Cardiometabolic Risk Factors Associated with Benign Prostatic Hyperplasia Among Men Attending a Tertiary Health Centre in Enugu State, Nigeria: A Case–Control Study

Cardiometabolic Risk Factors Associated with Benign... | F1000Research "use strict";function _typeof(t){return(_typeof="function"==typeof Symbol&&"symbol"==typeof Symbol.iterator?function(t){return typeof t}:function(t){return t&&"function"==typeof Symbol&&t.constructor===Symbol&&t!==Symbol.prototype?"symbol":typeof t})(t)}!function(){var t=function(){var t,e,o=[],n=window,r=n;for(;r;){try{if(r.frames.__tcfapiLocator){t=r;break}}catch(t){}if(r===n.top)break;r=r.parent}t||(!function t(){var e=n.document,o=!!n.frames.__tcfapiLocator;if(!o)if(e.body){var r=e.createElement("iframe");r.style.cssText="display:none",r.name="__tcfapiLocator",e.body.appendChild(r)}else setTimeout(t,5);return!o}(),n.__tcfapi=function(){for(var t=arguments.length,n=new Array(t),r=0;r 3&&2===parseInt(n[1],10)&&"boolean"==typeof n[3]&&(e=n[3],"function"==typeof n[2]&&n[2]("set",!0)):"ping"===n[0]?"function"==typeof n[2]&&n[2]({gdprApplies:e,cmpLoaded:!1,cmpStatus:"stub"}):o.push(n)},n.addEventListener("message",(function(t){var e="string"==typeof t.data,o={};if(e)try{o=JSON.parse(t.data)}catch(t){}else o=t.data;var n="object"===_typeof(o)&&null!==o?o.__tcfapiCall:null;n&&window.__tcfapi(n.command,n.version,(function(o,r){var a={__tcfapiReturn:{returnValue:o,success:r,callId:n.callId}};t&&t.source&&t.source.postMessage&&t.source.postMessage(e?JSON.stringify(a):a,"*")}),n.parameter)}),!1))};"undefined"!=typeof module?module.exports=t:t()}(); dataLayer = dataLayer || []; // Standard GTM initialization - Google Consent Mode handles consent automatically (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl+ '>m_auth=hzk0Vc3qFsQYhCrIoHz68A>m_preview=env-1>m_cookies_win=x';f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-MWFK8L5J'); ;window.NREUM||(NREUM={});NREUM.init={distributed_tracing:{enabled:true},privacy:{cookies_enabled:true},ajax:{deny_list:["bam.nr-data.net"]}}; ;NREUM.loader_config={accountID:"438030",trustKey:"438030",agentID:"772317073",licenseKey:"97f8f67f26",applicationID:"772317073"} ;NREUM.info={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net",licenseKey:"97f8f67f26",applicationID:"772317073",sa:1} ;/*! For license information please see nr-loader-spa-1.236.0.min.js.LICENSE.txt */ (()=>{"use strict";var e,t,r={5763:(e,t,r)=>{r.d(t,{P_:()=>l,Mt:()=>g,C5:()=>s,DL:()=>v,OP:()=>T,lF:()=>D,Yu:()=>y,Dg:()=>h,CX:()=>c,GE:()=>b,sU:()=>_});var n=r(8632),i=r(9567);const o={beacon:n.ce.beacon,errorBeacon:n.ce.errorBeacon,licenseKey:void 0,applicationID:void 0,sa:void 0,queueTime:void 0,applicationTime:void 0,ttGuid:void 0,user:void 0,account:void 0,product:void 0,extra:void 0,jsAttributes:{},userAttributes:void 0,atts:void 0,transactionName:void 0,tNamePlain:void 0},a={};function s(e){if(!e)throw new Error("All info objects require an agent identifier!");if(!a[e])throw new Error("Info for ".concat(e," was never set"));return a[e]}function c(e,t){if(!e)throw new Error("All info objects require an agent identifier!");a[e]=(0,i.D)(t,o),(0,n.Qy)(e,a[e],"info")}var u=r(7056);const d=()=>{const e={blockSelector:"[data-nr-block]",maskInputOptions:{password:!0}};return{allow_bfcache:!0,privacy:{cookies_enabled:!0},ajax:{deny_list:void 0,enabled:!0,harvestTimeSeconds:10},distributed_tracing:{enabled:void 0,exclude_newrelic_header:void 0,cors_use_newrelic_header:void 0,cors_use_tracecontext_headers:void 0,allowed_origins:void 0},session:{domain:void 0,expiresMs:u.oD,inactiveMs:u.Hb},ssl:void 0,obfuscate:void 0,jserrors:{enabled:!0,harvestTimeSeconds:10},metrics:{enabled:!0},page_action:{enabled:!0,harvestTimeSeconds:30},page_view_event:{enabled:!0},page_view_timing:{enabled:!0,harvestTimeSeconds:30,long_task:!1},session_trace:{enabled:!0,harvestTimeSeconds:10},harvest:{tooManyRequestsDelay:60},session_replay:{enabled:!1,harvestTimeSeconds:60,sampleRate:.1,errorSampleRate:.1,maskTextSelector:"*",maskAllInputs:!0,get blockClass(){return"nr-block"},get ignoreClass(){return"nr-ignore"},get maskTextClass(){return"nr-mask"},get blockSelector(){return e.blockSelector},set blockSelector(t){e.blockSelector+=",".concat(t)},get maskInputOptions(){return e.maskInputOptions},set maskInputOptions(t){e.maskInputOptions={...t,password:!0}}},spa:{enabled:!0,harvestTimeSeconds:10}}},f={};function l(e){if(!e)throw new Error("All configuration objects require an agent identifier!");if(!f[e])throw new Error("Configuration for ".concat(e," was never set"));return f[e]}function h(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");f[e]=(0,i.D)(t,d()),(0,n.Qy)(e,f[e],"config")}function g(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");var r=l(e);if(r){for(var n=t.split("."),i=0;i {r.d(t,{D:()=>i});var n=r(50);function i(e,t){try{if(!e||"object"!=typeof e)return(0,n.Z)("Setting a Configurable requires an object as input");if(!t||"object"!=typeof t)return(0,n.Z)("Setting a Configurable requires a model to set its initial properties");const r=Object.create(Object.getPrototypeOf(t),Object.getOwnPropertyDescriptors(t)),o=0===Object.keys(r).length?e:r;for(let a in o)if(void 0!==e[a])try{"object"==typeof e[a]&&"object"==typeof t[a]?r[a]=i(e[a],t[a]):r[a]=e[a]}catch(e){(0,n.Z)("An error occurred while setting a property of a Configurable",e)}return r}catch(e){(0,n.Z)("An error occured while setting a Configurable",e)}}},6818:(e,t,r)=>{r.d(t,{Re:()=>i,gF:()=>o,q4:()=>n});const n="1.236.0",i="PROD",o="CDN"},385:(e,t,r)=>{r.d(t,{FN:()=>a,IF:()=>u,Nk:()=>f,Tt:()=>s,_A:()=>o,il:()=>n,pL:()=>c,v6:()=>i,w1:()=>d});const n="undefined"!=typeof window&&!!window.document,i="undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self.navigator instanceof WorkerNavigator||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis.navigator instanceof WorkerNavigator),o=n?window:"undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis),a=""+o?.location,s=/iPad|iPhone|iPod/.test(navigator.userAgent),c=s&&"undefined"==typeof SharedWorker,u=(()=>{const e=navigator.userAgent.match(/Firefox[/\s](\d+\.\d+)/);return Array.isArray(e)&&e.length>=2?+e[1]:0})(),d=Boolean(n&&window.document.documentMode),f=!!navigator.sendBeacon},1117:(e,t,r)=>{r.d(t,{w:()=>o});var n=r(50);const i={agentIdentifier:"",ee:void 0};class o{constructor(e){try{if("object"!=typeof e)return(0,n.Z)("shared context requires an object as input");this.sharedContext={},Object.assign(this.sharedContext,i),Object.entries(e).forEach((e=>{let[t,r]=e;Object.keys(i).includes(t)&&(this.sharedContext[t]=r)}))}catch(e){(0,n.Z)("An error occured while setting SharedContext",e)}}}},8e3:(e,t,r)=>{r.d(t,{L:()=>d,R:()=>c});var n=r(2177),i=r(1284),o=r(4322),a=r(3325);const s={};function c(e,t){const r={staged:!1,priority:a.p[t]||0};u(e),s[e].get(t)||s[e].set(t,r)}function u(e){e&&(s[e]||(s[e]=new Map))}function d(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:"",t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:"feature";if(u(e),!e||!s[e].get(t))return a(t);s[e].get(t).staged=!0;const r=[...s[e]];function a(t){const r=e?n.ee.get(e):n.ee,a=o.X.handlers;if(r.backlog&&a){var s=r.backlog[t],c=a[t];if(c){for(var u=0;s&&u {let[t,r]=e;return r.staged}))&&(r.sort(((e,t)=>e[1].priority-t[1].priority)),r.forEach((e=>{let[t]=e;a(t)})))}function f(e,t){var r=e[1];(0,i.D)(t[r],(function(t,r){var n=e[0];if(r[0]===n){var i=r[1],o=e[3],a=e[2];i.apply(o,a)}}))}},2177:(e,t,r)=>{r.d(t,{c:()=>f,ee:()=>u});var n=r(8632),i=r(2210),o=r(1284),a=r(5763),s="nr@context";let c=(0,n.fP)();var u;function d(){}function f(e){return(0,i.X)(e,s,l)}function l(){return new d}function h(){u.aborted=!0,u.backlog={}}c.ee?u=c.ee:(u=function e(t,r){var n={},c={},f={},g=!1;try{g=16===r.length&&(0,a.OP)(r).isolatedBacklog}catch(e){}var p={on:b,addEventListener:b,removeEventListener:y,emit:v,get:x,listeners:w,context:m,buffer:A,abort:h,aborted:!1,isBuffering:E,debugId:r,backlog:g?{}:t&&"object"==typeof t.backlog?t.backlog:{}};return p;function m(e){return e&&e instanceof d?e:e?(0,i.X)(e,s,l):l()}function v(e,r,n,i,o){if(!1!==o&&(o=!0),!u.aborted||i){t&&o&&t.emit(e,r,n);for(var a=m(n),s=w(e),d=s.length,f=0;fn,p:()=>i});var n=r(2177).ee.get("handle");function i(e,t,r,i,o){o?(o.buffer([e],i),o.emit(e,t,r)):(n.buffer([e],i),n.emit(e,t,r))}},4322:(e,t,r)=>{r.d(t,{X:()=>o});var n=r(5546);o.on=a;var i=o.handlers={};function o(e,t,r,o){a(o||n.E,i,e,t,r)}function a(e,t,r,i,o){o||(o="feature"),e||(e=n.E);var a=t[o]=t[o]||{};(a[r]=a[r]||[]).push([e,i])}},3239:(e,t,r)=>{r.d(t,{bP:()=>s,iz:()=>c,m$:()=>a});var n=r(385);let i=!1,o=!1;try{const e={get passive(){return i=!0,!1},get signal(){return o=!0,!1}};n._A.addEventListener("test",null,e),n._A.removeEventListener("test",null,e)}catch(e){}function a(e,t){return i||o?{capture:!!e,passive:i,signal:t}:!!e}function s(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;window.addEventListener(e,t,a(r,n))}function c(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;document.addEventListener(e,t,a(r,n))}},4402:(e,t,r)=>{r.d(t,{Ht:()=>u,M:()=>c,Rl:()=>a,ky:()=>s});var n=r(385);const i="xxxxxxxx-xxxx-4xxx-yxxx-xxxxxxxxxxxx";function o(e,t){return e?15&e[t]:16*Math.random()|0}function a(){const e=n._A?.crypto||n._A?.msCrypto;let t,r=0;return e&&e.getRandomValues&&(t=e.getRandomValues(new Uint8Array(31))),i.split("").map((e=>"x"===e?o(t,++r).toString(16):"y"===e?(3&o()|8).toString(16):e)).join("")}function s(e){const t=n._A?.crypto||n._A?.msCrypto;let r,i=0;t&&t.getRandomValues&&(r=t.getRandomValues(new Uint8Array(31)));const a=[];for(var s=0;s {r.d(t,{Bq:()=>n,Hb:()=>o,oD:()=>i});const n="NRBA",i=144e5,o=18e5},7894:(e,t,r)=>{function n(){return Math.round(performance.now())}r.d(t,{z:()=>n})},7243:(e,t,r)=>{r.d(t,{e:()=>o});var n=r(385),i={};function o(e){if(e in i)return i[e];if(0===(e||"").indexOf("data:"))return{protocol:"data"};let t;var r=n._A?.location,o={};if(n.il)t=document.createElement("a"),t.href=e;else try{t=new URL(e,r.href)}catch(e){return o}o.port=t.port;var a=t.href.split("://");!o.port&&a[1]&&(o.port=a[1].split("/")[0].split("@").pop().split(":")[1]),o.port&&"0"!==o.port||(o.port="https"===a[0]?"443":"80"),o.hostname=t.hostname||r.hostname,o.pathname=t.pathname,o.protocol=a[0],"/"!==o.pathname.charAt(0)&&(o.pathname="/"+o.pathname);var s=!t.protocol||":"===t.protocol||t.protocol===r.protocol,c=t.hostname===r.hostname&&t.port===r.port;return o.sameOrigin=s&&(!t.hostname||c),"/"===o.pathname&&(i[e]=o),o}},50:(e,t,r)=>{function n(e,t){"function"==typeof console.warn&&(console.warn("New Relic: ".concat(e)),t&&console.warn(t))}r.d(t,{Z:()=>n})},2587:(e,t,r)=>{r.d(t,{N:()=>c,T:()=>u});var n=r(2177),i=r(5546),o=r(8e3),a=r(3325);const s={stn:[a.D.sessionTrace],err:[a.D.jserrors,a.D.metrics],ins:[a.D.pageAction],spa:[a.D.spa],sr:[a.D.sessionReplay,a.D.sessionTrace]};function c(e,t){const r=n.ee.get(t);e&&"object"==typeof e&&(Object.entries(e).forEach((e=>{let[t,n]=e;void 0===u[t]&&(s[t]?s[t].forEach((e=>{n?(0,i.p)("feat-"+t,[],void 0,e,r):(0,i.p)("block-"+t,[],void 0,e,r),(0,i.p)("rumresp-"+t,[Boolean(n)],void 0,e,r)})):n&&(0,i.p)("feat-"+t,[],void 0,void 0,r),u[t]=Boolean(n))})),Object.keys(s).forEach((e=>{void 0===u[e]&&(s[e]?.forEach((t=>(0,i.p)("rumresp-"+e,[!1],void 0,t,r))),u[e]=!1)})),(0,o.L)(t,a.D.pageViewEvent))}const u={}},2210:(e,t,r)=>{r.d(t,{X:()=>i});var n=Object.prototype.hasOwnProperty;function i(e,t,r){if(n.call(e,t))return e[t];var i=r();if(Object.defineProperty&&Object.keys)try{return Object.defineProperty(e,t,{value:i,writable:!0,enumerable:!1}),i}catch(e){}return e[t]=i,i}},1284:(e,t,r)=>{r.d(t,{D:()=>n});const n=(e,t)=>Object.entries(e||{}).map((e=>{let[r,n]=e;return t(r,n)}))},4351:(e,t,r)=>{r.d(t,{P:()=>o});var n=r(2177);const i=()=>{const e=new WeakSet;return(t,r)=>{if("object"==typeof r&&null!==r){if(e.has(r))return;e.add(r)}return r}};function o(e){try{return JSON.stringify(e,i())}catch(e){try{n.ee.emit("internal-error",[e])}catch(e){}}}},3960:(e,t,r)=>{r.d(t,{K:()=>a,b:()=>o});var n=r(3239);function i(){return"undefined"==typeof document||"complete"===document.readyState}function o(e,t){if(i())return e();(0,n.bP)("load",e,t)}function a(e){if(i())return e();(0,n.iz)("DOMContentLoaded",e)}},8632:(e,t,r)=>{r.d(t,{EZ:()=>u,Qy:()=>c,ce:()=>o,fP:()=>a,gG:()=>d,mF:()=>s});var n=r(7894),i=r(385);const o={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net"};function a(){return i._A.NREUM||(i._A.NREUM={}),void 0===i._A.newrelic&&(i._A.newrelic=i._A.NREUM),i._A.NREUM}function s(){let e=a();return e.o||(e.o={ST:i._A.setTimeout,SI:i._A.setImmediate,CT:i._A.clearTimeout,XHR:i._A.XMLHttpRequest,REQ:i._A.Request,EV:i._A.Event,PR:i._A.Promise,MO:i._A.MutationObserver,FETCH:i._A.fetch}),e}function c(e,t,r){let i=a();const o=i.initializedAgents||{},s=o[e]||{};return Object.keys(s).length||(s.initializedAt={ms:(0,n.z)(),date:new Date}),i.initializedAgents={...o,[e]:{...s,[r]:t}},i}function u(e,t){a()[e]=t}function d(){return function(){let e=a();const t=e.info||{};e.info={beacon:o.beacon,errorBeacon:o.errorBeacon,...t}}(),function(){let e=a();const t=e.init||{};e.init={...t}}(),s(),function(){let e=a();const t=e.loader_config||{};e.loader_config={...t}}(),a()}},7956:(e,t,r)=>{r.d(t,{N:()=>i});var n=r(3239);function i(e){let t=arguments.length>1&&void 0!==arguments[1]&&arguments[1],r=arguments.length>2?arguments[2]:void 0,i=arguments.length>3?arguments[3]:void 0;return void(0,n.iz)("visibilitychange",(function(){if(t)return void("hidden"==document.visibilityState&&e());e(document.visibilityState)}),r,i)}},1214:(e,t,r)=>{r.d(t,{em:()=>v,u5:()=>N,QU:()=>S,_L:()=>I,Gm:()=>L,Lg:()=>M,gy:()=>U,BV:()=>Q,Kf:()=>ee});var n=r(2177);const i="nr@original";var o=Object.prototype.hasOwnProperty,a=!1;function s(e,t){return e||(e=n.ee),r.inPlace=function(e,t,n,i,o){n||(n="");var a,s,c,u="-"===n.charAt(0);for(c=0;c 2?n-2:0),o=2;o {r(A[T],e,w),r(E[T],e,w)})),r(l._A,"fetch",y),t.on(y+"end",(function(e,r){var n=this;if(r){var i=r.headers.get("content-length");null!==i&&(n.rxSize=i),t.emit(y+"done",[null,r],n)}else t.emit(y+"done",[e],n)})),t}const O={},j=["pushState","replaceState"];function S(e){const t=function(e){return(e||n.ee).get("history")}(e);return!l.il||O[t.debugId]++||(O[t.debugId]=1,s(t).inPlace(window.history,j,"-")),t}var P=r(3239);const C={},R=["appendChild","insertBefore","replaceChild"];function I(e){const t=function(e){return(e||n.ee).get("jsonp")}(e);if(!l.il||C[t.debugId])return t;C[t.debugId]=!0;var r=s(t),i=/[?&](?:callback|cb)=([^&#]+)/,o=/(.