Large Waist Circumference Linked With ED

ANAHEIM, CALIF. — A tape measure may not only help predict whether a patient has metabolic syndrome; it also may be one of the most useful tools to predict the presence of hypertension, dyslipidemia, coronary artery disease, erectile dysfunction, a large prostate, a high prostate-specific-antigen level, and ejaculatory dysfunction.

In a study of 88 men aged 50–75 years with moderate to severe lower urinary tract symptoms, waist circumference was powerfully correlated with numerous components of male pelvic health as well as with metabolic syndrome and male pelvic health, making it a “home run in terms of prediction,” said Dr. Steven Kaplan, who is professor of urology at Cornell University, New York.

“The results are simply remarkable,” said Dr. Kaplan at the annual meeting of the American Urological Association, where he presented his study during a podium session and at a press briefing. “The results even surprised us.”

Men with moderate to severe lower urinary tract symptoms (International Prostate Symptom Scores of 8 or greater) but no prior treatment were divided into three groups based on their waist sizes: 30–36 inches; 36–40 inches; or greater than 40 inches. Their waists were measured at the level of the uppermost border of the iliac crest.

Waist measurement was highly correlated with every parameter included in the study, including prostate volume, prostate-specific antigen (PSA), prostate symptom score, erectile dysfunction, ejaculatory dysfunction, and incidence of hypertension, coronary artery disease, and diabetes mellitus.

For example, the mean prostate volumes in cubic centimeters, as measured by rectal ultrasound, were 28.53, 31.67, and 36.78, respectively, for the three categories of waist circumference.

Incidence of diabetes was 11.2%, 22.3%, and 34.5%, respectively.

Percentages of patients with hypertension were 12.6%, 24.7%, and 37.8%.

Erectile dysfunction was seen in 34.6%, 49.5%, and 78.6%, respectively, of men in the three waist-circumference groups.

Dr. Kaplan said waist circumference may be a more accurate predictor of metabolic problems than body mass index (BMI), because it takes into account very muscular individuals, such as professional baseball player Barry Bonds.

“He's got a high BMI, however he got it,” Dr. Kaplan mused. “But certainly he doesn't have a problem with a big gut.”

Physicians may want to begin thinking about belly fat as “almost a separate organ … a new gland, if you will,” he said.

High aromatase levels within visceral fat may interfere not only with metabolism, but also with testosterone homeostasis.

“Theoretically, by altering that metabolism, perhaps you fuel prostate growth,” Dr. Kaplan said during the press briefing.

A second study presented by Dr. Kaplan at the meeting found a high correlation between obesity and prostate volume (P less than .0001) in the 9,000-subject Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial. The same study found high correlations between prostate volume and glucose, insulin resistance, high HDL cholesterol, total cholesterol, and hypertension.

Physicians may need to pay heed to increasing evidence from these and other studies that male pelvic health and metabolic syndrome are highly linked, according to Dr. Kaplan.

“Perhaps [one] component of the metabolic syndrome should be male pelvic dysfunction,” which includes voiding dysfunction, erectile dysfunction, and ejaculatory dysfunction, Dr. Kaplan said.

A large waist measurement was highly correlated with a high PSA level and with erectile dysfunction in an 88-patient study. ©Keith Frith/FOTOLIA

ANAHEIM, CALIF. — A tape measure may not only help predict whether a patient has metabolic syndrome; it also may be one of the most useful tools to predict the presence of hypertension, dyslipidemia, coronary artery disease, erectile dysfunction, a large prostate, a high prostate-specific-antigen level, and ejaculatory dysfunction.

In a study of 88 men aged 50–75 years with moderate to severe lower urinary tract symptoms, waist circumference was powerfully correlated with numerous components of male pelvic health as well as with metabolic syndrome and male pelvic health, making it a “home run in terms of prediction,” said Dr. Steven Kaplan, who is professor of urology at Cornell University, New York.

“The results are simply remarkable,” said Dr. Kaplan at the annual meeting of the American Urological Association, where he presented his study during a podium session and at a press briefing. “The results even surprised us.”

Men with moderate to severe lower urinary tract symptoms (International Prostate Symptom Scores of 8 or greater) but no prior treatment were divided into three groups based on their waist sizes: 30–36 inches; 36–40 inches; or greater than 40 inches. Their waists were measured at the level of the uppermost border of the iliac crest.

Waist measurement was highly correlated with every parameter included in the study, including prostate volume, prostate-specific antigen (PSA), prostate symptom score, erectile dysfunction, ejaculatory dysfunction, and incidence of hypertension, coronary artery disease, and diabetes mellitus.

For example, the mean prostate volumes in cubic centimeters, as measured by rectal ultrasound, were 28.53, 31.67, and 36.78, respectively, for the three categories of waist circumference.

Incidence of diabetes was 11.2%, 22.3%, and 34.5%, respectively.

