Tall men at risk for prostate enlargement studyNEW YORK (Reuters Health) — Tall men seem to have a heightened risk of developing an enlarged prostate, also known as benign prostatic hyperplasia (BPH), a new study shows.Advancing age and high fasting blood sugar levels also raise the odds of BPH, whereas a greater systolic blood pressure — the first number in the blood pressure reading — may indicate a lower risk.

One of the most common ailments in elderly men, BPH leads to bothersome lower urinary symptoms and is associated with complications such as urinary retention, bloody urine, stones, and urinary tract infections. Surgery may be required to relieve BPH.

Dr. Claus G. Roehrborn from University of Texas Southwestern Medical Center, Dallas and colleagues studied the relationship among factors such as height, weight, blood pressure, blood sugar and lipid levels, and the development of BPH in roughly 1,200 Vietnam War veterans. During follow-up lasting 15.6 years, 623 of the men developed BPH, and as expected, advancing age was an independent risk factor. They also found increased height to be an independent predictor of BPH.

“It is entirely plausible that taller men have proportionally larger prostates,” Roehrborn and colleagues report in the journal Urology, noting that in a previous study they found that men with larger prostates had a greater absolute increase in prostate volume over time.

“Thus, a positive relationship between height and BPH is not unexpected and is biologically plausible,” the researchers point out. There was no relationship between BPH and weight or body mass index (BMI) or with a change in weight or BMI over time. BMI is a measure of height in relation to weight and is often used to determine if a person is underweight or overweight.

These results only add to conflicting data already published, the researchers say.

Nonetheless, they note that “overall, the preponderance of evidence, especially considering the results from prospective studies, favours either no association or an inverse association between BMI or obesity and BPH or lower urinary tract symptoms.”

Consistent with at least one other study, the Dallas study found that a greater systolic blood pressure — the first and larger of the two numbers that comprise a blood pressure reading — was associated with decreasing odds of BPH, whereas the diastolic blood pressure — the second number — had no effect.Diabetes linked to kidney stonesNEW YORK (Reuters Health) — Recent studies suggest that the incidence of kidney stones is increasing, both in the U.S. and worldwide, and data compiled by researchers at the Mayo Clinic in Rochester, Minnesota, suggest that diabetes may be a predisposing factor, particularly for kidney stones composed of uric acid.A kidney stone is a solid mass consisting of tiny crystals made of calcium, uric acid or other substances. Pain in the back, flank or abdomen is a common feature, along with bloody urine, excessive or painful urination, nausea and vomiting, and other symptoms. Dr. John C. Lieske and his associates identify all Olmsted County residents diagnosed with kidney stones between 1980 and 1999. The 3,561 patients were matched by age and gender with an equal number of individuals without kidney stones. The researchers also examined patients diagnosed with diabetes, high blood pressure and obesity.

After taking into account the effects of age, time of year, high blood pressure, and obesity, diabetes was significantly associated with a diagnosis of kidney stones, the team reports in the American Journal of Kidney Disease.

For closer scrutiny, Lieske’s group obtained a random sample of 269 subjects with confirmed kidney stones and matched them with 260 individuals without kidney stones. The odds of having diabetes in those with kidney stones was of a similar magnitude, but was no longer statistically significant due to the smaller sample size.

However, when the researchers analysed the cases according to stone type, the prevalence of diabetes was 40 percent among the ten individuals with uric acid stones, versus nine percent among the 112 with calcium stones and seven percent in those without kidney stones.Oesophageal cancer surgery not linked to obesityNEW YORK (Reuters Health) — Obese patients who undergo surgery for oesophageal cancer with a procedure called transhiatal oesophagectomy appear to fare just as well as their normal weight counterparts, according to study findings presented Tuesday at the Society of Thoracic Surgeons annual meeting in San Diego.In the last 20 years, the most common cell type involved in oesophageal cancer in the US has changed. Most of these cancers were composed of squamous cell carcinomas, cells derived from the middle layer of skin. But now, 85 percent of oesophageal cancers are adenocarcinomas, cells that originate from the lining of certain organs.

Researchers believe this is due, in large part, to the rising obesity epidemic, since adenocarcinoma is related to gastro-oesophageal reflux, or “GERD,” which, in turn, is associated with obesity. Transhiatal oesophagectomy, which avoids the longer recovery time required after a chest incision, approaches the oesophagus through the abdomen, and typically takes longer to perform in obese patients. The current study findings indicate that the longer procedural time does not translate into an increase in hospital length of stay, more complications or a higher death rate.

However, comparable outcomes in obese patients may not be attained at all hospitals — the key is experience. As senior investigator Dr. Mark Orringer told Reuters Health, “this is an operation that needs to be performed at high-volume centres by experienced surgeons.”

He added that at his centre, the University of Michigan Health System in Ann Arbor, “we’ve even developed special instruments for use in obese patients.”