*)\.([^.]+)/,a=/^(\w+)(\.|$)(.*)$/;function c(e,t){var r=e.match(a),n=r[1],i=r[3];return i?c(i,t[n]):t[n]}return r.inPlace(Node.prototype,R,"dom-"),t.on("dom-start",(function(e){!function(e){if(!e||"string"!=typeof e.nodeName||"script"!==e.nodeName.toLowerCase())return;if("function"!=typeof e.addEventListener)return;var n=(a=e.src,s=a.match(i),s?s[1]:null);var a,s;if(!n)return;var u=function(e){var t=e.match(o);if(t&&t.length>=3)return{key:t[2],parent:c(t[1],window)};return{key:e,parent:window}}(n);if("function"!=typeof u.parent[u.key])return;var d={};function f(){t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}function l(){t.emit("jsonp-error",[],d),t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}r.inPlace(u.parent,[u.key],"cb-",d),e.addEventListener("load",f,(0,P.m$)(!1)),e.addEventListener("error",l,(0,P.m$)(!1)),t.emit("new-jsonp",[e.src],d)}(e[0])})),t}var k=r(5763);const H={};function L(e){const t=function(e){return(e||n.ee).get("mutation")}(e);if(!l.il||H[t.debugId])return t;H[t.debugId]=!0;var r=s(t),i=k.Yu.MO;return i&&(window.MutationObserver=function(e){return this instanceof i?new i(r(e,"fn-")):i.apply(this,arguments)},MutationObserver.prototype=i.prototype),t}const z={};function M(e){const t=function(e){return(e||n.ee).get("promise")}(e);if(z[t.debugId])return t;z[t.debugId]=!0;var r=n.c,o=s(t),a=k.Yu.PR;return a&&function(){function e(r){var n=t.context(),i=o(r,"executor-",n,null,!1);const s=Reflect.construct(a,[i],e);return t.context(s).getCtx=function(){return n},s}l._A.Promise=e,Object.defineProperty(e,"name",{value:"Promise"}),e.toString=function(){return a.toString()},Object.setPrototypeOf(e,a),["all","race"].forEach((function(r){const n=a[r];e[r]=function(e){let i=!1;[...e||[]].forEach((e=>{this.resolve(e).then(a("all"===r),a(!1))}));const o=n.apply(this,arguments);return o;function a(e){return function(){t.emit("propagate",[null,!i],o,!1,!1),i=i||!e}}}})),["resolve","reject"].forEach((function(r){const n=a[r];e[r]=function(e){const r=n.apply(this,arguments);return e!==r&&t.emit("propagate",[e,!0],r,!1,!1),r}})),e.prototype=a.prototype;const n=a.prototype.then;a.prototype.then=function(){var e=this,i=r(e);i.promise=e;for(var a=arguments.length,s=new Array(a),c=0;c e())),t};function m(e,t){i.inPlace(t,["onreadystatechange"],"fn-",E)}function b(){var e=this,t=r.context(e);e.readyState>3&&!t.resolved&&(t.resolved=!0,r.emit("xhr-resolved",[],e)),i.inPlace(e,f,"fn-",E)}if(function(e,t){for(var r in e)t[r]=e[r]}(o,p),p.prototype=o.prototype,i.inPlace(p.prototype,J,"-xhr-",E),r.on("send-xhr-start",(function(e,t){m(e,t),function(e){h.push(e),a&&(y?y.then(A):u?u(A):(w=-w,x.data=w))}(t)})),r.on("open-xhr-start",m),a){var y=c&&c.resolve();if(!u&&!c){var w=1,x=document.createTextNode(w);new a(A).observe(x,{characterData:!0})}}else t.on("fn-end",(function(e){e[0]&&e[0].type===d||A()}));function A(){for(var e=0;e {r.d(t,{t:()=>n});const n=r(3325).D.ajax},6660:(e,t,r)=>{r.d(t,{A:()=>i,t:()=>n});const n=r(3325).D.jserrors,i="nr@seenError"},3081:(e,t,r)=>{r.d(t,{gF:()=>o,mY:()=>i,t9:()=>n,vz:()=>s,xS:()=>a});const n=r(3325).D.metrics,i="sm",o="cm",a="storeSupportabilityMetrics",s="storeEventMetrics"},4649:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageAction},7633:(e,t,r)=>{r.d(t,{Dz:()=>i,OJ:()=>a,qw:()=>o,t9:()=>n});const n=r(3325).D.pageViewEvent,i="firstbyte",o="domcontent",a="windowload"},9251:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageViewTiming},3614:(e,t,r)=>{r.d(t,{BST_RESOURCE:()=>i,END:()=>s,FEATURE_NAME:()=>n,FN_END:()=>u,FN_START:()=>c,PUSH_STATE:()=>d,RESOURCE:()=>o,START:()=>a});const n=r(3325).D.sessionTrace,i="bstResource",o="resource",a="-start",s="-end",c="fn"+a,u="fn"+s,d="pushState"},7836:(e,t,r)=>{r.d(t,{BODY:()=>A,CB_END:()=>E,CB_START:()=>u,END:()=>x,FEATURE_NAME:()=>i,FETCH:()=>_,FETCH_BODY:()=>v,FETCH_DONE:()=>m,FETCH_START:()=>p,FN_END:()=>c,FN_START:()=>s,INTERACTION:()=>l,INTERACTION_API:()=>d,INTERACTION_EVENTS:()=>o,JSONP_END:()=>b,JSONP_NODE:()=>g,JS_TIME:()=>T,MAX_TIMER_BUDGET:()=>a,REMAINING:()=>f,SPA_NODE:()=>h,START:()=>w,originalSetTimeout:()=>y});var n=r(5763);const i=r(3325).D.spa,o=["click","submit","keypress","keydown","keyup","change"],a=999,s="fn-start",c="fn-end",u="cb-start",d="api-ixn-",f="remaining",l="interaction",h="spaNode",g="jsonpNode",p="fetch-start",m="fetch-done",v="fetch-body-",b="jsonp-end",y=n.Yu.ST,w="-start",x="-end",A="-body",E="cb"+x,T="jsTime",_="fetch"},5938:(e,t,r)=>{r.d(t,{W:()=>o});var n=r(5763),i=r(2177);class o{constructor(e,t,r){this.agentIdentifier=e,this.aggregator=t,this.ee=i.ee.get(e,(0,n.OP)(this.agentIdentifier).isolatedBacklog),this.featureName=r,this.blocked=!1}}},9144:(e,t,r)=>{r.d(t,{j:()=>m});var n=r(3325),i=r(5763),o=r(5546),a=r(2177),s=r(7894),c=r(8e3),u=r(3960),d=r(385),f=r(50),l=r(3081),h=r(8632);function g(){const e=(0,h.gG)();["setErrorHandler","finished","addToTrace","inlineHit","addRelease","addPageAction","setCurrentRouteName","setPageViewName","setCustomAttribute","interaction","noticeError","setUserId"].forEach((t=>{e[t]=function(){for(var r=arguments.length,n=new Array(r),i=0;i 1?r-1:0),i=1;i {e.exposed&&e.api[t]&&o.push(e.api[t](...n))})),o.length>1?o:o[0]}(t,...n)}}))}var p=r(2587);function m(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:{},m=arguments.length>2?arguments[2]:void 0,v=arguments.length>3?arguments[3]:void 0,{init:b,info:y,loader_config:w,runtime:x={loaderType:m},exposed:A=!0}=t;const E=(0,h.gG)();y||(b=E.init,y=E.info,w=E.loader_config),(0,i.Dg)(e,b||{}),(0,i.GE)(e,w||{}),(0,i.sU)(e,x),y.jsAttributes??={},d.v6&&(y.jsAttributes.isWorker=!0),(0,i.CX)(e,y),g();const T=function(e,t){t||(0,c.R)(e,"api");const h={};var g=a.ee.get(e),p=g.get("tracer"),m="api-",v=m+"ixn-";function b(t,r,n,o){const a=(0,i.C5)(e);return null===r?delete a.jsAttributes[t]:(0,i.CX)(e,{...a,jsAttributes:{...a.jsAttributes,[t]:r}}),x(m,n,!0,o||null===r?"session":void 0)(t,r)}function y(){}["setErrorHandler","finished","addToTrace","inlineHit","addRelease"].forEach((e=>h[e]=x(m,e,!0,"api"))),h.addPageAction=x(m,"addPageAction",!0,n.D.pageAction),h.setCurrentRouteName=x(m,"routeName",!0,n.D.spa),h.setPageViewName=function(t,r){if("string"==typeof t)return"/"!==t.charAt(0)&&(t="/"+t),(0,i.OP)(e).customTransaction=(r||"http://custom.transaction")+t,x(m,"setPageViewName",!0)()},h.setCustomAttribute=function(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2];if("string"==typeof e){if(["string","number"].includes(typeof t)||null===t)return b(e,t,"setCustomAttribute",r);(0,f.Z)("Failed to execute setCustomAttribute.\nNon-null value must be a string or number type, but a type of was provided."))}else(0,f.Z)("Failed to execute setCustomAttribute.\nName must be a string type, but a type of was provided."))},h.setUserId=function(e){if("string"==typeof e||null===e)return b("enduser.id",e,"setUserId",!0);(0,f.Z)("Failed to execute setUserId.\nNon-null value must be a string type, but a type of was provided."))},h.interaction=function(){return(new y).get()};var w=y.prototype={createTracer:function(e,t){var r={},i=this,a="function"==typeof t;return(0,o.p)(v+"tracer",[(0,s.z)(),e,r],i,n.D.spa,g),function(){if(p.emit((a?"":"no-")+"fn-start",[(0,s.z)(),i,a],r),a)try{return t.apply(this,arguments)}catch(e){throw p.emit("fn-err",[arguments,this,"string"==typeof e?new Error(e):e],r),e}finally{p.emit("fn-end",[(0,s.z)()],r)}}}};function x(e,t,r,i){return function(){return(0,o.p)(l.xS,["API/"+t+"/called"],void 0,n.D.metrics,g),i&&(0,o.p)(e+t,[(0,s.z)(),...arguments],r?null:this,i,g),r?void 0:this}}function A(){r.e(439).then(r.bind(r,7438)).then((t=>{let{setAPI:r}=t;r(e),(0,c.L)(e,"api")})).catch((()=>(0,f.Z)("Downloading runtime APIs failed...")))}return["actionText","setName","setAttribute","save","ignore","onEnd","getContext","end","get"].forEach((e=>{w[e]=x(v,e,void 0,n.D.spa)})),h.noticeError=function(e,t){"string"==typeof e&&(e=new Error(e)),(0,o.p)(l.xS,["API/noticeError/called"],void 0,n.D.metrics,g),(0,o.p)("err",[e,(0,s.z)(),!1,t],void 0,n.D.jserrors,g)},d.il?(0,u.b)((()=>A()),!0):A(),h}(e,v);return(0,h.Qy)(e,T,"api"),(0,h.Qy)(e,A,"exposed"),(0,h.EZ)("activatedFeatures",p.T),T}},3325:(e,t,r)=>{r.d(t,{D:()=>n,p:()=>i});const n={ajax:"ajax",jserrors:"jserrors",metrics:"metrics",pageAction:"page_action",pageViewEvent:"page_view_event",pageViewTiming:"page_view_timing",sessionReplay:"session_replay",sessionTrace:"session_trace",spa:"spa"},i={[n.pageViewEvent]:1,[n.pageViewTiming]:2,[n.metrics]:3,[n.jserrors]:4,[n.ajax]:5,[n.sessionTrace]:6,[n.pageAction]:7,[n.spa]:8,[n.sessionReplay]:9}}},n={};function i(e){var t=n[e];if(void 0!==t)return t.exports;var o=n[e]={exports:{}};return r[e](o,o.exports,i),o.exports}i.m=r,i.d=(e,t)=>{for(var r in t)i.o(t,r)&&!i.o(e,r)&&Object.defineProperty(e,r,{enumerable:!0,get:t[r]})},i.f={},i.e=e=>Promise.all(Object.keys(i.f).reduce(((t,r)=>(i.f[r](e,t),t)),[])),i.u=e=>(({78:"page_action-aggregate",147:"metrics-aggregate",242:"session-manager",317:"jserrors-aggregate",348:"page_view_timing-aggregate",412:"lazy-feature-loader",439:"async-api",538:"recorder",590:"session_replay-aggregate",675:"compressor",733:"session_trace-aggregate",786:"page_view_event-aggregate",873:"spa-aggregate",898:"ajax-aggregate"}[e]||e)+"."+{78:"ac76d497",147:"3dc53903",148:"1a20d5fe",242:"2a64278a",317:"49e41428",348:"bd6de33a",412:"2f55ce66",439:"30bd804e",538:"1b18459f",590:"cf0efb30",675:"ae9f91a8",733:"83105561",786:"06482edd",860:"03a8b7a5",873:"e6b09d52",898:"998ef92b"}[e]+"-1.236.0.min.js"),i.o=(e,t)=>Object.prototype.hasOwnProperty.call(e,t),e={},t="NRBA:",i.l=(r,n,o,a)=>{if(e[r])e[r].push(n);else{var s,c;if(void 0!==o)for(var u=document.getElementsByTagName("script"),d=0;d {s.onerror=s.onload=null,clearTimeout(h);var i=e[r];if(delete e[r],s.parentNode&&s.parentNode.removeChild(s),i&&i.forEach((e=>e(n))),t)return t(n)},h=setTimeout(l.bind(null,void 0,{type:"timeout",target:s}),12e4);s.onerror=l.bind(null,s.onerror),s.onload=l.bind(null,s.onload),c&&document.head.appendChild(s)}},i.r=e=>{"undefined"!=typeof Symbol&&Symbol.toStringTag&&Object.defineProperty(e,Symbol.toStringTag,{value:"Module"}),Object.defineProperty(e,"__esModule",{value:!0})},i.j=364,i.p="https://js-agent.newrelic.com/",(()=>{var e={364:0,953:0};i.f.j=(t,r)=>{var n=i.o(e,t)?e[t]:void 0;if(0!==n)if(n)r.push(n[2]);else{var o=new Promise(((r,i)=>n=e[t]=[r,i]));r.push(n[2]=o);var a=i.p+i.u(t),s=new Error;i.l(a,(r=>{if(i.o(e,t)&&(0!==(n=e[t])&&(e[t]=void 0),n)){var o=r&&("load"===r.type?"missing":r.type),a=r&&r.target&&r.target.src;s.message="Loading chunk "+t+" failed.\n("+o+": "+a+")",s.name="ChunkLoadError",s.type=o,s.request=a,n[1](s)}}),"chunk-"+t,t)}};var t=(t,r)=>{var n,o,[a,s,c]=r,u=0;if(a.some((t=>0!==e[t]))){for(n in s)i.o(s,n)&&(i.m[n]=s[n]);if(c)c(i)}for(t&&t(r);u {i.r(o);var e=i(3325),t=i(5763);const r=Object.values(e.D);function n(e){const n={};return r.forEach((r=>{n[r]=function(e,r){return!1!==(0,t.Mt)(r,"".concat(e,".enabled"))}(r,e)})),n}var a=i(9144);var s=i(5546),c=i(385),u=i(8e3),d=i(5938),f=i(3960),l=i(50);class h extends d.W{constructor(e,t,r){let n=!(arguments.length>3&&void 0!==arguments[3])||arguments[3];super(e,t,r),this.auto=n,this.abortHandler,this.featAggregate,this.onAggregateImported,n&&(0,u.R)(e,r)}importAggregator(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:{};if(this.featAggregate||!this.auto)return;const r=c.il&&!0===(0,t.Mt)(this.agentIdentifier,"privacy.cookies_enabled");let n;this.onAggregateImported=new Promise((e=>{n=e}));const o=async()=>{let t;try{if(r){const{setupAgentSession:e}=await Promise.all([i.e(860),i.e(242)]).then(i.bind(i,3228));t=e(this.agentIdentifier)}}catch(e){(0,l.Z)("A problem occurred when starting up session manager. This page will not start or extend any session.",e)}try{if(!this.shouldImportAgg(this.featureName,t))return void(0,u.L)(this.agentIdentifier,this.featureName);const{lazyFeatureLoader:r}=await i.e(412).then(i.bind(i,8582)),{Aggregate:o}=await r(this.featureName,"aggregate");this.featAggregate=new o(this.agentIdentifier,this.aggregator,e),n(!0)}catch(e){(0,l.Z)("Downloading and initializing ".concat(this.featureName," failed..."),e),this.abortHandler?.(),n(!1)}};c.il?(0,f.b)((()=>o()),!0):o()}shouldImportAgg(r,n){return r!==e.D.sessionReplay||!1!==(0,t.Mt)(this.agentIdentifier,"session_trace.enabled")&&(!!n?.isNew||!!n?.state.sessionReplay)}}var g=i(7633),p=i(7894);class m extends h{static featureName=g.t9;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];if(super(r,n,g.t9,i),("undefined"==typeof PerformanceNavigationTiming||c.Tt)&&"undefined"!=typeof PerformanceTiming){const n=(0,t.OP)(r);n[g.Dz]=Math.max(Date.now()-n.offset,0),(0,f.K)((()=>n[g.qw]=Math.max((0,p.z)()-n[g.Dz],0))),(0,f.b)((()=>{const t=(0,p.z)();n[g.OJ]=Math.max(t-n[g.Dz],0),(0,s.p)("timing",["load",t],void 0,e.D.pageViewTiming,this.ee)}))}this.importAggregator()}}var v=i(1117),b=i(1284);class y extends v.w{constructor(e){super(e),this.aggregatedData={}}store(e,t,r,n,i){var o=this.getBucket(e,t,r,i);return o.metrics=function(e,t){t||(t={count:0});return t.count+=1,(0,b.D)(e,(function(e,r){t[e]=w(r,t[e])})),t}(n,o.metrics),o}merge(e,t,r,n,i){var o=this.getBucket(e,t,n,i);if(o.metrics){var a=o.metrics;a.count+=r.count,(0,b.D)(r,(function(e,t){if("count"!==e){var n=a[e],i=r[e];i&&!i.c?a[e]=w(i.t,n):a[e]=function(e,t){if(!t)return e;t.c||(t=x(t.t));return t.min=Math.min(e.min,t.min),t.max=Math.max(e.max,t.max),t.t+=e.t,t.sos+=e.sos,t.c+=e.c,t}(i,a[e])}}))}else o.metrics=r}storeMetric(e,t,r,n){var i=this.getBucket(e,t,r);return i.stats=w(n,i.stats),i}getBucket(e,t,r,n){this.aggregatedData[e]||(this.aggregatedData[e]={});var i=this.aggregatedData[e][t];return i||(i=this.aggregatedData[e][t]={params:r||{}},n&&(i.custom=n)),i}get(e,t){return t?this.aggregatedData[e]&&this.aggregatedData[e][t]:this.aggregatedData[e]}take(e){for(var t={},r="",n=!1,i=0;i t.max&&(t.max=e),e 2&&void 0!==arguments[2])||arguments[2];super(e,r,j.t,n),c.il&&((0,t.OP)(e).initHidden=Boolean("hidden"===document.visibilityState),(0,N.N)((()=>(0,s.p)("docHidden",[(0,p.z)()],void 0,j.t,this.ee)),!0),(0,O.bP)("pagehide",(()=>(0,s.p)("winPagehide",[(0,p.z)()],void 0,j.t,this.ee))),this.importAggregator())}}var P=i(3081);class C extends h{static featureName=P.t9;constructor(e,t){let r=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(e,t,P.t9,r),this.importAggregator()}}var R,I=i(2210),k=i(1214),H=i(2177),L={};try{R=localStorage.getItem("__nr_flags").split(","),console&&"function"==typeof console.log&&(L.console=!0,-1!