LUTS/BPH was 3.19 times higher than class 1's. The link between LUTS/BPH and multimorbidity was shown to be strongly mediated by depression, according to assessments of causal mediation.

Overall, among middle-aged and older Chinese males, the multimorbidity class and the number of chronic illnesses are linked to varying probabilities of developing LUTS/BPH. Two significant mediating variables that may link multimorbidity and LUTS/BPH are chronic inflammation and depression.

Reference:

Hu, Z., Tian, Y., & Hu, X. (2025). Associations between the risk of LUTS/BPH and the number and class of chronic diseases among middle-aged and elder men. Scientific Reports, 15(1), 14965. https://doi.org/10.1038/s41598-025-00057-8