Abstract
Introduction: The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have recently been proposed as easily accessible inflammatory biomarkers and as surrogate markers for metabolic disease, cardiovascular disease, and malignancies, including prostate cancer. However, scant studies have investigated the association of NLR, PLR, and LMR with benign prostatic hyperplasia (BPH). Methods: Data from 8,727 middle-aged men who had participated in a health checkup were analyzed. BPH was defined as prostate volume ≥30 mL, International Prostate Symptom Score > 7, and maximal flow rate <15 mL/s. Propensity score matching was considered for 269 men with BPH (cases), and 7,136 men with no BPH (controls), but ultimately, propensity scores were matched at a 2:1 ratio of controls to cases (538 men in the control group and 269 men in the case group). Results: After propensity score matching, age, International Index of Erectile Function-5, testosterone, and number of metabolic syndrome component variables were evenly distributed and did not differ significantly between the groups. After matching, PLR and LMR were not significantly different between the 2 groups. However, NLR was significantly higher in the case group than in the control group (median [interquartile range]: 1.4 [1.1; 1.8] vs. 1.5 [1.2; 1.9]; p = 0.024) after matching. Conclusion: High NLR was significantly associated with the presence of BPH. Our results suggest the possible effect of inflammation on BPH development. A prospective study is needed to investigate the potential role of NLR as a candidate biomarker of BPH.
References
1.
Verhamme
KM
, Dieleman
JP
, Bleumink
GS
, Van der Lei
J
, Sturkenboom
MC
, Artibani
W
, et al
. Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care: the Triumph project
. Eur Urol
. 2002
;42
(4
):323
–8
. 2.
Fibbi
B
, Penna
G
, Morelli
A
, Adorini
L
, Maggi
M
. Chronic inflammation in the pathogenesis of benign prostatic hyperplasia
. Int J Androl
. 2010
;33
(3
):475
–88
. .3.
Schenk
JM
, Kristal
AR
, Neuhouser
ML
, Tangen
CM
, White
E
, Lin
DW
, Biomarkers of systemic inflammation and risk of incident, symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial
. Am J Epidemiol
. 2010
;171
(5
):571
–82
. .4.
Zhou
J
, Wei
Y
, Lan
Y
, Zuo
J
, Hou
X
, Hou
W
. Individual and joint association of bioavailable testosterone and aging with neutrophil-to-lymphocyte ratio in Chinese middle-aged and elderly men
. Aging Clin Exp Res
. 2020 Aug
;32
(8
):1515
–23
.5.
Buyukkaya
E
, Karakas
MF
, Karakas
E
, Akçay
AB
, Tanboga
IH
, Kurt
M
, Correlation of neutrophil to lymphocyte ratio with the presence and severity of metabolic syndrome
. Clin Appl Thromb Hemost
. 2014
;20
(2
):159
–63
. .6.
Sciarra
A
, Gentilucci
A
, Salciccia
S
, Pierella
F
, Del Bianco
F
, Gentile
V
, Prognostic value of inflammation in prostate cancer progression and response to therapeutic: a critical review
. J Inflamm
. 2016
;13
(1
):35
–11
. .7.
Tanik
S
, Albayrak
S
, Zengin
K
, Borekci
H
, Bakirtas
H
, Imamoglu
MA
, Is the neutrophil-lymphocyte ratio an indicator of progression in patients with benign prostatic hyperplasia?
Asian Pac J Cancer Prev
. 2014
;15
(15
):6375
–9
. .8.
Ozer
K
, Horsanali
MO
, Gorgel
SN
, Horsanali
BO
, Ozbek
E
. Association between benign prostatic hyperplasia and neutrophil-lymphocyte ratio, an indicator of inflammation and metabolic syndrome
. Urol Int
. 2017
;98
(4
):466
–71
. .9.
Chung
MS
, Yang
YJ
, Lee
SH
, Yoon
BI
. Association between the neutrophil-to-lymphocyte ratio and intravesical prostatic protrusion in men with benign prostatic hyperplasia
. Low Urin Tract Symptoms
. 2020
;12
(1
):62
–7
. .10.
Lee
JH
, Lee
SW
. Relationship between premature ejaculation and chronic prostatitis/chronic pelvic pain syndrome
. J Sex Med
. 2015
;12
(3
):697
–704
. .11.
Vuichoud
C
, Loughlin
KR
. Benign prostatic hyperplasia: epidemiology, economics and evaluation
. Can J Urol
. 2015
;22
(Suppl 1
):1
–6
.12.
Sambel
M
, Kilic
M
, Demirbas
M
, Onen
E
, Oner
S
, Erdogan
A
, Relationship between erectile dysfunction and the neutrophil to lymphocyte and platelet to lymphocyte ratios
. Int J Impot Res
. 2018
;30
(1
):27
–35
. .13.