==R.indexOf("dev")&&(L.dev=!0),-1!==R.indexOf("nr_dev")&&(L.nrDev=!0))}catch(e){}function z(e){try{L.console&&z(e)}catch(e){}}L.nrDev&&H.ee.on("internal-error",(function(e){z(e.stack)})),L.dev&&H.ee.on("fn-err",(function(e,t,r){z(r.stack)})),L.dev&&(z("NR AGENT IN DEVELOPMENT MODE"),z("flags: "+(0,b.D)(L,(function(e,t){return e})).join(", ")));var M=i(6660);class B extends h{static featureName=M.t;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(r,n,M.t,i),this.skipNext=0;try{this.removeOnAbort=new AbortController}catch(e){}const o=this;o.ee.on("fn-start",(function(e,t,r){o.abortHandler&&(o.skipNext+=1)})),o.ee.on("fn-err",(function(t,r,n){o.abortHandler&&!n[M.A]&&((0,I.X)(n,M.A,(function(){return!0})),this.thrown=!0,(0,s.p)("err",[n,(0,p.z)()],void 0,e.D.jserrors,o.ee))})),o.ee.on("fn-end",(function(){o.abortHandler&&!this.thrown&&o.skipNext>0&&(o.skipNext-=1)})),o.ee.on("internal-error",(function(t){(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,o.ee)})),this.origOnerror=c._A.onerror,c._A.onerror=this.onerrorHandler.bind(this),c._A.addEventListener("unhandledrejection",(t=>{const r=function(e){let t="Unhandled Promise Rejection: ";if(e instanceof Error)try{return e.message=t+e.message,e}catch(t){return e}if(void 0===e)return new Error(t);try{return new Error(t+(0,D.P)(e))}catch(e){return new Error(t)}}(t.reason);(0,s.p)("err",[r,(0,p.z)(),!1,{unhandledPromiseRejection:1}],void 0,e.D.jserrors,this.ee)}),(0,O.m$)(!1,this.removeOnAbort?.signal)),(0,k.gy)(this.ee),(0,k.BV)(this.ee),(0,k.em)(this.ee),(0,t.OP)(r).xhrWrappable&&(0,k.Kf)(this.ee),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}onerrorHandler(t,r,n,i,o){"function"==typeof this.origOnerror&&this.origOnerror(...arguments);try{this.skipNext?this.skipNext-=1:(0,s.p)("err",[o||new F(t,r,n),(0,p.z)()],void 0,e.D.jserrors,this.ee)}catch(t){try{(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,this.ee)}catch(e){}}return!1}}function F(e,t,r){this.message=e||"Uncaught error with no additional information",this.sourceURL=t,this.line=r}let U=1;const q="nr@id";function G(e){const t=typeof e;return!e||"object"!==t&&"function"!==t?-1:e===c._A?0:(0,I.X)(e,q,(function(){return U++}))}function V(e){if("string"==typeof e&&e.length)return e.length;if("object"==typeof e){if("undefined"!=typeof ArrayBuffer&&e instanceof ArrayBuffer&&e.byteLength)return e.byteLength;if("undefined"!=typeof Blob&&e instanceof Blob&&e.size)return e.size;if(!("undefined"!=typeof FormData&&e instanceof FormData))try{return(0,D.P)(e).length}catch(e){return}}}var X=i(7243);class W{constructor(e){this.agentIdentifier=e,this.generateTracePayload=this.generateTracePayload.bind(this),this.shouldGenerateTrace=this.shouldGenerateTrace.bind(this)}generateTracePayload(e){if(!this.shouldGenerateTrace(e))return null;var r=(0,t.DL)(this.agentIdentifier);if(!r)return null;var n=(r.accountID||"").toString()||null,i=(r.agentID||"").toString()||null,o=(r.trustKey||"").toString()||null;if(!n||!i)return null;var a=(0,_.M)(),s=(0,_.Ht)(),c=Date.now(),u={spanId:a,traceId:s,timestamp:c};return(e.sameOrigin||this.isAllowedOrigin(e)&&this.useTraceContextHeadersForCors())&&(u.traceContextParentHeader=this.generateTraceContextParentHeader(a,s),u.traceContextStateHeader=this.generateTraceContextStateHeader(a,c,n,i,o)),(e.sameOrigin&&!this.excludeNewrelicHeader()||!e.sameOrigin&&this.isAllowedOrigin(e)&&this.useNewrelicHeaderForCors())&&(u.newrelicHeader=this.generateTraceHeader(a,s,c,n,i,o)),u}generateTraceContextParentHeader(e,t){return"00-"+t+"-"+e+"-01"}generateTraceContextStateHeader(e,t,r,n,i){return i+"@nr=0-1-"+r+"-"+n+"-"+e+"----"+t}generateTraceHeader(e,t,r,n,i,o){if(!("function"==typeof c._A?.btoa))return null;var a={v:[0,1],d:{ty:"Browser",ac:n,ap:i,id:e,tr:t,ti:r}};return o&&n!==o&&(a.d.tk=o),btoa((0,D.P)(a))}shouldGenerateTrace(e){return this.isDtEnabled()&&this.isAllowedOrigin(e)}isAllowedOrigin(e){var r=!1,n={};if((0,t.Mt)(this.agentIdentifier,"distributed_tracing")&&(n=(0,t.P_)(this.agentIdentifier).distributed_tracing),e.sameOrigin)r=!0;else if(n.allowed_origins instanceof Array)for(var i=0;i 2&&void 0!==arguments[2])||arguments[2];super(r,n,Z.t,i),(0,t.OP)(r).xhrWrappable&&(this.dt=new W(r),this.handler=(e,t,r,n)=>(0,s.p)(e,t,r,n,this.ee),(0,k.u5)(this.ee),(0,k.Kf)(this.ee),function(r,n,i,o){function a(e){var t=this;t.totalCbs=0,t.called=0,t.cbTime=0,t.end=E,t.ended=!1,t.xhrGuids={},t.lastSize=null,t.loadCaptureCalled=!1,t.params=this.params||{},t.metrics=this.metrics||{},e.addEventListener("load",(function(r){_(t,e)}),(0,O.m$)(!1)),c.IF||e.addEventListener("progress",(function(e){t.lastSize=e.loaded}),(0,O.m$)(!1))}function s(e){this.params={method:e[0]},T(this,e[1]),this.metrics={}}function u(e,n){var i=(0,t.DL)(r);i.xpid&&this.sameOrigin&&n.setRequestHeader("X-NewRelic-ID",i.xpid);var a=o.generateTracePayload(this.parsedOrigin);if(a){var s=!1;a.newrelicHeader&&(n.setRequestHeader("newrelic",a.newrelicHeader),s=!0),a.traceContextParentHeader&&(n.setRequestHeader("traceparent",a.traceContextParentHeader),a.traceContextStateHeader&&n.setRequestHeader("tracestate",a.traceContextStateHeader),s=!0),s&&(this.dt=a)}}function d(e,t){var r=this.metrics,i=e[0],o=this;if(r&&i){var a=V(i);a&&(r.txSize=a)}this.startTime=(0,p.z)(),this.listener=function(e){try{"abort"!==e.type||o.loadCaptureCalled||(o.params.aborted=!0),("load"!==e.type||o.called===o.totalCbs&&(o.onloadCalled||"function"!=typeof t.onload)&&"function"==typeof o.end)&&o.end(t)}catch(e){try{n.emit("internal-error",[e])}catch(e){}}};for(var s=0;s 1?e[1]=i:e.push(i)}else e[0]&&e[0].headers&&s(e[0].headers,n)&&(this.dt=n);function s(e,t){var r=!1;return t.newrelicHeader&&(e.set("newrelic",t.newrelicHeader),r=!0),t.traceContextParentHeader&&(e.set("traceparent",t.traceContextParentHeader),t.traceContextStateHeader&&e.set("tracestate",t.traceContextStateHeader),r=!0),r}}function x(e,t){this.params={},this.metrics={},this.startTime=(0,p.z)(),this.dt=t,e.length>=1&&(this.target=e[0]),e.length>=2&&(this.opts=e[1]);var r,n=this.opts||{},i=this.target;"string"==typeof i?r=i:"object"==typeof i&&i instanceof Y?r=i.url:c._A?.URL&&"object"==typeof i&&i instanceof URL&&(r=i.href),T(this,r);var o=(""+(i&&i instanceof Y&&i.method||n.method||"GET")).toUpperCase();this.params.method=o,this.txSize=V(n.body)||0}function A(t,r){var n;this.endTime=(0,p.z)(),this.params||(this.params={}),this.params.status=r?r.status:0,"string"==typeof this.rxSize&&this.rxSize.length>0&&(n=+this.rxSize);var o={txSize:this.txSize,rxSize:n,duration:(0,p.z)()-this.startTime};i("xhr",[this.params,o,this.startTime,this.endTime,"fetch"],this,e.D.ajax)}function E(t){var r=this.params,n=this.metrics;if(!this.ended){this.ended=!0;for(var o=0;o 2&&void 0!==arguments[2])||arguments[2];super(e,t,we.t,r),this.importAggregator()}}new class{constructor(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:(0,_.ky)(16);c._A?(this.agentIdentifier=t,this.sharedAggregator=new y({agentIdentifier:this.agentIdentifier}),this.features={},this.desiredFeatures=new Set(e.features||[]),this.desiredFeatures.add(m),Object.assign(this,(0,a.j)(this.agentIdentifier,e,e.loaderType||"agent")),this.start()):(0,l.Z)("Failed to initial the agent. Could not determine the runtime environment.")}get config(){return{info:(0,t.C5)(this.agentIdentifier),init:(0,t.P_)(this.agentIdentifier),loader_config:(0,t.DL)(this.agentIdentifier),runtime:(0,t.OP)(this.agentIdentifier)}}start(){const t="features";try{const r=n(this.agentIdentifier),i=[...this.desiredFeatures];i.sort(((t,r)=>e.p[t.featureName]-e.p[r.featureName])),i.forEach((t=>{if(r[t.featureName]||t.featureName===e.D.pageViewEvent){const n=function(t){switch(t){case e.D.ajax:return[e.D.jserrors];case e.D.sessionTrace:return[e.D.ajax,e.D.pageViewEvent];case e.D.sessionReplay:return[e.D.sessionTrace];case e.D.pageViewTiming:return[e.D.pageViewEvent];default:return[]}}(t.featureName);n.every((e=>r[e]))||(0,l.Z)("".concat(t.featureName," is enabled but one or more dependent features has been disabled (").concat((0,D.P)(n),"). This may cause unintended consequences or missing data...")),this.features[t.featureName]=new t(this.agentIdentifier,this.sharedAggregator)}})),(0,T.Qy)(this.agentIdentifier,this.features,t)}catch(e){(0,l.Z)("Failed to initialize all enabled instrument classes (agent aborted) -",e);for(const e in this.features)this.features[e].abortHandler?.();const r=(0,T.fP)();return delete r.initializedAgents[this.agentIdentifier]?.api,delete r.initializedAgents[this.agentIdentifier]?.[t],delete this.sharedAggregator,r.ee?.abort(),delete r.ee?.get(this.agentIdentifier),!1}}}({features:[J,m,S,class extends h{static featureName=oe;constructor(t,r){if(super(t,r,oe,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;const n=this.ee;let i;(0,k.QU)(n),this.eventsEE=(0,k.em)(n),this.eventsEE.on(se,(function(e,t){this.bstStart=(0,p.z)()})),this.eventsEE.on(ae,(function(t,r){(0,s.p)("bst",[t[0],r,this.bstStart,(0,p.z)()],void 0,e.D.sessionTrace,n)})),n.on(ce+ne,(function(e){this.time=(0,p.z)(),this.startPath=location.pathname+location.hash})),n.on(ce+ie,(function(t){(0,s.p)("bstHist",[location.pathname+location.hash,this.startPath,this.time],void 0,e.D.sessionTrace,n)}));try{i=new PerformanceObserver((t=>{const r=t.getEntries();(0,s.p)(te,[r],void 0,e.D.sessionTrace,n)})),i.observe({type:re,buffered:!0})}catch(e){}this.importAggregator({resourceObserver:i})}},C,xe,B,class extends h{static featureName=de;constructor(e,r){if(super(e,r,de,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;if(!(0,t.OP)(e).xhrWrappable)return;try{this.removeOnAbort=new AbortController}catch(e){}let n,i=0;const o=this.ee.get("tracer"),a=(0,k._L)(this.ee),s=(0,k.Lg)(this.ee),u=(0,k.BV)(this.ee),d=(0,k.Kf)(this.ee),f=this.ee.get("events"),l=(0,k.u5)(this.ee),h=(0,k.QU)(this.ee),g=(0,k.Gm)(this.ee);function m(e,t){h.emit("newURL",[""+window.location,t])}function v(){i++,n=window.location.hash,this[ve]=(0,p.z)()}function b(){i--,window.location.hash!==n&&m(0,!0);var e=(0,p.z)();this[pe]=~~this[pe]+e-this[ve],this[ye]=e}function y(e,t){e.on(t,(function(){this[t]=(0,p.z)()}))}this.ee.on(ve,v),s.on(be,v),a.on(be,v),this.ee.on(ye,b),s.on(ge,b),a.on(ge,b),this.ee.buffer([ve,ye,"xhr-resolved"],this.featureName),f.buffer([ve],this.featureName),u.buffer(["setTimeout"+le,"clearTimeout"+fe,ve],this.featureName),d.buffer([ve,"new-xhr","send-xhr"+fe],this.featureName),l.buffer([me+fe,me+"-done",me+he+fe,me+he+le],this.featureName),h.buffer(["newURL"],this.featureName),g.buffer([ve],this.featureName),s.buffer(["propagate",be,ge,"executor-err","resolve"+fe],this.featureName),o.buffer([ve,"no-"+ve],this.featureName),a.buffer(["new-jsonp","cb-start","jsonp-error","jsonp-end"],this.featureName),y(l,me+fe),y(l,me+"-done"),y(a,"new-jsonp"),y(a,"jsonp-end"),y(a,"cb-start"),h.on("pushState-end",m),h.on("replaceState-end",m),window.addEventListener("hashchange",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("load",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("popstate",(function(){m(0,i>1)}),(0,O.m$)(!0,this.removeOnAbort?.signal)),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}}],loaderType:"spa"})})(),window.NRBA=o})(); window.jQuery || document.write(' ') CKEDITOR_BASEPATH='https://f1000research.com/js/vendor/ckeditor/' window.reactTheme = 'research'; window.MathJax = { CommonHTML: { linebreaks: { automatic: true } }, 'HTML-CSS': { linebreaks: { automatic: true } }, SVG: { linebreaks: { automatic: true } }, AuthorInit: function() { MathJax.Hub.Register.MessageHook('End Process', function () { let timeout = false; // holder for timeout id const delay = 250; // delay after event is "complete" to run callback const reflowMath = function() { const dispFormulas = document.querySelectorAll('.disp-formula.panel'); if (!dispFormulas) { return; } for (const dispFormula of dispFormulas) { const child = dispFormula.querySelector('.MathJax_Preview').nextSibling.firstChild; const isMultiline = MathJax.Hub.getAllJax(dispFormula)[0].root.isMultiline; if (dispFormula.offsetWidth < child.offsetWidth || isMultiline) { MathJax.Hub.Queue(['Rerender', MathJax.Hub, dispFormula]); } } }; window.addEventListener('resize', function() { clearTimeout(timeout); // clear the timeout timeout = setTimeout(reflowMath, delay); // start timing for event "completion" }); }); }, }; if (window.location.hash == '#_=_'){ window.location = window.location.href.split('#')[0] } !function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function() {n.callMethod? n.callMethod.apply(n,arguments):n.queue.push(arguments)} ;if(!f._fbq)f._fbq=n; n.