Endocrine Abstracts

Introduction: The impact of metabolic syndrome (MetS) on male infertility has been poorly studied. We recently reported that MetS is associated with hypogonadism, poor sperm morphology and testis ultrasound inhomogeneity. However, the possible associations between MetS and prostate-related symptoms and signs are still lacking.

Methods: Out of 351 subjects without genetic abnormalities previously evaluated for couple infertility clinically and by scrotal ultrasound, 171 underwent also transrectal ultrasound and are here analysed. MetS was defined according to NCEP-ATPIII classification. All men underwent hormonal (including total testosterone (TT) and insulin), seminal and transrectal ultrasound evaluation. Prostate-related symptoms were assessed by National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and International Prostate Symptom Score (IPSS).

Results: Out of 171 patients, 22 (13%) fulfilled MetS criteria. In an age-adjusted regression model, insulin levels increased as a function of MetS components (β=0.134, P<0.0001) and showed an inverse correlation with TT (adj.r=−0.359, P<0.0001). In an age-TT-insulin-ordinal regression model, normal morphology was negatively related to the number of MetS components (β=−0.083, P<0.02). At univariate analysis, the number of MetS components was weakly associated with NIH-CPSI void subdomain (r=0.110, P<0.05) and IPSS (r=0.143, P<0.05) score, however not confirmed after adjusting for confounders. Using an age-TT-insulin-adjusted model, a positive correlation between the number of MetS components and sIL-8 levels was observed (β=0.760, P<0.05). When transrectal ultrasound features were evaluated, using an age-TT-insulin-adjusted ordinal regression model, the number of MetS components was positively related to prostate volume (β=0.086, P<0.0001), arterial prostatic peak systolic velocity (β=0.148, P=0.02), prostate inhomogeneity severity (β=0.521, P<0.01) and prostate calcification size (β=0.087, P<0.02). No association between MetS and seminal vesicles features was found.

Conclusions: In men with couple infertility, MetS is positively associated with a higher prostate volume, biochemical (sIL8) and ultrasound signs of prostate inflammation, but not with prostate-related symptoms.