Can Metabolic Syndrome Cause An Enlarged Prostate?

BPH causes are not completely understood, but numerous studies suggest one cause may include metabolic syndrome. Research indicates that metabolic syndrome, which is a major risk factor for diabetes and heart disease, may also increase a man’s chances of developing an enlarged prostate, or benign prostatic hyperplasia (BPH).

What causes BPH?

Experts have composed a lengthy list of possible causes and risk factors for BPH, a condition that affects more than 50 percent of men older than 50. Some of the items on that list include age, being overweight, having diabetes, a weakened immune system, poor diet, high “bad” cholesterol, high blood pressure, family history, and elevated dihydrotestosterone (DHT) levels.

Of these, excessive DHT is considered one of the major BPH causes because the prostate is greatly influenced by testosterone. When the enzyme 5-alpha-reductase converts testosterone into DHT, the DHT stimulates the growth of prostate cells. The result is an enlarged prostate.

However, BPH is a complex condition and many factors can be involved. In fact, when looking at the list of risk factors and BPH causes, there are several associated with metabolic syndrome. The five disorders that make up the syndrome include the following:

  • High blood pressure
  • Obesity (specifically abdominal obesity or a large waistline)
  • Glucose intolerance or insulin resistance (an inability of normal amounts of insulin to carry glucose [sugar] into the cells) which results in mildly high or high blood sugar levels
  • High triglyceride levels
  • Low high-density lipoprotein (HDL) cholesterol levels

Generally, someone is said to have metabolic syndrome if he has any three of the five disorders.

Studies of BPH causes

A review team in Italy evaluated 11 studies that involved BPH and metabolic syndrome. The authors concluded that most of them indicated a clear association between an enlarged prostate and metabolic syndrome. For example, the reviewers noted that men who had at least three of the five components of metabolic syndrome had an 80 percent increased risk of lower urinary tract symptoms (LUTS).

The reviewers emphasized that their findings do not prove that men who have metabolic syndrome are at an increased risk of developing BPH. A subsequent study, however, shed even more light on the topic of BPH causes and metabolic syndrome.

The study appeared in the November 2012 issue of the Korean Journal of Urology.  Researchers reported on 521 men ages 40 to 70 who underwent transrectal ultrasound. Men who had metabolic syndrome had significantly higher prostate specific antigen (PSA) levels and prostate volume than did men without metabolic syndrome. In fact, men with as few as two disorders associated with metabolic syndrome were significantly more likely to have a larger prostate volume and higher PSA levels. These findings lead the authors to conclude that each metabolic syndrome component “could be an important factor in BPH development and management.”

The disorders associated with metabolic syndrome are largely lifestyle issues. That is, they can be prevented and managed with lifestyle changes, such as diet, exercise, and stress management. Since metabolic syndrome may be one of several BPH causes, it is recommended men take steps now to prevent the associated disorders. Preventing BPH and metabolic syndrome can begin with steps such as following a healthful diet (e.g., the Prostate Health Diet), exercising regularly, achieving and maintaining a healthy weight, and managing stress, among other things.


Byun HK et al. Relationships between prostate-specific antigen, prostate volume, and components of metabolic syndrome in healthy Korean men. Korean Journal of Urology 2012 Nov; 53(11): 774-78

De Nunzio C et al. The correlation between metabolic syndrome and prostatic diseases. European Urology 2012 Mar; 61(3): 560-70

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