Association of Sarcopenic Obesity with Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms: A Nationwide Cross-sectional Study.

Background and objective: This study explores the associations of sarcopenia, obesity, and their coexistence (sarcopenic obesity) with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Methods: Data from the China Health and Retirement Longitudinal Study (CHARLS) 2011 and 2015 were analyzed. Participants aged ≥45 yr were categorized into four groups: normal, sarcopenia, obesity (defined as body mass index >25 kg/m2), and sarcopenic obesity. LUTS/BPH was assessed according to each patient's medical history. Logistic regression was used to evaluate the association of obesity, sarcopenia, and sarcopenic obesity with BPH/LUTS. Interaction effects were further assessed to investigate the combined impact of sarcopenia and obesity. Key findings and limitations: Among 6236 participants, 17% of those in the sarcopenic obesity group had BPH/LUTS, which is a significantly higher rate than in the other groups. Unadjusted logistic regression analysis showed that obesity (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.10-1.58; p = 0.003) and sarcopenia (OR 1.19, 95% CI 1.06-1.35; p = 0.004) were associated with higher risk of LUTS/BPH. However, after adjusting for other biomarkers, only coexisting sarcopenia and obesity (OR 1.51, 95% 1.01-2.27; p = 0.046) was associated with significantly higher risk of LUTS/BPH, while no association was observed for either sarcopenia alone (OR 0.88, 95% CI 0.67-1.15; p = 0.3) or obesity alone (OR 0.99, 95% CI 0.72-1.35; p = 0.9). Sensitivity analyses confirmed these findings. The interaction between sarcopenia and obesity was significant, with 40% (95% CI 13-56%) of the risk attributed to their combined effect. Conclusions and clinical implications: Sarcopenic obesity was independently associated with higher risk of BPH/LUTS among older men in our cohort. Our study highlights the synergistic interaction between sarcopenia and obesity, and suggests a need for comprehensive management of both conditions to reduce the risk of BPH/LUTS. Patient summary: We looked at associations between a condition called sarcopenic obesity (obesity and a loss of muscle mass) and benign enlargement of the prostate gland causing urinary problems (called BPH/LUTS for short). We found that sarcopenic obesity is associated with a higher risk of BPH/LUTS in older men.