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Research Article
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Published Online: 17 November 2014

Thiazolidinedione and Metformin Use and the Risk of Benign Prostate Hyperplasia in Veterans with Diabetes Mellitus

Publication: Journal of Men's Health
Volume 11, Issue Number 4

Abstract

Background: Chronic inflammation is important in the development of benign prostatic hyperplasia (BPH), and certain oral antidiabetic medications have anti-inflammatory properties. The purpose of this study was to determine if use of thiazolidinediones or metformin was associated with a reduced risk of requiring medical or surgical treatment for BPH compared with the use of sulfonylureas among diabetic men.
Methods: We constructed a retrospective cohort of 192,457 male veterans newly prescribed either rosiglitazone, pioglitazone, metformin, or a sulfonylurea. We used Cox proportional hazard regression to assess the association between use of a thiazolidinedione or metformin and the risk of requiring medical or surgical treatment for BPH compared with sulfonylurea use. New BPH treatment was defined by either a new prescription for an α-1 blocker or 5α-reductase inhibitors or a surgical procedure indicated for severe BPH.
Results: In 259,995 person-years of follow-up we identified 14,690 new treatments for BPH. After adjusting for covariates including age, HbA1c, and body mass index, we found no association between rosiglitazone (adjusted hazard ratio [aHR] 1.02; 95% confidence interval [CI] 0.86, 1.20); pioglitazone (aHR 0.79; 95% CI 0.45, 1.38), or metformin use (aHR 0.99; 95% CI 0.94, 1.03) and risk of new medical or surgical treatment for BPH compared with sulfonylureas. Analyses ignoring prescriptions for nonselective α-1 blockers (terazosin, doxazosin, prazosin) from our BPH case definition (n=11,079) yielded similar results.
Conclusions: In this large cohort, we observed no association between the use of thiazolidinediones or metformin and new medical or surgical treatment for BPH compared with sulfonylureas.

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Information & Authors

Information

Published In

cover image Journal of Men's Health
Journal of Men's Health
Volume 11Issue Number 4December 2014
Pages: 157 - 162
PubMed: 25798210

History

Published in print: December 2014
Published online: 17 November 2014

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    Authors

    Affiliations

    Harvey J. Murff, MD, MPH
    Veterans Health Administration–Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, HSR&D Center, Nashville, Tennessee.
    Department of Medicine, Vanderbilt University, Nashville, Tennessee.
    Christianne L. Roumie, MD, MPH
    Veterans Health Administration–Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, HSR&D Center, Nashville, Tennessee.
    Department of Medicine, Vanderbilt University, Nashville, Tennessee.
    Robert A. Greevy, PhD
    Veterans Health Administration–Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, HSR&D Center, Nashville, Tennessee.
    Department of Biostatistics, Vanderbilt University, Nashville, Tennessee.
    Carlos G. Grijalva, MD, MPH
    Veterans Health Administration–Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, HSR&D Center, Nashville, Tennessee.
    Department of Preventive Medicine, Vanderbilt University, Nashville, Tennessee.
    Adrianna H. Hung, MD, MPH
    Veterans Health Administration–Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, HSR&D Center, Nashville, Tennessee.
    Department of Medicine, Vanderbilt University, Nashville, Tennessee.
    Xulei Liu, MD, MS
    Veterans Health Administration–Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, HSR&D Center, Nashville, Tennessee.
    Department of Biostatistics, Vanderbilt University, Nashville, Tennessee.
    Marie R. Griffin, MD, MPH
    Veterans Health Administration–Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, HSR&D Center, Nashville, Tennessee.
    Department of Medicine, Vanderbilt University, Nashville, Tennessee.
    Department of Preventive Medicine, Vanderbilt University, Nashville, Tennessee.

    Notes

    Address correspondence to:Harvey J. Murff, MD, MPHVanderbilt University Medical Center6012 Medical Center East1215 21st Avenue SouthNashville, TN 37232E-mail: [email protected]

    Author Disclosure Statement

    No competing financial interests exist.

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