{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:53Z","timestamp":1784557073922,"version":"3.55.0"},"reference-count":12,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Diabetes mellitus type 2 (DM-2) is one of the important causes of low-grade chronic inflammation (meta inflammation) seen in almost all tissues in the body. Other possible mechanisms involved in the development of lower urinary tract symptoms (LUTS) with DM-2 are the hypertonicity of the peripheral sympathetic nerves and hyperinsulinemia effects on the autonomous nervous system activity. These further suggests that abnormalities in glucose homeostasis influence the hyperproliferation of the prostate cells resulting in benign prostatic hyperplasia (BPH). Similarly, hepatic steatosis, a form of non-alcoholic fatty liver disease (NAFLD) prevalence among patients with DM-2, is as high as 75%. NAFLD has no symptoms in most diabetic patients. In this study, we present a case of a 64-year-old Black male who had worsening urinary urgency and hesitancy for 4 months, with increasing abdominal girth. Patient was found to have symptoms, diagnostic studies, and physical exam findings indicative of BPH and fatty liver disease. He was treated with hepato-protective medications, tighter control of his blood glucose levels, and blood pressure meds for 13 months. Upon follow-up, most of his symptoms were resolved. Timeline of BPH resolution and decrease in liver size following treatment suggest that DM-2 has a strong correlation with the development of BPH and fatty liver disease in most patients living with diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Men with type 2 diabetes mellitus (DM-2) tend to have significantly lower serum PSA level, lower testosterone levels, and larger prostate volume compared to non-diabetic male patients.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Patients with DM-2 have higher prevalence of hepatic steatosis, liver cirrhosis, and end-stage liver failure.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>The role of metformin in reducing hepatic steatosis as stated by several studies is yet to be validated as our patient has been on metformin for 22 years for the management of DM-2 with fatty liver disease.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-22-0290","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T06:56:37Z","timestamp":1663656997000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Diabetes mellitus-induced lower urinary tract symptoms and hepatic steatosis in an older male"],"prefix":"10.1530","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2761-2424","authenticated-orcid":true,"given":"Nnennaya U","family":"Opara","sequence":"first","affiliation":[{"name":"Emergency Medicine, Charleston Area Medical Centre, Institute for Academic Medicine, Charleston, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"BJU International","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1111\/j.1464-410X.2005.05728.x","article-title":"Diabetes mellitus is associated with subnormal serum levels of free testosterone in men","volume":"96","author":"Rhoden","year":"2005","unstructured":"Rhoden ELRibeiro EPTeloken CSouto CA. Diabetes mellitus is associated with subnormal serum levels of free testosterone in men. BJU International200596867\u2013870. (https:\/\/doi.org\/10.1111\/j.1464-410X.2005.05728.x)10.1111\/j.1464-410X.2005.05728.x"},{"key":"bib2","series-title":"BJU International","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1111\/bju.14753","article-title":"The independent association of non-alcoholic fatty liver disease with lower urinary tract symptoms\/benign prostatic hyperplasia and erectile function scores","volume":"124","author":"Eren","year":"2019","unstructured":"Eren HHorsanali MO. The independent association of non-alcoholic fatty liver disease with lower urinary tract symptoms\/benign prostatic hyperplasia and erectile function scores. BJU International2019124329\u2013335. 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