This study aimed to elucidate the relationship between dynamic abdominal obesity (DAO) and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) among middle-aged and elderly Chinese adults from the dimensions of cross-sectional and longitudinal analyses.
We used cross-sectional data from the 2011 China Health and Retirement Longitudinal Study (CHARLS). Logistic regression was performed to examine the association between D/AO and prevalent BPH/LUTS, with subgroup analyses to assess potential effect modification. We further established a prospective cohort using CHARLS data from 2011 to 2018. Kaplan‑Meier curves and log‑rank tests were used to compare cumulative BPH/LUTS incidence across D/AO subgroups. Cox regression and BMI‑stratified analyses were then applied to investigate the effect of D/AO on the long-term risk of BPH/LUTS.
This study ultimately included 5,849 participants in the baseline cross-sectional study, among whom 571 self-reported having BPH/LUTS. In adjusted logistic regression models, only participants with both dynapenia and abdominal obesity (D/AO) had a significantly higher risk of prevalent BPH/LUTS (OR = 1.677, 95% CI: 1.012-2.686, P = 0.037). Subgroup analysis revealed that the association was more evident in participants with primary school education or below (OR = 1.874, 95% CI: 1.044-3.226, P = 0.028), and those with BMI ≥ 24.0 kg/m² (OR = 2.111, 95% CI: 1.069-4.040, P = 0.027). In adjusted Cox models, only participants with abdominal obesity without dynapenia (ND/AO) had an increased risk of incident BPH/LUTS (HR = 1.337, 95% CI: 1.091-1.638, P = 0.005). Stratified BMI analysis revealed that the association between DAO subtypes and the risk of BPH/LUTS onset exhibited significant stratified differences, with an interaction P value of 0.037.
In cross-sectional analyses, DAO was identified as a potential risk factor for prevalent BPH/LUTS among middle-aged and elderly Chinese adults. In cohort analyses, however, obesity without low muscle strength appeared to increase the long-term risk of developing BPH/LUTS, and this association was modified by BMI.
World journal of urology. 2026 Jun 25*** epublish ***
Huilin Liu, Beibei Li, Yuhao Huang, Wanling Wang, Jian Cai
Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China., Department of Urology and Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, No.39 Shi-er-Qiao Road, Chengdu, 610075, China. .