Metabolic syndrome has become a major public health challenge worldwide. Patients with MS are twice as likely to have cardiovascular disease and four times as likely to have type II diabetes mellitus than patients without MS. The mortality rate of cardiovascular or coronary arterial diseases is also increased 2.9–4.0 times in patients with MS.1–3 Recently, the incidence of obesity has risen rapidly, even in

Asian countries, making obesity-related disease a paramount concern.4,5 MS is one of the most important obesity-related phenotype complexes of hypertension, insulin resistance, low high-density lipoprotein (HDL)-cholesterol and hypertriglyceridemia.6 There is increasing evidence from clinical and epidemiological studies of associations between lower urinary tract symptoms (LUTS) and major chronic medical diseases as well as related lifestyle factors.7 These associations have stimulated interest in the contribution of factors R428 outside the urinary tract to urological symptoms; the so-called “beyond the bladder” hypothesis.8,9 Traditionally, the pathogenesis of benign prostatic Fulvestrant mw hyperplasia (BPH) and LUTS was explained as interaction between hormonal

and genetic factors. Increasing clinical significance of BPH and LUTS with increasing age is not only a urological issue. With increasing life expectancy, people demand better health-related life quality, which could cause an obesity epidemic. Several cohort studies have independently reported that components of MS, including obesity, influence the development of BPH and LUTS. Increasing evidence suggests that modifiable risk factors may participate in the development of BPH and LUTS. The characteristics of MS may differ due to a population’s socioeconomic and cultural basis. Metabolic syndrome is defined based on the Adult Treatment Panel III of the National Cholesterol Education Program (ATPIII NCEP) diagnosis criteria as three or more of the following cardiovascular risk factors: (i) abdominal obesity (waist circumference ≥88 cm); (ii) elevated blood pressure

(≥130 mmHg systolic or ≥85 mmHg diastolic); (iii) high triglyceride level (≥150 mg/dL); (iv) glucose intolerance (fasting glucose Anacetrapib ≥110 mg/dL); and (v) low HDL-cholesterol level (<50 mg/dL).10 In the present study, body mass index (BMI) ≥25 kg/m2 was used as an indicator of obesity instead of waist circumference.11 For Asian populations, BMI ≥25 kg/m2 the new cut-off value for obesity because Asians have a proportionally higher percentage of total body fat and abdominal fat than Caucasians with the same BMI and thus obesity-related complications occur at a lower BMI.12–14 It is important to apply unified definition criteria, but racial and cultural differences should be considered among different populations in different countries. In a study of Asian North Indians, modified NCEP ATP III criteria showed the highest occurrence of MS in incident-type II diabetes mellitus (DM) patients.