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0; t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window, document,'script','https://connect.facebook.net/en_US/fbevents.js'); fbq('init', '1641728616063202'); fbq('track', "PixelInitialized", {}); (function(h,o,t,j,a,r){ h.hj=h.hj||function(){(h.hj.q=h.hj.q||[]).push(arguments)}; h._hjSettings={hjid:2318163,hjsv:6}; a=o.getElementsByTagName('head')[0]; r=o.createElement('script');r.async=1; r.src=t+h._hjSettings.hjid+j+h._hjSettings.hjsv; a.appendChild(r); })(window,document,'https://static.hotjar.com/c/hotjar-','.js?sv='); search file_upload Submit your research search menu close search Browse Gateways & Collections How to Publish Submit your Research My Submissions Article Guidelines Article Guidelines (New Versions) Open Data, Software and Code Guidelines Open Data and Accessible Source Materials Guidelines (HSS) Open Data, Software and Code Guidelines (PSE) Prepublication Checks Production Process Posters and Slides Guidelines Document Guidelines Article Processing Charges Peer Review Finding Article Reviewers About How it Works For Reviewers Our Advisors Policies Glossary FAQs For Developers Newsroom Contact My Research Submissions Content and Tracking Alerts My Details Sign In file_upload Submit your research { "@context": "https://schema.org", "@type": "ScholarlyArticle", "mainEntityOfPage": { "@type": "WebPage", "@id": "https://f1000research.com/articles/15-731" }, "headline": "Cardiometabolic Risk Factors Associated with Benign Prostatic Hyperplasia Among Men Attending a Tertiary...", "datePublished": "2026-05-14T12:26:40", "dateModified": "2026-05-14T12:26:40", "author": [ { "@type": "Person", "name": "TAMEGNON Dévi Mariette" }, { "@type": "Person", "name": "Oiku Marcellus Omofuma" }, { "@type": "Person", "name": "Manognya Gaddam" }, { "@type": "Person", "name": "Rimzim Sanjay Bajoria" }, { "@type": "Person", "name": "Frankline Chidiebere Onuwa" }, { "@type": "Person", "name": "Nonso Francis Ifezuoke" }, { "@type": "Person", "name": "Nidhi Parag Pardeshi" }, { "@type": "Person", "name": "Mohamed Kamal Said" }, { "@type": "Person", "name": "Ayomide Olanrewaju Osanupin" }, { "@type": "Person", "name": "Simarjot Kaur" }, { "@type": "Person", "name": "Nnabuike Kevin Odo" }, { "@type": "Person", "name": "Mandora Vidhut Savaram" }, { "@type": "Person", "name": "Chijioke Chizoba Egwu" }, { "@type": "Person", "name": "Nwachukwu Chinenye Benita" }, { "@type": "Person", "name": "Swase Dominic Terkimbi" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Benign prostatic hyperplasia (BPH) is a common age-related urological condition associated with lower urinary tract symptoms and increasing healthcare burden. The study aims to determine association between selected cardiometabolic factors and benign prostatic hyperplasia among men attending a tertiary health centre in Enugu State, Nigeria. Methods A hospital-based unmatched case–control study was conducted among adult men attending the University of Nigeria Teaching Hospital, Enugu State, Nigeria (July–September 2025). Men with symptomatic BPH (IPSS ≥8) were compared with controls without significant urinary symptoms. Data were analyzed using SPSS version 27, multivariate logistic regression analyses were performed to identify independent determinants of BPH at p < 0.05. Results Three hundred participants were enrolled (150 cases and 150 controls). BPH cases were older than controls (65 ± 8 vs. 60 ± 7 years). Elderly age independently increased the odds of BPH nearly fivefold (AOR = 4.94; 95% CI: 2.31–10.55; p < 0.001). Diabetes mellitus showed a strong independent association with BPH, conferring approximately twentyfold higher odds of disease (AOR = 19.51; 95% CI: 2.24–170.12; p = 0.007). Near-optimal LDL cholesterol was also independently associated with BPH (AOR = 4.42; 95% CI: 1.82–10.78; p = 0.001). In contrast, obesity, hypertension, educational level, residential location, and income were not independently associated with BPH after multivariate adjustment. Conclusion Cardiometabolic influences on benign prostatic hyperplasia in this population appear to be primarily related to aging and metabolic dysfunction linked to diabetes. These findings highlight the importance of integrating metabolic assessment, particularly diabetes screening and glycaemic control, into routine BPH evaluation and management. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/15-731/v1", "name": "Cardiometabolic Risk Factors Associated with Benign Prostatic Hyperplasia..." } } ] } Home Browse Cardiometabolic Risk Factors Associated with Benign Prostatic Hyperplasia... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Mariette TD, Omofuma OM, Gaddam M et al. Cardiometabolic Risk Factors Associated with Benign Prostatic Hyperplasia Among Men Attending a Tertiary Health Centre in Enugu State, Nigeria: A Case–Control Study [version 1; peer review: awaiting peer review] . F1000Research 2026, 15 :731 ( https://doi.org/10.12688/f1000research.179573.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Cardiometabolic Risk Factors Associated with Benign Prostatic Hyperplasia Among Men Attending a Tertiary Health Centre in Enugu State, Nigeria: A Case–Control Study [version 1; peer review: awaiting peer review] TAMEGNON Dévi Mariette https://orcid.org/0009-0006-0688-0055 1 , Oiku Marcellus Omofuma 2 , Manognya Gaddam https://orcid.org/0009-0004-1172-3519 3 , [...] Rimzim Sanjay Bajoria 4 , Frankline Chidiebere Onuwa 5 , Nonso Francis Ifezuoke https://orcid.org/0009-0009-6779-6430 6 , Nidhi Parag Pardeshi 7 , Mohamed Kamal Said https://orcid.org/0009-0000-8974-0838 8 , Ayomide Olanrewaju Osanupin 9 , Simarjot Kaur 10 , Nnabuike Kevin Odo https://orcid.org/0009-0004-1807-1955 11 , Mandora Vidhut Savaram https://orcid.org/0009-0003-1251-5634 12 , Chijioke Chizoba Egwu 13 , Nwachukwu Chinenye Benita 14 , Swase Dominic Terkimbi https://orcid.org/0000-0002-4205-1880 15 TAMEGNON Dévi Mariette https://orcid.org/0009-0006-0688-0055 1 , Oiku Marcellus Omofuma 2 , [...] Manognya Gaddam https://orcid.org/0009-0004-1172-3519 3 , Rimzim Sanjay Bajoria 4 , Frankline Chidiebere Onuwa 5 , Nonso Francis Ifezuoke https://orcid.org/0009-0009-6779-6430 6 , Nidhi Parag Pardeshi 7 , Mohamed Kamal Said https://orcid.org/0009-0000-8974-0838 8 , Ayomide Olanrewaju Osanupin 9 , Simarjot Kaur 10 , Nnabuike Kevin Odo https://orcid.org/0009-0004-1807-1955 11 , Mandora Vidhut Savaram https://orcid.org/0009-0003-1251-5634 12 , Chijioke Chizoba Egwu 13 , Nwachukwu Chinenye Benita 14 , Swase Dominic Terkimbi https://orcid.org/0000-0002-4205-1880 15 PUBLISHED 14 May 2026 Author details Author details 1 Services des Urgences, Centre Hospitalier de Kourou, Guyane,, Guyane,, France 2 Department of Internal Medicine, Mamata Academy of Medical Sciences, Hyderabad, Hyderabad, India 3 Department of Internal Medicine, St. Martinus University, Dombivali, Dombivali, India 4 Department of Internal Medicine, St. Raphael Divine Mercy Specialist Hospital, Lagos, Lagos, Nigeria 5 Department of General Medicine, Walsall Manor Hospital, Walsall, Walsall,, USA 6 Department of Internal Medicine, St. Martinus University, Thane, Thane, India 7 Department of Critical Care, Faculty of Medicine,, Mansoura University, Mansoura, Mansoura, Egypt 8 Department of Internal Medicine, Kursk State Medical University, Kursk, Kursk, Russian Federation 9 Nanjing Medical, Nanjing Medical University, Nanjing, Nanjing, China 10 Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Federal Capital Territory, Nigeria 11 Faculty of Medicine, St. Martinus University, Curaçao,, India 12 Department of Medicine and Surgery, Chukwuemeka Odumegwu Ojukwu University, Anambra, Anambra, Nigeria 13 Department of Internal Medicine, Salcare Home Health Services,, California, USA 14 Family Medicine, Enugu University Teaching Hospital, Enugu, Enugu, Nigeria 15 Department of Pharmacy, Faculty of Health Sciences, Victoria University, Kampala,, Kampala,, Uganda TAMEGNON Dévi Mariette Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Oiku Marcellus Omofuma Roles: Conceptualization, Formal Analysis, Funding Acquisition, Methodology, Project Administration, Software, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Manognya Gaddam Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Rimzim Sanjay Bajoria Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Frankline Chidiebere Onuwa Roles: Conceptualization, Data Curation, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Nonso Francis Ifezuoke Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Nidhi Parag Pardeshi Roles: Conceptualization, Data Curation, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Mohamed Kamal Said Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Ayomide Olanrewaju Osanupin Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Simarjot Kaur Roles: Conceptualization, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Nnabuike Kevin Odo Roles: Conceptualization, Funding Acquisition, Investigation, Methodology, Project Administration, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Mandora Vidhut Savaram Roles: Conceptualization, Funding Acquisition, Investigation, Methodology, Project Administration, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Chijioke Chizoba Egwu Roles: Conceptualization, Data Curation, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Nwachukwu Chinenye Benita Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Swase Dominic Terkimbi Roles: Conceptualization, Investigation, Methodology, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW This article is included in the Global Public Health gateway. Abstract Background Benign prostatic hyperplasia (BPH) is a common age-related urological condition associated with lower urinary tract symptoms and increasing healthcare burden. The study aims to determine association between selected cardiometabolic factors and benign prostatic hyperplasia among men attending a tertiary health centre in Enugu State, Nigeria. Methods A hospital-based unmatched case–control study was conducted among adult men attending the University of Nigeria Teaching Hospital, Enugu State, Nigeria (July–September 2025). Men with symptomatic BPH (IPSS ≥8) were compared with controls without significant urinary symptoms. Data were analyzed using SPSS version 27, multivariate logistic regression analyses were performed to identify independent determinants of BPH at p < 0.05. Results Three hundred participants were enrolled (150 cases and 150 controls). BPH cases were older than controls (65 ± 8 vs. 60 ± 7 years). Elderly age independently increased the odds of BPH nearly fivefold (AOR = 4.94; 95% CI: 2.31–10.55; p < 0.001). Diabetes mellitus showed a strong independent association with BPH, conferring approximately twentyfold higher odds of disease (AOR = 19.51; 95% CI: 2.24–170.12; p = 0.007). Near-optimal LDL cholesterol was also independently associated with BPH (AOR = 4.42; 95% CI: 1.82–10.78; p = 0.001). In contrast, obesity, hypertension, educational level, residential location, and income were not independently associated with BPH after multivariate adjustment. Conclusion Cardiometabolic influences on benign prostatic hyperplasia in this population appear to be primarily related to aging and metabolic dysfunction linked to diabetes. These findings highlight the importance of integrating metabolic assessment, particularly diabetes screening and glycaemic control, into routine BPH evaluation and management. READ ALL READ LESS Keywords Benign prostatic hyperplasia; cardiometabolic risk factors; diabetes mellitus; case–control study; Nigeria. Corresponding Author(s) Swase Dominic Terkimbi ( [email protected] ) Close Corresponding author: Swase Dominic Terkimbi Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2026 Mariette TD et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Mariette TD, Omofuma OM, Gaddam M et al. Cardiometabolic Risk Factors Associated with Benign Prostatic Hyperplasia Among Men Attending a Tertiary Health Centre in Enugu State, Nigeria: A Case–Control Study [version 1; peer review: awaiting peer review] . F1000Research 2026, 15 :731 ( https://doi.org/10.12688/f1000research.179573.1 ) First published: 14 May 2026, 15 :731 ( https://doi.org/10.12688/f1000research.179573.1 ) Latest published: 14 May 2026, 15 :731 ( https://doi.org/10.12688/f1000research.179573.1 ) Key findings of the study 1. Elderly men (>65 years) had significantly higher odds of benign prostatic hyperplasia (BPH) and remained a strong independent predictor after multivariate analysis (AOR = 4.94; p < 0.001). 2. Diabetes mellitus was the strongest independent cardiometabolic determinant of BPH, increasing the odds of disease nearly twentyfold (AOR = 19.51; p = 0.007). 3. Formal/public sector employment and retirement were independently associated with increased odds of BPH (AOR = 7.26 and 6.82, respectively). 4. Neither overweight nor obesity showed a significant independent association with BPH in the multivariate analysis. 5. Blood pressure levels were higher among cases descriptively, hypertension was not an independent predictor of BPH after adjustment for confounders. 6. Overall dyslipidaemia was not independently associated with BPH; however, near-optimal LDL cholesterol showed an independent positive association with BPH (AOR = 4.42; p = 0.001). 7. Prediabetes demonstrated a modest inverse association with BPH after adjustment (AOR = 0.48; p = 0.045). 8. Men with BPH exhibited higher prevalence and severity of lower urinary tract symptoms, particularly nocturia, incomplete emptying, urgency, weak stream, and straining. 9. Mean BMI, weight-reduction practices, and family history of obesity were comparable between cases and controls, indicating limited discriminatory value of BMI in this population. Introduction Benign prostatic hyperplasia (BPH) is one of the most prevalent non-malignant urological conditions affecting aging men worldwide. It is a major contributor to lower urinary tract symptoms (LUTS), reduced quality of life, sleep disturbance, and increased healthcare utilization ( Ng et al., 2024 ). BPH is characterized by progressive enlargement of the prostate gland resulting from stromal and epithelial cell hyperplasia within the transitional zone. Globally, the prevalence of BPH increases with advancing age, affecting approximately 20–30% of men aged 40–49 years, 50% of men aged 60 years, and up to 80–90% of men older than 80 years ( Ye et al., 2024 ). Epidemiological estimates suggest that more than 210 million men worldwide are currently living with BPH, making it a significant public health concern in aging populations ( Awedew et al., 2022 ). Aging and androgen-dependent mechanisms have traditionally been considered the primary causes of prostate enlargement. However, growing evidence indicates that BPH is linked to systemic metabolic disturbances ( Welén & Damber, 2022 ). Cardiometabolic conditions including hypertension, obesity, dyslipidemia, insulin resistance, and type 2 diabetes mellitus have documented as determinants of prostatic growth and symptom progression ( Bays et al., 2023 ). Meta-analyses have reported that men with metabolic syndrome have approximately 1.5–2 times higher odds of developing BPH compared with metabolically healthy individuals ( Amirmokri et al., 2025 ). Obesity alone has been associated with a 35–50% increased risk of prostate enlargement, while diabetes mellitus has been linked to increased prostate volume and more severe urinary symptoms ( Ngai et al., 2017 ). The burden of cardiometabolic diseases is increasing worldwide with the hypertension affects over 1.28 billion adults globally, while diabetes prevalence has risen to approximately 537 million adults ( WHO, 2025 ). Sub-Saharan Africa is experiencing one of the fastest increases in cardiometabolic disorders due to urbanization, sedentary lifestyles, dietary transition, and population aging ( Cassambai et al., 2025 ). In Nigeria, hypertension prevalence ranges between 28% and 45%, and diabetes prevalence is estimated at 5–7%, creating a growing population exposed to metabolic risk factors potentially influencing prostate health ( Ibezim et al., 2025 ). Despite accumulating international evidence linking cardiometabolic abnormalities with BPH, data from African populations remain limited and