Challenging the inevitability of prostate enlargement: Low levels of benign prostatic hyperplasia among Tsimane forager-horticulturalists - Abstract

BACKGROUND: Often considered an inevitable part of male aging, benign prostatic hyperplasia (BPH) is the most common non-life threatening disease to affect men in Western populations.

We examine age-related change in prostate size and BPH risk and related serum biomarkers among the Tsimane Amerindians of the Bolivian Amazon who live a traditional lifestyle of hunting and small-scale horticulture. The Tsimane are a critical case study for understanding the etiology of BPH as they have low levels of obesity and metabolic syndrome, as well as lower levels of testosterone than age matched U.S. males, factors associated with BPH in previous research.

METHODS: Ultrasounds were conducted on 348 men aged 28-89 years (median age 56 years). Testosterone, prostate specific antigen, sex hormone binding globulin, and glycosylated hemoglobin were examined in relationship to prostate size and BPH.

RESULTS: Tsimane have less than half of the BPH prevalence experienced by U.S. men, and prostate volumes 62.6% smaller. While Tsimane have low levels of testosterone and subclinical levels of metabolic syndrome compared to U.S. men, Tsimane with high testosterone were more likely to experience BPH, as were those with higher glycosylated hemoglobin, suggesting targets for clinical interventions to reduce BPH.

CONCLUSIONS: These results have clinical significance for the growing number of men taking testosterone supplementation; even at low levels the additional testosterone exposure could be placing these men at higher risk of BPH. Overall, these data suggest that BPH may not have been an inevitable part of male aging throughout human evolutionary history.

Written by:
Trumble BC, Stieglitz J, Rodriguez DE, Linares EC, Kaplan HS, Gurven MD.   Are you the author?
Department of Anthropology, University of California Santa Barbara; Department of Anthropology, University of New Mexico, Albuquerque; Institute for Advanced Study in Toulouse, France; Tsimane Health and Life History Project, San Borja, Bolivia.  

Reference: J Gerontol A Biol Sci Med Sci. 2015 Apr 28. pii: glv051.
doi: 10.1093/gerona/glv051


PubMed Abstract
PMID: 25922348

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