The assessment of serum levels of selected hormones and morphological, histochemical and immunohistochemical evaluation of the prostate gland in men with benign prostatic hyperplasia and with coexisting metabolic syndrome

Aleksandra Rył


Introduction: Benign prostatic hyperplasia (BPH) is one of the most common diseases occurring in aging men. The relationship between BPH and metabolic syndrome (MetS) has been poorly elucidated. Evidence was also provided for the relationship between disorders diagnosed in the course of MetS, the volume of the prostate. Metabolic syndrome may play a part in BPH progression.

The aim of this study was to assess the influence of the levels of selected hormones, and to make a morphological, histochemical, and immunohistochemical evaluation of the prostate in men with BPH and coexisting MetS.

Materials and methods: The study involved 151 men with diagnosed and surgically treated BPH. The control group consisted of 142 men without BPH. The men in the study and control groups were divided into subgroups: without MetS diagnosis and with MetS diagnosis. In both groups, anthropometric parameters were measured, and metabolic parameters and the levels of selected hormones and proteins – total testosterone, free testosterone, estradiol, insulin, dehydroepiandrosterone sulfate, luteinizing hormone, sex hormone binding protein and insulin-like growth factor-1 – in serum were determined. An immunohistochemical reaction was performed on the sections to identify an 

androgen receptor (AR) and an oestrogen receptor α (ERα), as well as a proliferating cell nuclear antigen (PCNA). Additionally, a histochemical reaction for apoptosis was performed using the TUNEL method. The preparations were scanned and subjected to computer image analysis.

Results and conclusions: Our study showed that a disturbed lipid profile in serum and a diagnosis of MetS were factors raising the risk of BPH. Changes in the levels of proteins, as well as metabolic and hormonal parameters, had no effects on the severity of clinical symptoms accompanying benign prostatic hyperplasia. Metabolic syndrome in BPH patients had no influence on the localization and expression of AR and ERα in the prostate cells. Nevertheless, metabolic disorders diagnosed in BPH patients may have an impact on the change in the balance between the number of AR(+) and ERα(+) cells and hormone metabolism parameters. Metabolic syndrome in BPH patients had no influence on the number of TUNEL(+) and PCNA(+) cells in the prostate gland. An important factor decreasing the number of TUNEL(+) cells and increasing the number of PCNA(+) cells in BPH patients was central obesity.


benign prostatic hyperplasia; metabolic syndrome; hormones

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