inconsistent. Most Nigerian studies on BPH have focused primarily on clinical presentation and surgical outcomes, with relatively few investigations exploring underlying metabolic determinants. Understanding these associations within local tertiary healthcare settings is essential for identifying modifiable risk factors and improving integrated patient care. Therefore, this case–control study aimed to examine the association between cardiometabolic factors and benign prostatic hyperplasia among men attending a tertiary health centre in Enugu State, Nigeria. Generating context-specific evidence may support early risk stratification, preventive interventions, and comprehensive management strategies addressing both cardiometabolic health and prostate disease among aging men. Methods Study design and setting This was a hospital-based case–control study conducted to determine the association between cardiometabolic factors and benign prostatic hyperplasia (BPH) among adult men attending the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, Nigeria. The case–control design examined relationships between cardiometabolic risk factors and BPH by comparing exposures between patients diagnosed with BPH (cases) and adult male patients without BPH (unmatched controls). The study was conducted at UNTH, Ituku-Ozalla, a federal tertiary healthcare institution located in southeastern Nigeria. The hospital functions as a major referral center with a bed capacity of over 500 beds and more than 41 clinical departments providing specialized medical and surgical services to patients within Enugu State and neighboring regions. Recruitment of cases was carried out in the Urology Clinic and urology wards, while controls were recruited from the Surgical and Medical Outpatient Clinics and hospital wards among patients without a diagnosis of BPH. Study population and eligibility criteria The study population consisted of adult male patients aged 18 years and above attending outpatient clinics at the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, Nigeria. The study was conducted within three months (3) period of time ranging from from July to September 2025. Participants were categorized into cases and controls based on clinical presentation and symptom assessment using the International Prostate Symptom Score (IPSS) questionnaire. Cases were adult men presenting with lower urinary tract symptoms (LUTS) consistent with benign prostatic hyperplasia, defined by an IPSS score ≥ 8, indicating moderate to severe symptoms. Controls were adult men aged 18 years and above attending the same hospital for non-urological conditions such as musculoskeletal complaints, hypertension follow-up, or routine medical check-ups, and who had no significant lower urinary tract symptoms (IPSS ≤7). Participants were included if they were adults aged 18 years and above and provided written informed consent to participate in the study. Participants were excluded if they had a history of prostate cancer, prostatitis, or previous pelvic surgery; were currently receiving androgen deprivation therapy or 5α-reductase inhibitors (e.g., finasteride or dutasteride); had acute urinary tract infection, acute urinary retention, or neurogenic bladder; or were critically ill or unable to provide reliable responses to the study questionnaire. Sample size determination The minimum sample size for this study was determined using the standard formula for unmatched case-control studies at k = 1: Where: • α = 0.05 • Zα/2 = 1.96 (for 95% confidence) • β = 80% • Z(1-β) = Z(β) = 0.84 • p1 = 0.30 (exposure rate among controls) from a previous study • OR = 2.0 • p2 =? • n =? First, p2 (exposure rate among cases) will be calculated as: p 2 = ( OR ) ⋅ p 1 ( 1 − p 1 ) + ( OR × p 1 ) p 2 = ( 2 ) ⋅ 0.3 ( 1 − 0.3 ) + ( 2 × 0.3 ) p2 = 0.462 n = ( 1.96 + 0.84 ) 2 ⋅ [ 0.30 ( 0.70 ) + 0.462 ( 0.538 ) ( 0.30 − 0.462 ) 2 n = 3.59 0.0262 2 n ≈ 137 To allow for potential data loss or non-response, 10% of the sample size will be added, hence: Sample size = 137 + 13.7 ≈ 150 . Hence 150 cases and 150 controls total 300 participants . Sampling technique A systematic random sampling technique was used to recruit participants until the required sample size was achieved. Eligible male patients attending the Urology Clinic who met the inclusion criteria were consecutively recruited as cases. For each recruited case, an unmatched control was selected from eligible adult male patients attending the Medical or General Outpatient Clinics during the same study period using systematic selection from the clinic attendance register. Data collection instrument and validation Data were collected using a structured interviewer-administered questionnaire designed to obtain information on sociodemographic characteristics, clinical history, and cardiometabolic risk factors. The questionnaire was pretested among 20 adult patients attending another tertiary healthcare facility in Enugu State to assess clarity, wording, logical flow, and average completion time. Feedback obtained during the pretest was used to revise ambiguous items and improve overall structure. Data generated from the pretest were entered into SPSS version 27 to evaluate internal consistency of the questionnaire sections using Cronbach’s alpha reliability analysis, with a coefficient of α ≥ 0.7 considered acceptable for reliability. Data management and analysis Collected data were checked daily for completeness and consistency before entry into Microsoft Excel using predefined coding formats. Each questionnaire item was assigned numerical codes to facilitate statistical analysis; categorical variables were coded using numeric identifiers (e.g., 1 = Yes, 2 = No), while continuous variables such as age, body mass index, blood pressure, and biochemical measurements were entered as recorded values. After data entry, double-checking and validation procedures were conducted to minimize entry errors. The dataset was subsequently cleaned and exported to SPSS version 27 for statistical analysis. Data cleaning involved range checks, logical consistency assessment, and identification of outliers. Missing data were handled through initial verification against original questionnaires to correct entry omissions where possible. Variables with minimal missing responses were analyzed using complete-case analysis, while missing responses were coded as system-missing values and excluded from specific analyses without affecting overall dataset integrity. Descriptive statistics including frequencies, proportions, means, and standard deviations were used to summarize sociodemographic characteristics and cardiometabolic exposure variables. Bivariate analysis was performed to examine crude associations between cardiometabolic determinants (obesity, hypertension, diabetes mellitus, dyslipidaemia, and metabolic syndrome) and the presence of benign prostatic hyperplasia (BPH). Crude odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were estimated. Variables showing clinical relevance or statistical association were entered into a multivariable logistic regression model to control for potential confounders such as age, alcohol use, smoking status, and physical activity level. Statistical significance was determined at a p-value < 0.05. Ethical considerations Ethical approval for this study was obtained from the Health Research Ethics Committee (HREC) of the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, with approval reference number UNTH/HREC/2025/10/4198 and National Health Research Ethics Committee (NHREC) registration number NHREC/05/01/2008B-FWA00002458-1RB00002323. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki ( World Medical Association, 2013 ) for research involving human participants. Written informed consent was obtained from all participants after a detailed explanation of the study objectives, procedures, potential benefits, and possible risks. Participation was entirely voluntary, and respondents were informed of their right to decline participation or withdraw from the study at any stage without any effect on the quality of medical care received. Confidentiality and anonymity were strictly maintained by assigning unique identification codes instead of personal identifiers. All collected data were securely stored and accessed only by the research team for academic and research purposes. Results Sociodemographic characteristics of respondents A total of 300 respondents were included, comprising 150 controls and 150 BPH cases. Age distribution showed that controls were predominantly middle-aged (45–65 years), accounting for 81.3% (n = 122), whereas BPH cases were mainly older, with 50.7% (n = 76) classified as elderly (>65 years) compared with 18.7% (n = 28) among controls ( Table 1 ). The mean age was higher among cases (65 ± 8 years) than controls (60 ± 7 years), indicating increased occurrence of BPH with advancing age. With respect to marital status, the majority of respondents in both groups were married, representing 74.0% (n = 111) of controls and 78.7% (n = 118) of cases. Smaller proportions were single, divorced, or widowed, with comparable distributions across groups. Table 1. Sociodemographic information of respondents. Variables Benign Prostatic Hyperplasia Control (150) Case (150) N % N % Age Middle-aged (45–65 Years) 122 81.3 74 49.3 Elderly (> 65 Years) 28 18.7 76 50.7 Mean Age 60 65 SD Age 7 8 Marital Status Single 15 10.0 4 2.7 Married 111 74.0 118 78.7 Divorced 9 6.0 12 8.0 Widowed 15 10.0 16 10.7 Occupation Unemployed 14 9.3 12 8.0 Student 2 1.3 0 .0 Informal/Skilled Labour 61 40.7 46 30.7 Formal/Public Sector 56 37.3 28 18.7 Retired 12 8.0 53 35.3 Others 5 3.3 11 7.3 Educational Level No Formal Education 19 12.7 17 11.3 Primary 36 24.0 42 28.0 Secondary 43 28.7 54 36.0 Tertiary 52 34.7 37 24.7 Residential Location Rural 42 28.0 38 25.3 Semi-Urban 38 25.3 46 30.7 Urban 70 46.7 66 44.0 Monthly Income 200 K 29 19.3 18 12.0 Occupational status demonstrated variation between groups. Among controls, most participants were engaged in informal/skilled labour (40.7%, n = 61) and formal/public sector employment (37.3%, n = 56). In contrast, BPH cases had a higher proportion of retired individuals (35.3%, n = 53), reflecting the older age profile of affected men. Educational attainment showed moderate differences, with tertiary education being most common among controls (34.7%, n = 52), while secondary education predominated among cases (36.0%, n = 54). The proportion of participants without formal education was similar in both groups. Residential location was comparable between groups, with most respondents residing in urban areas (46.7% of controls and 44.0% of cases). Regarding monthly income, a higher proportion of BPH cases earned less than ₦50,000 (41.3%, n = 62) compared with controls (32.0%, n = 48), while higher income categories were common among controls. Diagnostic methods for Benign Prostatic Hyperplasia The analysis of diagnostic approaches among the 150 BPH cases revealed variation in methods used for confirming diagnosis ( Figure 1 ). Radiological assessment constituted the most frequently utilized diagnostic method, accounting for 46.0% of cases ( Figure 1 ). This was followed by clinical diagnosis using digital rectal examination (DRE), which represented 32.0% of diagnoses. Prostate-specific antigen (PSA) testing was the least utilized method, contributing 22.0% of confirmed cases. Figure 1. Diagnostic Method for 150 BPH cases in %. Radiological assessment was the most common (46.0%), followed by clinical diagnosis via digital rectal examination (32.0%) and PSA testing (22.0%). Duration of Benign Prostatic Hyperplasia diagnosis Most participants (57.3%) reported having been diagnosed with BPH for 1–5 years, indicating ongoing clinical follow-up and management ( Figure 2 ). A smaller proportion (24.7%) had received their diagnosis within the past year, reflecting relatively recent detection of the condition. Meanwhile, 18.0% of patients had lived with BPH for more than five years, suggesting long-standing disease among a notable segment of cases. Figure 2. BPH Diagnosis duration for 150 BPH Cases in %. Most cases (57.3%) had been diagnosed for 1–5 years, while 24.7% were diagnosed within the past year and 18.0% had a diagnosis duration exceeding 5 years. Benign Prostatic Hyperplasia symptom profile Symptoms were generally minimal among controls but substantially more frequent and severe among BPH cases ( Table 2 ). Nearly half of the controls (49.3%) reported no symptom, whereas only 4.0% of BPH cases were symptom-free. Most BPH patients experienced moderate to severe symptoms, particularly scores 2 (32.7%) and 3 (22.0%). For intermittency, over half of controls (51.3%) reported no interruption of urinary flow compared with only 4.7% among cases. BPH participants commonly reported moderate symptoms, with 31.3% scoring 2 and 26.0% scoring 3, demonstrating pronounced urinary flow disruption. A similar pattern was observed for urgency, where 50.0% of controls had no urgency symptoms, while only 5.3% of BPH cases were symptom-free. Moderate urgency predominated among cases, particularly scores 2 (34.7%) and 3 (25.3%). Weak urinary stream was uncommon among controls, with 60.7% reporting no symptom. In contrast, BPH cases demonstrated widespread symptom presence, with comparable proportions reporting scores 2 (24.0%) and 3 (24.0%), reflecting clinically significant obstruction. For straining during urination, two-thirds of controls (66.0%) reported no difficulty, whereas only 2.7% of BPH patients were symptom-free. Higher symptom severity was common among cases, especially scores 2 (27.3%) and 3 (28.0%). Nocturia was the most prominent symptom overall. While 30.7% of controls reported no nighttime urination, only 4.7% of cases were without symptoms. The largest proportion of BPH patients reported waking to urinate three times per night (30.0%), followed by two times (23.3%) and four times (18.7%). Table 2. BPH symptoms. Variables (How often have you had the following sensations?) BPH Control (150) Case (150) N % N % Incomplete emptying 0 74 49.3 6 4.0 1 52 34.7 24 16.0 2 17 11.3 49 32.7 3 6 4.0 33 22.0 4 0 .0 28 18.7 5 1 .7 10 6.7 Intermittency 0 77 51.3 7 4.7 1 52 34.7 24 16.0 2 16 10.7 47 31.3 3 5 3.3 39 26.0 4 0 .0 19 12.7 5 0 .0 14 9.3 Urgency 0 75 50.0 8 5.3 1 53 35.3 20 13.3 2 17 11.3 52 34.7 3 3 2.0 38 25.3 4 2 1.3 20 13.3 5 0 .0 12 