Central obesity as measured by waist circumference is predictive of severity of lower urinary tract symptoms

OBJECTIVES To determine if central obesity as measured by waist circumference (WC) is a risk factor in metabolic dysfunction, which includes hypertension, dyslipidaemia and type 2 diabetes (DM2). To test the hypothesis that central obesity and WC are associated with and predictive of the severity of voiding dysfunction. METHODS Men aged >= 40 years with moderate or severe lower urinary tract symptoms (LUTS, International Prostate Symptom Score >= 8) with no previous treatment were included for study. Subjects were divided into three groups according to WC (<90, 90-99 and >= 100 cm). Baseline parameters including International Prostate Symptom Score, prostate volume, serum prostate-specific antigen, presence of erectile dysfunction and ejaculatory dysfunction, and the prevalence of hypertension, coronary artery disease and DM2 were compared among the three WC categories. The association between WC and all parameters assessed was tested using multivariate logistic regression analysis. RESULTS In the 409 consecutive men analysed, WC was significantly and positively associated with prostate volume, serum prostate-specific antigen and International Prostate Symptom Score. Higher WCs were also significantly associated with a greater prevalence of hypertension, coronary artery disease, DM2 and obesity as well as the presence of erectile dysfunction and ejaculatory dysfunction. CONCLUSIONS Increased WC is associated with worsened voiding. There was a significantly increased prevalence of components of the metabolic syndrome in patients with higher WC. Obese men, in particular those with other features of the metabolic syndrome, are at increased risk of male pelvic dysfunction and can be easily recognized by measurement of WC.