Percentages of patients with hypertension were 12.6%, 24.7%, and 37.8%.

Erectile dysfunction was seen in 34.6%, 49.5%, and 78.6%, respectively, of men in the three waist-circumference groups.

Dr. Kaplan said waist circumference may be a more accurate predictor of metabolic problems than body mass index (BMI), because it takes into account very muscular individuals, such as professional baseball player Barry Bonds.

“He's got a high BMI, however he got it,” Dr. Kaplan mused. “But certainly he doesn't have a problem with a big gut.”

Physicians may want to begin thinking about belly fat as “almost a separate organ … a new gland, if you will,” he said.

High aromatase levels within visceral fat may interfere not only with metabolism, but also with testosterone homeostasis.

“Theoretically, by altering that metabolism, perhaps you fuel prostate growth,” Dr. Kaplan said during the press briefing.

A second study presented by Dr. Kaplan at the meeting found a high correlation between obesity and prostate volume (P less than .0001) in the 9,000-subject Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial. The same study found high correlations between prostate volume and glucose, insulin resistance, high HDL cholesterol, total cholesterol, and hypertension.

Physicians may need to pay heed to increasing evidence from these and other studies that male pelvic health and metabolic syndrome are highly linked, according to Dr. Kaplan.

“Perhaps [one] component of the metabolic syndrome should be male pelvic dysfunction,” which includes voiding dysfunction, erectile dysfunction, and ejaculatory dysfunction, Dr. Kaplan said.

A large waist measurement was highly correlated with a high PSA level and with erectile dysfunction in an 88-patient study. ©Keith Frith/FOTOLIA

ANAHEIM, CALIF. — A tape measure may not only help predict whether a patient has metabolic syndrome; it also may be one of the most useful tools to predict the presence of hypertension, dyslipidemia, coronary artery disease, erectile dysfunction, a large prostate, a high prostate-specific-antigen level, and ejaculatory dysfunction.

In a study of 88 men aged 50–75 years with moderate to severe lower urinary tract symptoms, waist circumference was powerfully correlated with numerous components of male pelvic health as well as with metabolic syndrome and male pelvic health, making it a “home run in terms of prediction,” said Dr. Steven Kaplan, who is professor of urology at Cornell University, New York.

“The results are simply remarkable,” said Dr. Kaplan at the annual meeting of the American Urological Association, where he presented his study during a podium session and at a press briefing. “The results even surprised us.”

Men with moderate to severe lower urinary tract symptoms (International Prostate Symptom Scores of 8 or greater) but no prior treatment were divided into three groups based on their waist sizes: 30–36 inches; 36–40 inches; or greater than 40 inches. Their waists were measured at the level of the uppermost border of the iliac crest.

Waist measurement was highly correlated with every parameter included in the study, including prostate volume, prostate-specific antigen (PSA), prostate symptom score, erectile dysfunction, ejaculatory dysfunction, and incidence of hypertension, coronary artery disease, and diabetes mellitus.

For example, the mean prostate volumes in cubic centimeters, as measured by rectal ultrasound, were 28.53, 31.67, and 36.78, respectively, for the three categories of waist circumference.

Incidence of diabetes was 11.2%, 22.3%, and 34.5%, respectively.

Percentages of patients with hypertension were 12.6%, 24.7%, and 37.8%.

Erectile dysfunction was seen in 34.6%, 49.5%, and 78.6%, respectively, of men in the three waist-circumference groups.

Dr. Kaplan said waist circumference may be a more accurate predictor of metabolic problems than body mass index (BMI), because it takes into account very muscular individuals, such as professional baseball player Barry Bonds.

“He's got a high BMI, however he got it,” Dr. Kaplan mused. “But certainly he doesn't have a problem with a big gut.”

Physicians may want to begin thinking about belly fat as “almost a separate organ … a new gland, if you will,” he said.

High aromatase levels within visceral fat may interfere not only with metabolism, but also with testosterone homeostasis.

“Theoretically, by altering that metabolism, perhaps you fuel prostate growth,” Dr. Kaplan said during the press briefing.

A second study presented by Dr. Kaplan at the meeting found a high correlation between obesity and prostate volume (P less than .0001) in the 9,000-subject Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial. The same study found high correlations between prostate volume and glucose, insulin resistance, high HDL cholesterol, total cholesterol, and hypertension.

Physicians may need to pay heed to increasing evidence from these and other studies that male pelvic health and metabolic syndrome are highly linked, according to Dr. Kaplan.

“Perhaps [one] component of the metabolic syndrome should be male pelvic dysfunction,” which includes voiding dysfunction, erectile dysfunction, and ejaculatory dysfunction, Dr. Kaplan said.

A large waist measurement was highly correlated with a high PSA level and with erectile dysfunction in an 88-patient study. ©Keith Frith/FOTOLIA