Association Between Lipid Accumulation Product Index and Lower Urinary Tract Symptom-Benign Prostatic Hyperplasia: a 7-Year Follow-Up Study

The distribution of adipose tissue plays a crucial role in the progression of lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH). This study was performed to explore the longitudinal association between the lipid accumulation product index (LAPI) and LUTS/BPH. Based on logistic and restricted cubic spline (RCS) regressions, data from the China Health and Retirement Longitudinal Study were used to evaluate the odds ratio (OR) and non-linear correlation between LAPI and LUTS/BPH. Subgroup and interactive analyses were adopted to determine the interactive effects of covariates. In addition, a 7 -year retrospective cohort from 2011-2018 was constructed to investigate the longitudinal association. After data cleansing, this study included 3967 males aged >40 years in 2011. In the full model, high LAPI was significantly associated with prevalent LUTS/BPH (OR = 1.007; 95% CI (confidence interval): 1.001-1.013, p = 0.016). Furthermore, as a categorical variable, the ORs were 1.21 (95% CI = 0.91- 1.62, p = 0.197) and 1.56 (95% CI = 1.09-2.23, p = 0.014) for the second and third tertile groups, respectively. No significant interactive effects were detected (all p for interaction > 0.05). The RCS regression revealed a linear association between LAPI and prevalent LUTS/BPH in the overall population (p for overall < 0.05) and an L-shaped association in males aged >= 60 years (p for non-linear = 0.006). In the 2011-2018 cohort, the ORs for the second and third tertile groups were 1.51 (95% CI = 1.11-2.04, p = 0.008) and 1.74 (95% CI = 1.21-2.50, p = 0.003) in the full models, respectively. All the sensitivity analyses supported similar findings. In conclusion, aging males with high LAPI have a higher risk of developing LUTS/BPH than their counterparts.