Objectives. To examine the association of diabetes and progression of benign prostatic hyperplasia in a prospective population-based sample of residents of Olmsted County, Minnesota, with serial surrogate measures of benign prostatic hyperplasia. Methods. A cohort of 2115 white men aged 40 to 79 years was randomly selected from an enumeration of the 1990 Olmsted County, Minnesota population (55% participation rate). Participants completed a previously validated baseline questionnaire that assessed lower urinary tract symptom severity from questions similar to the American Urological Association Symptom Index. The questionnaire also asked whether they had ever been diagnosed by a physician as having diabetes. Participants also voided into a portable urometer to measure the peak urinary flow rate. A 25% random subsample underwent transrectal ultrasonography to determine the prostate volume, and the prostate-specific antigen level was determined. Dynamic follow-up was performed biennially for 12 years with the measures repeated at each visit. Results. Of the 2115 men 111 had diabetes at baseline. The men with diabetes had a significantly greater median annual percentage change in the American Urological Association Symptom Index (0.40 versus 0.15, P = 0.04) and a trend toward a greater median annual percentage of change in the peak urinary flow rate (-4.7% versus -2.9%, P = 0.06) compared with those without diabetes. However, no significant difference was found in the annual percentage of change in the prostate volume or serum prostate-specific antigen level. Conclusions. The results of this study suggest that the presence of diabetes may be more closely associated with the dynamic components of lower urinary tract function than with benign prostatic hyperplasia progression, per se.
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