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American Journal of Epidemiology Advance Access originally published online on April 24, 2009
American Journal of Epidemiology 2009 169(11):1281-1290; doi:10.1093/aje/kwp085
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Associations Between C-Reactive Protein and Benign Prostatic Hyperplasia/Lower Urinary Tract Symptom Outcomes in a Population-based Cohort

Jennifer L. St. Sauver, Aruna V. Sarma, Debra J. Jacobson, Michaela E. McGree, Michael M. Lieber, Cynthia J. Girman, Ajay Nehra and Steven J. Jacobsen

Correspondence to Dr. Jennifer L. St. Sauver, Division of Epidemiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 (e-mail: stsauver.jennifer{at}mayo.edu).

Received for publication June 26, 2008. Accepted for publication November 4, 2008.

Inflammation may play a role in the development of benign prostatic hyperplasia and/or lower urinary tract symptoms (LUTS). Higher levels of C-reactive protein (CRP) may therefore be associated with the development of these outcomes. The authors examined the association of CRP levels measured in 1996 with rapid increases in prostate volume, prostate-specific antigen levels, and LUTS as well as rapid decreases in peak flow rates (through 2005) in a population-based cohort of men residing in Olmsted County, Minnesota. Men with CRP levels of ≥3.0 mg/L were more likely to have rapid increases in irritative LUTS (odds ratio (OR) = 2.14, 95% confidence interval (CI): 1.18, 3.85) and rapid decreases in peak flow rates (OR = 2.54, 95% CI: 1.09, 5.92) compared with men with CRP levels of <3.0 mg/L. CRP levels were not significantly associated with rapid increases in prostate volume, obstructive LUTS, or prostate-specific antigen levels. Associations were attenuated after adjusting for age, body mass index, hypertension, and smoking history (irritative LUTS: OR = 2.00, 95% CI: 1.04, 3.82; peak flow rate: OR = 2.45, 95% CI: 0.73, 8.25). These results suggest that rapid increases in irritative LUTS and rapid decreases in peak flow rates may be due to inflammatory processes.

C-reactive protein; inflammation; prostatic hyperplasia; signs and symptoms; urinary tract

Abbreviations: BPH, benign prostatic hyperplasia; CRP, C-reactive protein; LUTS, lower urinary tract symptoms; PSA, prostate-specific antigen

Editor's note: An invited commentary on this article appears on page 1291, and the authors’ response is published on page 1294.


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Related articles in Am. J. Epidemiol.:

Invited Commentary: Lower Urinary Tract Symptoms and Inflammation—Weighing the Evidence
Stephen J. Freedland and William J. Aronson
Am. J. Epidemiol. 2009 169: 1291-1293. [Abstract] [FREE Full Text]  

St. Sauver et al. Respond to "Lower Urinary Tract Symptoms and Inflammation"
Jennifer L. St. Sauver, Aruna V. Sarma, Debra J. Jacobson, Michaela E. McGree, and Steven J. Jacobsen
Am. J. Epidemiol. 2009 169: 1294-1295. [Extract] [FREE Full Text]  



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