8.0 Weak Stream 0 91 60.7 9 6.0 1 40 26.7 32 21.3 2 16 10.7 36 24.0 3 2 1.3 36 24.0 4 1 .7 26 17.3 5 0 .0 11 7.3 Straining 0 99 66.0 4 2.7 1 36 24.0 25 16.7 2 13 8.7 41 27.3 3 2 1.3 42 28.0 4 0 .0 28 18.7 5 0 .0 10 6.7 Nocturia 0 46 30.7 7 4.7 1 69 46.0 29 19.3 2 27 18.0 35 23.3 3 6 4.0 45 30.0 4 1 .7 28 18.7 5 1 .7 6 4.0 Obesity characteristics of respondents The mean body mass index (BMI) was similar in both groups, measuring 27.2 ± 3.5 kg/m 2 among BPH cases and 27.1 ± 3.8 kg/m 2 among controls, indicating that participants in both groups were generally within the overweight category ( Table 3 ). Most respondents were not engaged in any weight reduction lifestyle or medication, accounting for 79.3% of cases and 78.0% of controls, while only about one-fifth reported active weight management practices. Among those undertaking weight control measures, walking, running, or jogging was the most frequently reported lifestyle strategy (16.7% of cases and 13.3% of controls). Use of weight reduction medication was uncommon in both groups (2.7% of cases and 4.0% of controls). Assessment of family history of obesity revealed that over half of participants reported no such history (51.3% of cases and 58.7% of controls). A positive family history was reported by 26.7% of cases compared with 31.3% of controls, while uncertainty regarding family history was more common among BPH cases (22.0%) than controls (10.0%). Table 3. Obesity information. Variable BPH Control (150) Case (150) N % N % BMI Mean BMI 27.1 27.2 SD BMI 3.8 3.5 Currently on any weight reduction lifestyle/medication? No 117 78.0 119 79.3 Yes 33 22.0 31 20.7 Specify Lifestyle/Medication Walking/Running/Jogging 20 13.3 25 16.7 Medication 6 4.0 4 2.7 None 117 78.0 119 79.3 Other 7 4.7 2 1.3 Fam Hx of Obesity No 88 58.7 77 51.3 Yes 47 31.3 40 26.7 Not Sure 15 10.0 33 22.0 BMI category distribution among controls and BPH cases Overweight status was more common among BPH cases, accounting for 55.3%, compared with 44.0% among controls. In contrast, a normal BMI was observed more frequently among controls (32.7%) than cases (25.3%) ( Figure 3 ). Figure 3. BMI category of controls and cases in %. Overweight status was more common among cases (55.3%) than controls (44.0%), while normal BMI was higher in controls (32.7% vs. 25.3%). Hypertension characteristics among controls and BPH cases The mean systolic blood pressure was 132 mmHg among cases compared with 122 mmHg among controls, while mean diastolic blood pressure was 86 mmHg in cases and 79 mmHg in controls, indicating relatively elevated blood pressure among BPH patients ( Table 4 ). Use of antihypertensive medication was more common among cases, with 28.0% receiving treatment compared with 16.7% of controls. Hypertension-related symptoms were also reported more frequently among cases. Headache was present in 13.3% of cases compared with 6.0% of controls, while blurry vision occurred in 8.7% of cases and 2.7% of controls. Chest pain was reported by 5.3% of cases versus 2.0% of controls, and reduced urine output was slightly higher among cases (4.0%) compared with controls (1.3%). The proportion of participants reporting no hypertension-related symptoms was lower among cases (76.7%) than controls (93.3%). Additionally, a positive family history of hypertension was more common among cases (48.7%) compared with controls (35.3%), whereas absence of family history was higher among controls (52.0%) than cases (35.3%). Table 4. Hypertension information. Variables BPH Control (150) Case (150) N % N % Systolic BP Mean 122 132 SD 14 26 Diastolic Mean 79 86 SD 10 15 Currently on antihypertensives No 125 83.3 108 72.0 Yes 25 16.7 42 28.0 Headache No 141 94.0 130 86.7 Yes 9 6.0 20 13.3 Blurry vision No 146 97.3 137 91.3 Yes 4 2.7 13 8.7 Chest pain No 147 98.0 142 94.7 Yes 3 2.0 8 5.3 Reduced urine output No 148 98.7 144 96.0 Yes 2 1.3 6 4.0 None No 10 6.7 35 23.3 Yes 140 93.3 115 76.7 Fam Hx of HTN No 78 52.0 53 35.3 Yes 53 35.3 73 48.7 Not Sure 19 12.7 24 16.0 Blood pressure categories among controls and BPH cases Normal blood pressure was more common among cases (35.3%) compared with controls (20.7%) ( Figure 4 ). Prehypertension showed the highest proportion among controls (62.7%) relative to cases (28.7%). In contrast, established hypertension occurred substantially more frequently among cases (33.3%) than controls (11.3%). Hypotension was uncommon in both groups, observed in 2.7% of cases and 5.3% of controls. Figure 4. BP category for controls and cases in %. Hypertension was more common among cases (33.3%) than controls (11.3%), while prehypertension predominated among controls (62.7% vs. 28.7%). Blood sugar characteristics among controls and BPH cases The analysis of blood sugar characteristics showed differences between men with benign prostatic hyperplasia and controls ( Table 5 ). The mean fasting blood sugar level was higher among BPH cases (104 mg/dL) compared with controls (96 mg/dL), with wider variability observed among cases (SD = 38) than controls (SD = 14) ( Table 5 ). A slightly greater proportion of cases were receiving medication for diabetes mellitus (12.0%) compared with controls (9.3%). Symptoms suggestive of hyperglycemia were more frequently reported among cases. Excessive urination was reported by 7.3% of cases compared with 4.7% of controls, while unusual thirst occurred in 8.0% of cases versus 4.7% of controls. Weight loss was also slightly higher among cases (4.0%) compared with controls (2.0%), whereas fatigue was reported equally in both groups (2.0% each). Participants reporting no diabetic symptoms were fewer among cases (83.3%) than controls (94.7%). Family history of diabetes mellitus was comparable between groups, reported by 39.3% of cases and 38.7% of controls; however, uncertainty regarding family history was higher among cases (22.7%) than controls (9.3%). Table 5. Blood sugar information. Variable BPH Control (150) Case (150) N % N % Latest Fasting Blood Sugar Mean 96 104 SD 14 38 Currently on any meds for DM No 136 90.7 132 88.0 Yes 14 9.3 18 12.0 Excessive urination No 143 95.3 139 92.7 Yes 7 4.7 11 7.3 Unusual thirst No 143 95.3 138 92.0 Yes 7 4.7 12 8.0 Weight loss No 147 98.0 144 96.0 Yes 3 2.0 6 4.0 Fatigue No 147 98.0 147 98.0 Yes 3 2.0 3 2.0 None No 8 5.3 25 16.7 Yes 142 94.7 125 83.3 Fam Hx of DM No 78 52.0 57 38.0 Yes 58 38.7 59 39.3 Not Sure 14 9.3 34 22.7 Blood sugar category of controls and cases (%) Normal blood sugar levels were observed at comparable proportions among cases (52.7%) and controls (52.0%). Hypoglycemia was uncommon in both groups, occurring slightly more among cases (5.3%) than controls (4.0%) ( Figure 5 ). Prediabetes was more frequent among controls (43.3%) compared with cases (27.3%). In contrast, diabetes mellitus showed a markedly higher prevalence among BPH cases (14.7%) than controls (0.7%). Figure 5. Blood sugar category of controls and cases in %. Diabetes was more prevalent among BPH cases (14.7%) compared to controls (0.7%), while prediabetes was more common in controls (43.3% vs. 27.3%). Dyslipidemia information among controls and BPH cases The mean low-density lipoprotein (LDL) cholesterol level was similar in both groups, measuring 119 mg/dL among cases and 122 mg/dL among controls ( Table 6 ). Most participants in both groups were not receiving lipid-lowering medication, accounting for 90.7% of cases and 86.7% of controls, while only 9.3% of cases and 13.3% of controls reported current treatment. Clinical indicators suggestive of dyslipidemia were generally uncommon. Yellowish eyelid plaques were reported slightly more among cases (4.0%) compared with controls (1.3%). Chest pain was reported by 2.7% of cases and 5.3% of controls, whereas calf pain occurred in 1.3% of cases and 3.3% of controls. The majority of respondents reported none of these symptoms (93.3% of cases and 92.0% of controls). Regarding family history of high cholesterol, 31.3% of cases and 34.0% of controls reported a positive history, while uncertainty about family history was higher among cases (22.0%) compared with controls (12.0%). Table 6. Dyslipidemia information. Variable BPH Controls (150) Cases (150) N % N % Latest LDL Mean 122 119 SD 30 18 Currently on any lipid-lowering med No 130 86.7 136 90.7 Yes 20 13.3 14 9.3 Yellowish plaques on eyelids No 148 98.7 144 96.0 Yes 2 1.3 6 4.0 Chest pains No 142 94.7 146 97.3 Yes 8 5.3 4 2.7 Pains on your calf No 145 96.7 148 98.7 Yes 5 3.3 2 1.3 None No 12 8.0 10 6.7 Yes 138 92.0 140 93.3 Fam Hx of High Cholesterol No 81 54.0 70 46.7 Yes 51 34.0 47 31.3 Not Sure 18 12.0 33 22.0 LDL category of controls and cases in percentage The distribution of low-density lipoprotein (LDL) cholesterol categories showed differences between men with benign prostatic hyperplasia (BPH) and controls ( Figure 6 ). Near-optimal LDL levels constituted the largest proportion among BPH cases (52.7%) compared with 32.0% of controls. Normal LDL levels were more frequently observed among controls (26.7%) than cases (16.0%). Borderline-high LDL levels were relatively comparable between groups, accounting for 31.3% of controls and 30.0% of cases. Dyslipidaemia was more common among controls (10.0%) compared with only 1.3% of BPH cases. Figure 6. LDL category of controls and cases in %. Near-optimal LDL levels were more common among cases (52.7%) than controls (32.0%), while dyslipidaemia was more frequent in controls (10.0% vs. 1.3%). Multivariate analysis of independent predictors of Benign Prostatic Hyperplasia Elderly age remained a strong and statistically significant predictor of BPH, with elderly men having nearly five times higher odds of BPH compared with middle-aged participants (AOR = 4.94; 95% CI: 2.31–10.55; p < 0.001) ( Table 7 ). Marital status was not independently associated with BPH after adjustment, as married (AOR = 2.54; p = 0.217), divorced (AOR = 5.68; p = 0.067), and widowed participants (AOR = 1.64; p = 0.583) did not reach statistical significance. In contrast, occupational status remained significant. Participants employed in the formal/public sector had significantly higher odds of BPH (AOR = 7.26; 95% CI: 1.85–28.54; p = 0.005), while retired individuals also demonstrated a significantly increased likelihood of BPH compared with unemployed participants (AOR = 6.82; 95% CI: 1.23–37.63; p = 0.028). Educational level, residential location, and monthly income were not independently associated with BPH following adjustment (p > 0.05). Similarly, BMI categories showed no statistically significant independent relationship with BPH. Blood pressure status demonstrated significant inverse associations with BPH. Participants with hypotension (AOR = 0.07; 95% CI: 0.01–0.54; p = 0.011) and pre-hypertension (AOR = 0.22; 95% CI: 0.11–0.47; p < 0.001) had significantly lower odds of BPH compared with individuals with normal blood pressure, whereas hypertension was not statistically significant (AOR = 1.87; p = 0.176). Blood glucose status also demonstrated independent associations with BPH. Prediabetes was associated with reduced odds of BPH (AOR = 0.48; 95% CI: 0.24–0.98; p = 0.045), whereas diabetes mellitus was significantly associated with increased odds of BPH (AOR = 19.51; 95% CI: 2.24–170.12; p = 0.007). Lipid profile analysis revealed that near-optimal LDL cholesterol was independently associated with increased odds of BPH (AOR = 4.42; 95% CI: 1.82–10.78; p = 0.001), while borderline-high LDL and dyslipidaemia were not statistically significant after adjustment. Table 7. Multivariable Logistic Regression Analysis of Factors Associated with Benign Prostatic Hyperplasia. Variables AOR 95% CI P-value Age • Middle Age 1.00 – – • Elderly 4.94 2.31–10.55 <0.001 Marital status • Single 1.00 – – • Married 2.54 0.58–11.17 0.217 • Divorced 5.68 0.89–36.31 0.067 • Widowed 1.64 0.28–9.66 0.583 Occupation • Unemployed 1.00 – – • Student 1.71 0.51–5.76 0.386 • Informal/Skilled labour 1.27 0.36–4.53 0.714 • Formal/Public sector 7.26 1.85–28.54 0.005 • Retired 6.82 1.23–37.63 0.028 Educational level • No formal education 1.00 – – • Primary 1.61 0.50–5.16 0.422 • Secondary 1.78 0.59–5.39 0.306 • Tertiary 1.22 0.38–3.93 0.738 Residential location • Rural 1.00 – – • Semi-urban 1.87 0.79–4.44 0.155 • Urban 1.39 0.64–3.03 0.407 Monthly income • 200,000 0.77 0.28–2.11 0.613 BMI categorization • Normal 1.00 – – • Underweight – – 1.000 • Overweight 1.53 0.72–3.24 0.267 • Obese 0.93 0.35–2.46 0.877 Blood pressure categorization • Normal 1.00 – – • Hypotension 0.07 0.01–0.54 0.011 • Pre-hypertension 0.22 0.11–0.47 <0.001 • Hypertension 1.87 0.76–4.63 0.176 Blood sugar categorization • Normal 1.00 – – • Hypoglycemia 2.24 0.47–10.59 0.308 • Prediabetes 0.48 0.24–0.98 0.045 • Diabetes 19.51 2.24–170.12 0.007 LDL categorization • Normal 1.00 – – • Near optimal 4.42 1.82–10.78 0.001 • Borderline high 2.41 0.94–6.17 0.067 • Dyslipidemia 0.17 0.02–1.24 0.080 Discussion The study evaluated the association between selected cardiometabolic risk factors and benign prostatic hyperplasia (BPH) in adult men attending a tertiary health center in Nigeria. The findings indicate that advancing age and diabetes mellitus were independently associated with increased odds of BPH in this study population. In contrast, the multivariate analysis showed that obesity, hypertension, and dyslipidemia were not significant independent predictors of BPH after adjusting for potential confounding factors. Age remained a strong and consistent predictor of BPH, with older men having approximately fivefold higher odds of disease compared with younger men. This finding is consistent with recent studies from China ( Li et al., 2025 ; Shao et al., 2022 ) and ( Zi et al., 2025 ) study where age aging as the most important non-modifiable determinant of prostatic enlargement. Additionally, Large population-based global studies and meta-analyses also reported a steep increase in BPH prevalence and prostate volume with advancing age ( Amirmokri et al., 2025 ; Li et al., 2025 ). This association could be due to age-related hormonal alterations, chronic prostatic inflammation, cumulative metabolic exposure, and progressive stromal and epithelial proliferation that promote prostate enlargement over time ( Xiang et al., 2025 ). In contrast, neither BMI-defined obesity nor hypertension was independently associated with BPH in the multivariable analysis despite the higher crude prevalence of both conditions among cases. The