Date of Award


Document Type


Degree Name

Master of Medicine (MMed)


Pathology (East Africa)


Introduction: Benign prostatic hyperplasia is a highly prevalent disease and is considered an inevitable correlate of ageing. Several theories have been advanced in a bid to explain its pathogenesis, the most popular ones relating to sex steroid hormones (1). Currently facets of the metabolic syndrome of which two principal components are insulin resistance and high BMI have been postulated to be related to growth of the prostate (2). Insulin resistance is assessed by the HOMA-IR index. Some studies have demonstrated an association between these indices and the size of the prostate (3). While others have not (4). We set out to investigate this association.

Objectives: The aim of this study was to assess the relationship between the Quetelet‘s Index, HOMA-IR index and the prostate volume amongst patients scheduled for surgery for prostate enlargement.

Methods: Consecutive male patients attending the urology clinic were recruited into the study. Their anthropometric measures were taken and Quetelet‘s index was derived from the same. Prostate volumes were determined by transrectal ultrasonography (TRUS). Serum samples were taken, after an overnight fast and assayed for insulin and glucose levels. Tissue specimens were examined at the Aga khan University Hospital Histopathology labs. Prostate volume was considered the main outcome. Regression modeling was employed to assess the relationship between the BMI and prostate volume and that between the HOMAIR index and the prostate volume.

Results: A total of 130 patients fulfilled the inclusion criteria. The mean age was 69.8 (SD 9.152). The mean BMI was 22.66 (SD4.01), while the mean prostate volume was 81.2cc (SD38.98).

The age of the patients was associated with the prostate volume and according to our model there was an increase in the mean prostate volume with age. In addition, the Quetelet‘s index was also associated with the prostate volume, explaining 23% of the variability in prostate volume (R2=0.229, β = 0.475, p

Conclusion: The Quetelet‘s Index and the HOMA-IR Index are positively associated with the prostate volume and are potential modifiable risk factors for Benign Prostatic Hyperplasia.