Yifan Wu,1,2,* Jiayi Sheng,1,* Xinwei Liu,1,2 Yongneng Huang,1,2 Yuwei Zhang,1,3 Ninghan Feng1,2 

1Department of Urology, Jiangnan University Medical Center, Wuxi, Jiangsu Province, People’s Republic of China; 2Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, People’s Republic of China; 3Medical School of Nantong University, Nantong, Jiangsu Province, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ninghan Feng, Department of Urology, Jiangnan University Medical Center, 68 Zhongshan Road, Wuxi, 214002, People’s Republic of China, Tel +86 510 68562222, Email n.feng@jiangnan.edu.cn Yuwei Zhang, Medical School of Nantong University, 9 Qiangyuan Road, Nantong, 226019, People’s Republic of China, Tel +86 513 85051875, Email zhangyw0123@njmu.edu.cn

Purpose: Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are common urogenital system diseases in elderly men and can cause serious complications when the disease progresses to moderate and severe stages. Early and accurate identification is of great significance for prevention, treatment, and prognosis assessment. However, there is still a lack of effective and simple predictive indicators. This study aims to investigate whether immune-inflammatory markers derived from complete blood count (CBC) exhibit an independent association with the severity of BPH/LUTS.
Patients and Methods: This study included a total of 698 BPH/LUTS patients who met the inclusion criteria at the Department of Urology, Jiangnan University Medical Center. According to the International Prostate Symptom Score (IPSS) score, patients were divided into a mild group and a moderate-to-severe group. Binary logistic regression analysis was used to explore the association between the severity of BPH/LUTS and the neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), and systemic immune-inflammatory index (SII).
Results: The median age of the participants was 70.00 (65.00, 75.00) years. After adjusting for confounding factors, the NLR, SIRI, and SII were positively correlated with the severity of BPH/LUTS. Compared with the lowest quartile, the highest quartile of NLR (OR = 6.20 [3.49– 11.02]), SIRI (OR = 7.49 [4.15– 13.50]), and SII (OR =7.85 [4.73– 16.61]) were most significantly associated with the risk of BPH/LUTS aggravation. In subgroups stratified by age, diet, physical activity, cardiovascular disease, and diabetes, NLR, SIRI, and SII were positively correlated with BPH/LUTS severity. In subgroups defined by waist circumference and dyslipidemia, SIRI and SII were positively correlated with BPH/LUTS severity. In the smoking subgroup, only SIRI showed a positive correlation with BPH/LUTS severity.
Conclusion: The findings suggest that NLR, SIRI, and SII are affordable and readily available detection methods that can be used as indicators for assessing the severity of BPH/LUTS.

Keywords: lower urinary tract symptoms, benign prostatic hyperplasia, neutrophil-to-lymphocyte ratio, systemic inflammatory response index, systemic immune-inflammatory index, cross-sectional study