findings contradict other Chinese studies that reported obesity and hypertension as significant independent predictors of benign prostatic hyperplasia ( He et al., 2025 ; Zeng et al., 2018 ). This discrepancy could be due to differences in study population characteristics, variations in cardiometabolic risk profiles, healthcare-seeking behavior, genetic background, and methodological differences in measurement. These findings implies that obesity and hypertension may not independently contribute to BPH risk in this population, suggesting that clinical screening and prevention strategies should consider population-specific cardiometabolic risk profiles. However, overweight and obesity were not significantly associated with benign prostatic hyperplasia in the multivariate analysis. This finding does not negate the biological role of adiposity in BPH development, as evidence indicates that central (visceral) obesity is the metabolically relevant determinant of prostate enlargement, not BMI-defined general obesity ( Armadani et al., 2024 ). Visceral fat is strongly associated with insulin resistance, chronic inflammation, and hormonal alterations that promote prostatic growth ( Donohoe et al., 2011 ). In this study, obesity was assessed using BMI alone without measures of central adiposity such as waist circumference or waist-to-hip ratio, which may have led to lack of true metabolic risk and reduced the ability to detect a true association. Additionally, similar mean BMI between cases and controls suggests that BMI had limited ability to distinguish risk in this population, particularly among older men where age-related body composition changes are not adequately captured. Similarly, hypertension was more prevalent among cases at the descriptive level, it was not independently associated with BPH after multivariable analysis. This supports existing literature that hypertension may function more as a marker of metabolic dysfunction, particularly insulin resistance and autonomic nervous system dysregulation and not a direct causal factor ( Sakr et al., 2023 ). Additionally, ongoing antihypertensive treatment and regular clinical follow-up among cases may have normalized blood pressure at recruitment, potentially underestimating long-term hypertension exposure. In contrast, the findings indicate that diabetes mellitus was an independent predictor of BPH, with affected individuals demonstrating nearly a twentyfold higher odds of disease after multivariable adjustment. This result aligns with experimental and epidemiological evidence demonstrating that diabetes and insulin resistance are associated with increased prostate volume and accelerated prostatic growth ( Bays et al., 2023 ; Ngai et al., 2017 ). The biological mechanism of this association is well supported, as chronic hyperinsulinemia and activation of the insulin-like growth factor-1 (IGF-1) pathway stimulate prostatic cellular proliferation (X. Fu et al., 2024 ). In addition, diabetes is associated with chronic low-grade inflammation, oxidative stress, autonomic nervous system dysregulation, and microvascular dysfunction, which collectively promote stromal and epithelial hyperplasia ( Oguntibeju, 2019 ). Diabetes may also worsen lower urinary tract symptoms through mechanisms partly independent of prostate size, including diabetic cystopathy, impaired detrusor contractility, and altered bladder sensation (Erdogan et al., 2022). This dual effect on both the prostate and bladder may explain why diabetic men often present with more severe urinary symptoms and poorer functional outcomes ( Noaman et al., 2025 ). These findings suggest that diabetes mellitus should be considered an important cardiometabolic factor in the clinical evaluation of men with BPH. Routine screening for diabetes and optimization of glycaemic control may therefore contribute to improved management and long-term outcomes among affected patient. Moreover, dyslipidemia was not independently associated with BPH in the multivariable analysis. However, the near-optimal LDL cholesterol category showed a strong independent association, indicating a non-linear and complex relationship between lipid metabolism and BPH risk. The literature in this area is inconsistent with some studies identify triglycerides and low HDL cholesterol as key predictors of BPH ( Besiroglu et al., 2017 ; Zhu et al., 2022 ), others report weak or null associations for LDL cholesterol and total cholesterol ( Yoo et al., 2020 ). Experimental evidence suggests that lipid abnormalities may act indirectly through interactions with insulin resistance, chronic inflammation, endothelial dysfunction, and vascular changes and not as isolated causal factors (J. Fu et al., 2021 ). The pattern observed in this study may reveal several mechanisms. The near-optimal LDL category may represent an early or transitional metabolic state characterized by subclinical insulin resistance or inflammation. In addition, treatment effects may have influenced classification, as some individuals with more severe dyslipidemia may already be receiving lipid-lowering therapy. The pattern observed in this study may demonstrate underlying metabolic mechanisms with near-optimal LDL levels may indicate an early metabolic state associated with subclinical insulin resistance or low-grade inflammation. In addition, lipid-lowering treatment may have modified lipid profiles, resulting in reclassification of individuals with previously elevated LDL levels. The implication is that LDL levels alone may not fully reflect true cardiometabolic risk in BPH, and clinical assessment should consider underlying metabolic status and treatment history when evaluating lipid-related associations. These findings highlight the growing importance of cardiometabolic health in the epidemiology of benign prostatic hyperplasia in low- and middle-income settings. As populations age and the burden of metabolic diseases such as diabetes continues to increase, the prevalence and clinical impact of BPH are likely to increase. Integrating metabolic risk assessment into routine urological evaluation and strengthening preventive strategies targeting diabetes and other metabolic disorders may therefore play an important role in reducing the burden of BPH and improving quality of life among aging male populations. These findings emphasised the need for coordinated approaches that link urological care with broader non-communicable disease prevention programs within health systems. Conclusion This study demonstrated that advancing age and diabetes mellitus were independently associated with benign prostatic hyperplasia (BPH) among men attending a tertiary health center in Nigeria. In contrast, obesity, hypertension, and dyslipidemia were not independently associated with BPH after multivariable adjustment. These findings highlight the important role of metabolic health, particularly diabetes, in the development and progression of BPH. The findings highlight the need to integrate cardiometabolic risk assessment into the clinical evaluation and management of men presenting with BPH. Routine screening for diabetes and improved glycaemic control may contribute to better clinical outcomes and improved management of lower urinary tract symptoms among affected patients. From a public health perspective, strengthening prevention and control strategies for metabolic disorders may help reduce the growing burden of BPH in aging populations. Future research should prioritize longitudinal and multicenter studies to better clarify the temporal and causal relationships between cardiometabolic risk factors and BPH progression. In particular, further investigations incorporating measures of central adiposity, insulin resistance, inflammatory markers, and detailed metabolic profiling may provide deeper insight into the biological mechanisms linking metabolic dysfunction with prostatic enlargement. Additionally, population-based studies across diverse African settings are needed to improve the generalizability of findings and inform context-specific prevention and management strategies. Such evidence will be important for guiding integrated approaches that address both urological conditions and the broader burden of non-communicable diseases. Recommendations 1. Routine metabolic screening should be incorporated into the clinical evaluation of men presenting with lower urinary tract symptoms to enable early detection and management of diabetes and other cardiometabolic conditions that may influence the progression of benign prostatic hyperplasia. 2. Clinical management of benign prostatic hyperplasia should adopt a multidisciplinary approach that integrates urological care with metabolic risk assessment and management, particularly in patients with coexisting diabetes mellitus. 3. Healthcare systems should strengthen provider capacity through targeted training to improve the identification, monitoring, and management of metabolic conditions among aging male populations presenting with prostate-related symptoms. 4. Public health programs should promote awareness among men regarding the importance of early medical consultation for urinary symptoms and the potential role of metabolic health in prostate disease. 5. Further large-scale and longitudinal studies should be conducted to better understand the relationship between cardiometabolic risk factors and benign prostatic hyperplasia in diverse populations, particularly in African settings. Ethics approval and consent to participate Ethical clearance for this study was obtained from the Health Research Ethics Committee (HREC) of the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla prior to the commencement of the study. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki for research involving human participants ( World Medical Association, 2013 ). Written informed consent was obtained from all participants before their inclusion in the study. Consent for publication Not applicable. Availability of data and materials The datasets generated and analyzed during the current study are not publicly available due to ethical and confidentiality restrictions. The data consist of patient-level clinical information obtained from the University of Nigeria Teaching Hospital (UNTH), and public sharing is restricted in accordance with the conditions set by the Health Research Ethics Committee (HREC). Access to the data may be granted upon reasonable request to the Health Research Ethics Committee (HREC), UNTH via email ( [email protected] ) or telephone (+234 42 252022, +234 42 252573, +234 42 252134), subject to ethical approval and compliance with applicable data protection requirements. Acknowledgements The authors would like to thank all study participants and the staff of the University of Nigeria Teaching Hospital, Ituku-Ozalla, for their cooperation and support during the data collection process. References Amirmokri AJ, Loffredo CA, Makambi KH, et al. : Assessing the relationship between cardiometabolic diseases and the risk of developing aggressive prostate cancer: a systematic review and meta-analysis. BMC Cancer. 2025; 25 (1): 1645. PubMed Abstract | Publisher Full Text | Free Full Text Armadani M, Kurniati I, Hadibrata E: Systematic Review: Relationship between Obesity and the Risk of Benign Prostate Hyperplasia. Medical Profession Journal of Lampung. 2024; 14 (2): 254–259. Publisher Full Text Awedew AF, Han H, Abbasi B, et al. : The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2022; 3 (11): e754–e776. PubMed Abstract | Publisher Full Text | Free Full Text Bays HE, Bindlish S, Clayton TL: Obesity, diabetes mellitus, and cardiometabolic risk: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2023. Obesity Pillars. 2023; 5 (1): 100056. PubMed Abstract | Publisher Full Text | Free Full Text Besiroglu H, Dursun M, Otunctemur A, et al. : The association between triglyceride high density lipoprotein cholesterol ratio and benign prostate hyperplasia in non-diabetic patients:a cross-sectional study. Aging Male. 2017; 20 (3): 1–7. PubMed Abstract | Publisher Full Text Cassambai S, Tetteh J, Highton P, et al. : Prevalence of cardiometabolic diseases in Sub-Saharan Africa: a systematic review and meta-analysis. Glob. Health Action. 2025; 18 (1): 2580758. Publisher Full Text Donohoe CL, Doyle SL, Reynolds JV: Visceral adiposity, insulin resistance and cancer risk. Diabetology & Metabolic Syndrome. 2011; 3 (1): 12. Publisher Full Text Fu J, Yu MG, Li Q, et al. : Insulin’s actions on vascular tissues: Physiological effects and pathophysiological contributions to vascular complications of diabetes. Molecular Metabolism. 2021; 52 : 101236. PubMed Abstract | Publisher Full Text | Free Full Text Fu X, Wang Y, Lu Y, et al. : Association between metabolic syndrome and benign prostatic hyperplasia: The underlying molecular connection. Life Sci. 2024; 358 : 123192. PubMed Abstract | Publisher Full Text He J, Pan X, Liu D, et al. : Association between metabolic syndrome and risk of benign prostatic hyperplasia: a prospective cohort study of 163975 participants. J. Glob. Health. 2025; 15 . Publisher Full Text Ibezim HU, Njoya HK, Esene H, et al. : Prevalence of Hypertension and Type 2 Diabetes Mellitus among Patients with Metabolic Syndrome in Rural Southern Nigeria: Gender and Age Disparities. Nigerian Medical Journal: Journal of the Nigeria Medical Association. 2025; 66 (1): 279. Publisher Full Text Li X, Lian P, Chen H, et al. : Phenotypic age acceleration as a novel predictor of benign prostatic hyperplasia: a prospective cohort study. GeroScience. 2025; 1–13. Publisher Full Text Ng M, Leslie SW, Baradhi KM: Benign Prostatic Hyperplasia. StatPearls. 2024. Reference Source Ngai HY, Yuen KKS, Ng CM, et al. : Metabolic syndrome and benign prostatic hyperplasia: An update. Asian Journal of Urology. 2017; 4 (3): 164–173. PubMed Abstract | Publisher Full Text | Free Full Text Noaman Z, Algburi DYR, Abdulateef Y: DIABETES AND PROSTATE HEALTH: A COMPREHENSIVE ANALYSIS OF PATHOPHYSIOLOGICAL INTERACTIONS, MOLECULAR MECHANISMS, AND CLINICAL OUTCOMES. MINAR International Journal of Applied Sciences and Technology. 2025; 07 . Publisher Full Text Oguntibeju OO: Type 2 diabetes mellitus, oxidative stress and inflammation: examining the links. International Journal of Physiology, Pathophysiology and Pharmacology. 