Chronic inflammation and insulin resistance in the pathogenesis of benign prostate hyperplasia (review)

Benign prostatic hyperplasia (BPH) is an important problem in elder men. BPH was shown to be linked to many other diseases: obesity, arterial hypertension, atherosclerosis, diabetes mellitus type 2, psoriasis, non-alcoholic fat liver disease and many others. The common for all those diseases is a chronic indolent inflammation (low grade inflammation, LGI) and inflammation-induced insulin resistance (IR). Features of LGU and IR are present in patients with BPH, and anti-inflammatory medications ameliorate the BPH symptoms. In all described conditions anti-inflammatory cytokines and IR markers were shown to be increased: C-reactive protein, tumor necrosis factor alpha, interleukin-6 and others. The apprehension of the LGI and IR role in development of many diseases (including BPH) is a major step forward in the last 10 years. This could empirically clarify the fact of BPH regression with regular physical activity, diet with low content of saturated and oxidized fatty acids, control of carbohydrates metabolism, restriction of the emotional stress and open new possibilities for the search of effective pharmaceuticals, which should suppress LGI and IR. Specific inhibition of the LGI and SR is a new strategy in BPH treatment. Those medications are metformin and pioglitazone. This warrants further studies investigating suppression of the systemic inflammation.