The role of sex steroid hormones in benign prostatic hyperplasia

Figures & data

Figure 1. Androgen biosynthesis pathway: Androgens are synthesized via a classical and non-classical pathway. Classical pathway is shown in light gray arrows while the backdoor pathway is the hatched arrows [6].

Figure 2. Age profile of study participants. Controls were younger than BPH patients (p < 0.001).

Figure 3. Total PSA levels of study groups. Total PSA (tPSA) was significantly lower in control group than in BPH patients (p < 0.001).

Table 1. Comparison of hormone levels and enzyme indices between BPH patients and control.

	BPH patients		Controls
Variable	Mean (SD)	Median (25th–75th percentile)	Mean (SD)	Median (25th–75th percentile)	p-Value
Androstenediol, pg/ml	349.30 (97.99)	336.89 (298.51–379.84)	454.37 (45.89)	385.63 (342.61–476.69)	0.017
Testosterone, ng/ml	6.47 (2.32)	6.72 (4.64–8.23)	6.74 (0.58)	6.52 (4.42–8.97)	0.722
fT, pg/ml	121.56 (85.56)	98.57 (71.50–132.55)	103.61 (8.02)	101.17 (74.79–130.26)	0.907
DHT, pg/ml	306.16 (59.34)	302.23 (255.97–334.0)	331.15 (21.83)	294.95 (263.98–356.57)	0.761
3α-diol, ng/ml	2.47 (1.22)	1.94 (1.73–2.81)	3.55 (0.57)	2.57 (1.90–3.44)	0.203
3β-diol, ng/ml	1.04 (0.32)	0.95 (0.84–1.21)	2.21 (0.50)	1.14 (0.86–1.85)	0.135
Estrone, pg/ml	73.80 (36.52)	71.50 (56.28–95.58)	66.67 (8.09)	61.04 (33.13–88.82)	0.206
Estradiol, pg/ml	29.40 (6.32)	29.90 (23.47–33.65)	29.18 (3.02)	23.75 (20.36–28.59)	0.029
E2/T	0.005 (0.002)	0.004 (0.004–0.006)	0.011 (0.007)	0.004 (0.003–0.006)	0.088
3α-diol/DHT	1.39 (0.767)	1.32 (0.830–1.744)	0.010 (0.001)	0.008 (0.006–0.012)	<0.0001
3β-diol/DHT	0.99 (0.389)	0.96 (0.710–1.265)	5.56 (0.892)	3.94 (2.979–5.452)	<0.0001
DHT/T	0.055 (0.027)	0.049 (0.035–0.061)	0.112 (0.041)	0.049 (0.034–0.077)	0.863

^ap-Value< 0.050 was considered significant. p-Values were computed by Mann–Whitney test.

E2/T: Aromatase activity; DHT: T: 5 Alpha reductase activity; 3α-diol/DHT: AKRIC2 activity; 3β-diol/DHT: AKRIC1 activity.

Table 2. Correlation analysis between age, clinical outcome, hormones and enzyme indices in BPH patients.

	Age		T IPSS		Prostate volume(cm^3)		tPSA(ng/ml)
	r	p-Value	r	p-Value	r	p-Value	r	p-Value
Age	1
TIPSSS	0.14	0.56	1
Prostate volume	−0.33	0.20	−0.24	0.43	1
tPSA	0.35^b	0.00	0.05	0.84	−0.18	0.50	1
AED(pg/ml)	0.01	0.96	−0.23	0.34	0.34	0.18	−0.13	0.49
T(ng/ml)	0.268^a	0.04	−0.10	0.66	−0.06	0.83	−0.09	0.64
FT(pg/ml)	0.14	0.58	0.22	0.41	−0.514^a	0.01	−0.42^a	0.03
DHT(pg/ml)	0.02	0.89	−0.28	0.23	0.03	0.91	−0.15	0.42
3α-diol(ng/ml)	0.08	0.56	−0.24	0.31	0.00	0.99	0.00	0.98
3β-diol(ng/ml)	0.00	0.99	−0.656^b	0.00	0.16	0.54	−0.07	0.73
E1(pg/ml)	0.10	0.43	−0.38	0.10	−0.18	0.50	−0.16	0.40
E2(pg/ml)	0.17	0.19	−0.28	0.23	0.34	0.18	0.26^a	0.04
DHT/T	−0.33	0.08	−0.06	−0.82	0.05	0.84	0.06	0.76
E1/AED	0.04	0.76	−0.30	0.19	−0.29	0.26	−0.14	0.46
E2/T	−0.13	0.33	−0.05	0.85	0.19	0.46	0.27^a	0.04
3α-diol/DHT	0.04	0.76	−0.05	0.84	0.00	0.99	0.12	0.51
3β-diol/DHT	−0.06	0.66	−0.519^a	0.02	0.21	0.43	−0.03	0.87

Correlation was computed by Spearman’s

^a r, p < 0.05:

^b r, p < 0.01.

Table 3. Multiple regression analysis (R = 0.614, p = 0.048) using TIPSS as independent variable and age, hormone and metabolites as dependent variables.

	β	t	Sig.
Constant		−1.870	0.080
DHT	3.320	2.282	0.036
3β-diol	−2.473	−2.903	0.010

All variables were log transformed, then a backward linear multiple regression was performed to remove non-significant variables p-Value< 0.050 was considered significant.

Table 4. Multiple regression analysis (R = 0.136, p = 0.049) using tPSA as independent variable and age, hormone and metabolites as dependent variables.

	β	t	Sig.
Constant		3.856	0.001
fT	−0.657	−2.059	0.049

All variables were log transformed, then a backward linear multiple regression was performed to remove non-significant variables. p-Value< 0.050 was considered significant.

Mostaghel EA. Beyond T and DHT-novel steroid derivatives capable of wild type androgen receptor activation. Int J Biol Sci 2014;10:602

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