Huh
JS
, Kim
YJ
, Kim
SD
. Prevalence of benign prostatic hyperplasia on Jeju Island: analysis from a cross-sectional community-based survey
. World J Mens Health
. 2012
;30
(2
):131
–7
. .14.
Jepsen
JV
, Bruskewitz
RC
. Comprehensive patient evaluation for benign prostatic hyperplasia
. Urology
. 1998
;51
(4A Suppl
):13
–8
. .15.
Kim
SH
, Kim
SH
. Correlations between the various methods of estimating prostate volume: transabdominal, transrectal, and three-dimensional US
. Korean J Radiol
. 2008
;9
(2
):134
–9
. .16.
Stuart
EA
, King
G
, Imai
K
, Ho
DE
. MatchIt: nonparametric preprocessing for parametric causal inference
. J Stat Softw
. 2011
;42
(8
):1
–28
.17.
Guthrie
GJ
, Charles
KA
, Roxburgh
CS
, Horgan
PG
, McMillan
DC
, Clarke
SJ
. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer
. Crit Rev Oncol/Hematol
. 2013
;88
(1
):218
–30
.18.
Yuksel
OH
, Urkmez
A
, Akan
S
, Yldirim
C
, Verit
A
. Predictive value of the platelet-to-lymphocyte ratio in diagnosis of prostate cancer
. Asian Pac J Cancer Prev
. 2015
;16
(15
):6407
–12
. .19.
Caglayan
V
, Onen
E
, Avci
S
, Sambel
M
, Kilic
M
, Oner
S
, Lymphocyte-to-monocyte ratio is a valuable marker to predict prostate cancer in patients with prostate specific antigen between 4 and 10 ng/dL
. Arch Ital Urol Androl
. 2018
;90
(4
):270
–5
.20.
Madersbacher
S
, Sampson
N
, Culig
Z
. Pathophysiology of benign prostatic hyperplasia and benign prostatic enlargement: a mini-review
. Gerontology
. 2019
;65
(5
):458
–64
. .21.
Chughtai
B
, Lee
R
, Te
A
, Kaplan
S
. Role of inflammation in benign prostatic hyperplasia
. Rev Urol
. 2011
;13
(3
):147
.22.
De Nunzio
C
, Albisinni
S
, Gacci
M
, Tubaro
A
. The role of inflammation in the progression of benign prostatic hyperplasia
. Curr Bladder Dysfunct Rep
. 2013
;8
(2
):142
–9
. .23.
Zhang
Q
, Pang
S
, Zhang
Y
, Jiang
K
, Guo
X
. Association between inflammation and lower urinary tract symptoms of benign prostatic hyperplasia
. Urol J
. 2020 Mar 14
;17
(5
):505
–11
.24.
Falahatkar
S
, Mokhtari
G
, Pourreza
F
, Asgari
SA
, Kamran
AN
. Celecoxib for treatment of nocturia caused by benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled study
. Urology
. 2008
;72
(4
):813
–6
. .25.
Gorgel
SN
, Sefik
E
, Kose
O
, Olgunelma
V
, Sahin
E
. The effect of combined therapy with tamsulosin hydrochloride and meloxicam in patients with benign prostatic hyperplasia symptoms and impact on nocturia and sleep quality
. Int Braz J Urol
. 2013
;39
(5
):657
–62
. .26.
Gokkaya
CS
, Aktas
BK
, Ozden
C
, Bulut
S
, Karabakan
M
, Erkmen
AE
, Flurbiprofen alone and in combination with alfuzosin for the management of lower urinary tract symptoms
. Cent European J Urol
. 2015
;68
(1
):51
–6
. .27.
Park
DS
, Shim
JY
. Histologic influence of doxazosin and finasteride in benign prostatic hyperplasia accompanying chronic inflammation
. Urol Int
. 2008
;81
(4
):441
–6
. .28.
Lee
CB
, Ha
US
, Yim
SH
, Lee
HR
, Sohn
DW
, Han
CH
, Does finasteride have a preventive effect on chronic bacterial prostatitis? Pilot study using an animal model
. Urol Int
. 2011
;86
(2
):204
–9
. .29.
Peixoto
CA
, Gomes
FO
. The role of phosphodiesterase-5 inhibitors in prostatic inflammation: a review
. J Inflamm
. 2015
;12
(1
):54
–8
. .30.
Austin
PC
. An introduction to propensity score methods for reducing the effects of confounding in observational studies
. Multivariate Behav Res
. 2011
;46
(3
):399
–424
. .© 2021 S. Karger AG, Basel
2021
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
