Association of the triglyceride glucose-Chinese visceral adiposity index with self-reported LUTS/BPH in aging males

Background: The triglyceride glucose-Chinese visceral adiposity index (TyG-CVAI) is a novel marker for insulin resistance and visceral adiposity. This study investigated its longitudinal, average, and change patterns in relation to incident risk of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) among aging males.

Methods: This prospective study included 2,889 males from the China Health and Retirement Longitudinal Study who were free of self-reported LUTS/BPH at 2011 and followed up until 2018. Baseline and average TyG-CVAI were calculated, and participants were subsequently categorized as four change patterns (low-to-low, low-to-high, high-to-low, and high-to-high) from 2011 to 2015. Multivariable logistic and Cox regression, Kaplan-Meier survival analysis, and restricted cubic spline (RCS) regression were performed to evaluate incident risk.

Results: In the full model, higher TyG-CVAI tertiles were significantly associated with an increased risk of incident LUTS/BPH [T2: odds ratio (OR) =1.47, 95% confidence interval (CI): 1.11–1.94, P=0.007; T3: OR =1.91, 95% CI: 1.44–2.53, P<0.001]. Kaplan-Meier curve revealed that T2 and T3 groups had significantly higher incidence of LUTS/BPH than the T1 group (P for log-rank <0.0001). RCS revealed a non-linear dose-response pattern (P for non-linearity =0.020). In the 2011–2015 average TyG-CVAI analysis, the ORs for T2 and T3 were 1.84 (95% CI: 1.27–2.67, P=0.001) and 1.98 (95% CI: 1.35–2.90, P<0.001), respectively, with a non-linear dose-response effect (P for non-linearity =0.039). Regarding TyG-CVAI change patterns, the high-to-high group carried the highest risk (OR =1.72, 95% CI: 1.22–2.40, P=0.002), while the low-to-high and high-to-low groups showed intermediate risk levels.

Conclusions: Elevated single-point, average, and persistently high TyG-CVAI burdens were associated with an increased risk of incident LUTS/BPH in aging males. TyG-CVAI changes patterns, particularly persistent high exposure, may offer novel insights for clinical intervention of LUTS/BPH.