Metabolic syndrome and urinary problems in men

Dr Radzi Rodzlan, a consultant nephrologist and internal medicine physician, and Dato’ Dr Selvalingam Sothilingam, a consultant urologist and robotic surgeon discuss the unlikely link between metabolic syndrome (MetS) and urinary problems in men.

The prevalence of MetS in Malaysia is concerning, with rates ranging between 25 to 40 percent among adults. Radzi said MetS is characterized by at least three of five risk factors: central obesity, high serum triglycerides, low HDL cholesterol, high blood pressure, and elevated fasting blood sugar levels. Although MetS affects both men and women, men are more susceptible to the condition due to risk factors such as age, family history of diabetes, an unhealthy diet, and a sedentary lifestyle.

The outcomes of MetS are not limited to diabetes and cardiovascular disease; they lead to kidney disease and an elevated risk of urinary issues. Radzi said MetS can lead to a decrease in glomerular filtration rate (GFR) and increased urinary microalbumin, a sign of kidney issues. Such renal complications could progress to chronic kidney disease (CKD) or even end-stage renal disease, necessitating dialysis or a kidney transplant. Early symptoms and signs of kidney problems associated with MetS can include leg swelling, frothy urine, and abnormal results in blood and urine tests. To prevent the progression of CKD, he highlighted the importance of regular health screenings, as it is vital to avoid further complications of MetS.

MetS is also linked to urological issues, noted Selvalingam. There is increasing evidence that men with MetS are at a higher risk of experiencing moderate to severe urinary symptoms as they age, he says. Men may develop conditions like benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS), leading to problems such as delayed urination, weak urine flow, frequent urination, and disrupted sleep from nocturia. Selvalingam said that if left untreated, BPH can cause complications like urinary tract infections, blood in the urine, and even kidney failure. BPH may also result in kidney swelling (hydronephrosis) and, in severe cases, kidney failure due to kidney obstruction. This condition is frequently referred to as chronic obstruction, and men will frequently report bilateral leg edema, hypertension, and bedwetting (nocturnal enuresis).

Both experts stressed on the importance of early intervention. Health screenings can help detect MetS and related conditions early, allowing for lifestyle adjustments and medical interventions that can prevent serious complications. Selvalingam said: “Eighty percent of men with BPH can be successfully treated with medication.” In cases with complications, surgical options like transurethral resection of the prostate (TURP) or minimally invasive procedures like water vapor therapy are available.

The time to take action is now
A proactive approach is crucial as Malaysia shifts to an ageing society. By 2040, Malaysia's elderly population will hit 14.5 percent meaning conditions like MetS, diabetes, and urinary issues will be more common. [Available at https://www.dosm.gov.my/portal-main/release-content/population-projection-revised-malaysia-2010-2040 Accessed on 13 November 2024]  With the projected population hitting 41.5 million people, 14.5 percent is a staggering 6.02 million people. [Available at https://www.ceicdata.com/en/malaysia/population-projection-department-of-statistics Accessed on 13 November 2024]  Therefore, it is time to take action for both individual health and the health of the nation.