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Objective <p>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.</p> Methods and materials <p>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.</p> Results <p>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, <i>P</i> = 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, <i>P</i> = 0.028), and those with BMI ≥ 24.0&#xa0;kg/m² (OR = 2.111, 95% CI: 1.069–4.040, <i>P</i> = 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, <i>P</i> = 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.</p> Conclusion <p>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.</p>

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Association between dynamic abdominal obesity (DAO) and benign prostatic hyperplasia (lower urinary tract symptoms): evidence from the China Health and Retirement Longitudinal Study (CHARLS)

  • 期刊论文

  • 发表日期：

    2026年6月25日

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  • Huilin Liu,
  • Beibei Li,
  • Yuhao Huang,
  • Wanling Wang,
  • Jian Cai

摘要

Objective

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.

Methods and materials

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.

Results

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.

Conclusion

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.