Objective: To investigate whether metabolic syndrome (MetS) may be associated with the clinical progression of benign prostatic hyperplasia (BPH). Methods: A total of 525 community-dwelling men (aged 45-78) with lower urinary tract symptoms (LUTS) who had complete data at 3-year follow-up were included in this prospective study. International Prostate Symptom Score (IPSS) questionnaire, prostate ultrasonography for prostate volume (PV), maximum urine flow rate (Qmax) and biological parameters were recorded. Participants were divided into a BPH with the MetS group and a BPH without the MetS group, and all received a 3-year follow-up to monitor possible correlations between LUTS/BPH clinical progression and MetS. Results: The results showed that MetS was associated with IPSS, Qmax and PV (p < 0.05) after 3-year follow-up. The mean change of IPSS, PV and Qmax were positively and negatively correlated with time in the BPH with MetS group during the 3-year follow-up. In addition, the BPH clinical progression rate was significantly higher in the BPH with MetS group, compared with the BPH without MetS group (p < 0.05). Diabetes mellitus (DM) and hypertension were related to increased risk of BPH clinical progression. Conclusions: The present results suggest that MetS, in particular, DM and hypertension, may accelerate the clinical progression of BPH in community-dwelling middle-aged and older men.

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