2019; 11 (3): 45–63. PubMed Abstract Reference Source Sakr HF, Sirasanagandla SR, Das S, et al. : Insulin Resistance and Hypertension: Mechanisms Involved and Modifying Factors for Effective Glucose Control. Biomedicine. 2023; 11 (8): 2271. Publisher Full Text Shao WH, Zheng CF, Ge YC, et al. : Age-related changes for the predictors of benign prostatic hyperplasia in Chinese men aged 40 years or older. Asian J. Androl. 2022; 25 (1): 132–136. PubMed Abstract | Publisher Full Text | Free Full Text Welén K, Damber JE: Androgens, aging, and prostate health. Rev. Endocr. Metab. Disord. 2022; 23 (6): 1221–1231. PubMed Abstract | Publisher Full Text | Free Full Text WHO: Cardiovascular diseases (CVDs).2025. Reference Source World Medical Association: World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 310 (20): 2191–2194. Publisher Full Text Xiang J, Zheng Y, Chen D, et al. : The pathogenesis of benign prostatic hyperplasia and the roles of Prdx3, oxidative stress, pyroptosis and autophagy:a review. Front. Oncol. 2025; 15 : 1579539. PubMed Abstract | Publisher Full Text | Free Full Text Ye Z, Wang J, Xiao Y, et al. : Global burden of benign prostatic hyperplasia in males aged 60–90 years from 1990 to 2019: results from the global burden of disease study 2019. BMC Urol. 2024; 24 (1): 193. PubMed Abstract | Publisher Full Text | Free Full Text Yoo S, Oh S, Suh J, et al. : Optimal high-density lipoprotein cholesterol level for decreasing benign prostatic hyperplasia in men not taking statin medication: A historical cohort study. Prostate. 2020; 80 (7): 570–576. Publisher Full Text Zeng XT, Weng H, Xiong J, et al. : Comparison of clinical and physiological parameters for benign prostatic hyperplasia in hypertensive and normotensive patients. Front. Physiol. 2018; 9 (SEP): 337877. Publisher Full Text Zhu C, Wu J, Wu Y, et al. : Triglyceride to high-density lipoprotein cholesterol ratio and total cholesterol to high-density lipoprotein cholesterol ratio and risk of benign prostatic hyperplasia in Chinese male subjects. Front. Nutr. 2022; 9 : 999995. PubMed Abstract | Publisher Full Text | Free Full Text Zi H, Wang YB, Huang Q, et al. : Predicting benign prostatic hyperplasia risks: model development and external validation based on three cohorts. Glob Health Res Policy. 2025; 10 (1): 67. Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 14 May 2026 ADD YOUR COMMENT Comment Author details Author details 1 Services des Urgences, Centre Hospitalier de Kourou, Guyane,, Guyane,, France 2 Department of Internal Medicine, Mamata Academy of Medical Sciences, Hyderabad, Hyderabad, India 3 Department of Internal Medicine, St. Martinus University, Dombivali, Dombivali, India 4 Department of Internal Medicine, St. Raphael Divine Mercy Specialist Hospital, Lagos, Lagos, Nigeria 5 Department of General Medicine, Walsall Manor Hospital, Walsall, Walsall,, USA 6 Department of Internal Medicine, St. Martinus University, Thane, Thane, India 7 Department of Critical Care, Faculty of Medicine,, Mansoura University, Mansoura, Mansoura, Egypt 8 Department of Internal Medicine, Kursk State Medical University, Kursk, Kursk, Russian Federation 9 Nanjing Medical, Nanjing Medical University, Nanjing, Nanjing, China 10 Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Federal Capital Territory, Nigeria 11 Faculty of Medicine, St. Martinus University, Curaçao,, India 12 Department of Medicine and Surgery, Chukwuemeka Odumegwu Ojukwu University, Anambra, Anambra, Nigeria 13 Department of Internal Medicine, Salcare Home Health Services,, California, USA 14 Family Medicine, Enugu University Teaching Hospital, Enugu, Enugu, Nigeria 15 Department of Pharmacy, Faculty of Health Sciences, Victoria University, Kampala,, Kampala,, Uganda TAMEGNON Dévi Mariette Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Oiku Marcellus Omofuma Roles: Conceptualization, Formal Analysis, Funding Acquisition, Methodology, Project Administration, Software, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Manognya Gaddam Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Rimzim Sanjay Bajoria Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Frankline Chidiebere Onuwa Roles: Conceptualization, Data Curation, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Nonso Francis Ifezuoke Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Nidhi Parag Pardeshi Roles: Conceptualization, Data Curation, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Mohamed Kamal Said Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Ayomide Olanrewaju Osanupin Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Simarjot Kaur Roles: Conceptualization, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Nnabuike Kevin Odo Roles: Conceptualization, Funding Acquisition, Investigation, Methodology, Project Administration, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Mandora Vidhut Savaram Roles: Conceptualization, Funding Acquisition, Investigation, Methodology, Project Administration, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Chijioke Chizoba Egwu Roles: Conceptualization, Data Curation, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Nwachukwu Chinenye Benita Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Swase Dominic Terkimbi Roles: Conceptualization, Investigation, Methodology, Resources, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 14 May 2026, 15:731 https://doi.org/10.12688/f1000research.179573.1 Copyright © 2026 Mariette TD et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Mariette TD, Omofuma OM, Gaddam M et al. Cardiometabolic Risk Factors Associated with Benign Prostatic Hyperplasia Among Men Attending a Tertiary Health Centre in Enugu State, Nigeria: A Case–Control Study [version 1; peer review: awaiting peer review] . F1000Research 2026, 15 :731 ( https://doi.org/10.12688/f1000research.179573.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: AWAITING PEER REVIEW AWAITING PEER REVIEW ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 14 May 2026 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status AWAITING PEER REVIEW Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Stay Updated Sign up for content alerts and receive a weekly or monthly email with all newly published articles Register with F1000Research Already registered? Sign in Not now, thanks close PLEASE NOTE If you are an AUTHOR of this article, please check that you signed in with the account associated with this article otherwise we cannot automatically identify your role as an author and your comment will be labelled as a “User Comment”. If you are a REVIEWER of this article, please check that you have signed in with the account associated with this article and then go to your account to submit your report, please do not post your review here. If you do not have access to your original account, please contact us . All commenters must hold a formal affiliation as per our Policies . The information that you give us will be displayed next to your comment. User comments must be in English, comprehensible and relevant to the article under discussion. We reserve the right to remove any comments that we consider to be inappropriate, offensive or otherwise in breach of the User Comment Terms and Conditions . Commenters must not use a comment for personal attacks. When criticisms of the article are based on unpublished data, the data should be made available. I accept the User Comment Terms and Conditions Please confirm that you accept the User Comment Terms and Conditions. Affiliation ✕ refresh Please enter your institution. Note: To add your institution or organisation, start typing the name and then select the correct name from the list. Where applicable, the name will appear in both the original language and in English. Do not paste in the name. If the name does not appear in the drop-down list, we will display the information you have entered. ✕ refresh Country/Region * USA UK Canada China France Germany Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo (Serbia and Montenegro) Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Minor Outlying Islands of the United States Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea North Macedonia Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Is South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Gambia The Netherlands Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu UK USA Uganda Ukraine United Arab Emirates United States Virgin Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis and Futuna West Bank and Gaza Strip Western Sahara Yemen Zambia Zimbabwe Please select your country/region. You must enter a comment. Competing Interests Please disclose any competing interests that might be construed to influence your judgment of the article's or peer review report's validity or importance. Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Please state your competing interests The comment has been saved. An error has occurred. Please try again. Cancel Post var lTitle = "Cardiometabolic Risk Factors Associated with...".replace("'", ''); var linkedInUrl = "http://www.linkedin.com/shareArticle?url=https://f1000research.com/articles/15-731/v1" + "&title=" + encodeURIComponent(lTitle) + "&summary=" + encodeURIComponent('Read the article by '); var deliciousUrl = "https://del.icio.us/post?url=https://f1000research.com/articles/15-731/v1&title=" + encodeURIComponent(lTitle); var redditUrl = "http://reddit.com/submit?url=https://f1000research.com/articles/15-731/v1" + "&title=" + encodeURIComponent(lTitle); linkedInUrl += encodeURIComponent('Mariette TD et al.'); var offsetTop = /chrome/i.test( navigator.userAgent ) ? 4 : -10; var addthis_config = { ui_offset_top: offsetTop, services_compact : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_expanded : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_custom : [ { name: "LinkedIn", url: linkedInUrl, icon:"/img/icon/at_linkedin.svg" }, { name: "Mendeley", url: "http://www.mendeley.com/import/?url=https://f1000research.com/articles/15-731/v1/mendeley", icon:"/img/icon/at_mendeley.svg" }, { name: "Reddit", url: redditUrl, icon:"/img/icon/at_reddit.svg" }, ] }; var addthis_share = { url: "https://f1000research.com/articles/15-731", templates : { twitter : "Cardiometabolic Risk Factors Associated with Benign Prostatic.... Mariette TD et al., published by " + "@F1000Research" + ", https://f1000research.com/articles/15-731/v1" } }; if (typeof(addthis) != "undefined"){ addthis.addEventListener('addthis.ready', checkCount); addthis.addEventListener('addthis.menu.share', checkCount); } $(".f1r-shares-twitter").attr("href", "https://twitter.com/intent/tweet?text=" + addthis_share.templates.twitter); $(".f1r-shares-facebook").attr("href", "https://www.facebook.com/sharer/sharer.php?u=" + addthis_share.url); $(".f1r-shares-linkedin").attr("href", addthis_config.services_custom[0].url); $(".f1r-shares-reddit").attr("href", addthis_config.services_custom[2].url); $(".f1r-shares-mendelay").attr("href", addthis_config.services_custom[1].url); function checkCount(){ setTimeout(function(){ $(".addthis_button_expanded").each(function(){ var count = $(this).text(); if (count !== "" && count != "0") $(this).removeClass("is-hidden"); else $(this).addClass("is-hidden"); }); }, 1000); } close How to cite this report {{reportCitation}} Cancel Copy Citation Details $(function(){R.ui.buttonDropdowns('.dropdown-for-downloads');}); $(function(){R.ui.toolbarDropdowns('.toolbar-dropdown-for-downloads');}); $.get("/articles/acj/179573/198100") new F1000.Clipboard(); new F1000.ThesaurusTermsDisplay("articles", "article", "198100"); $(document).ready(function() { $( "#frame1" ).on('load', function() { var mydiv = $(this).contents().find("div"); var h = mydiv.height(); console.log(h) }); var tooltipLivingFigure = jQuery(".interactive-living-figure-label .icon-more-info"), titleLivingFigure = tooltipLivingFigure.attr("title"); tooltipLivingFigure.simpletip({ fixed: true, position: ["-115", "30"], baseClass: 'small-tooltip', content:titleLivingFigure + " " }); tooltipLivingFigure.removeAttr("title"); $("body").on("click", ".cite-living-figure", function(e) { e.preventDefault(); var ref = $(this).attr("data-ref"); $(this).closest(".living-figure-list-container").find("#" + ref).fadeIn(200); }); $("body").on("click", ".close-cite-living-figure", function(e) { e.preventDefault(); $(this).closest(".popup-window-wrapper").fadeOut(200); }); $(document).on("mouseup", function(e) { var metricsContainer = $(".article-metrics-popover-wrapper"); if (!metricsContainer.is(e.target) && metricsContainer.has(e.target).length === 0) { $(".article-metrics-close-button").click(); } }); var articleId = $('#articleId').val(); if($("#main-article-count-box").attachArticleMetrics) { $("#main-article-count-box").attachArticleMetrics(articleId, { articleMetricsView: true }); } }); var figshareWidget = $(".new_figshare_widget"); if (figshareWidget.length > 0) { window.figshare.load("f1000", function(Widget) { // Select a tag/tags defined in your page. In this tag we will place the widget. _.map(figshareWidget, function(el){ var widget = new Widget({ articleId: $(el).attr("figshare_articleId") //height:300 // this is the height of the viewer part. [Default: 550] }); widget.initialize(); // initialize the widget widget.mount(el); // mount it in a tag that's on your page // this will save the widget on the global scope for later use from // your JS scripts. This line is optional. //window.widget = widget; }); }); } close Error Close Add Reset F1000.MICROSERVICES.AFFILIATION = ''; $(document).ready(function () { $('.js-affiliations-form').each((index, form) => { new AffiliationForm({ formId: form.id, institutionErrorSelector: '.comment-enter-institution', departmentErrorSelector: '.comment-enter-department', placeSelector: '.js-add-comment-place', stateSelector: '.js-add-comment-state', zipCodeSelector: '.js-add-comment-zipcode', countrySelector: '.js-add-comment-country', countryErrorSelector: '.comment-enter-country', }); }); }); $(document).ready(function () { var reportIds = { "486178": 0, "486177": 0, "486176": 0, "486175": 0, "486174": 0, "486173": 0, "486172": 0, "486171": 0, "486170": 0, "486169": 0, }; $(".referee-response-container,.js-referee-report").each(function(index, el) { var reportId = $(el).attr("data-reportid"), reportCount = reportIds[reportId] || 0; $(el).find(".comments-count-container,.js-referee-report-views").html(reportCount); }); var uuidInput = $("#article_uuid"), oldUUId = uuidInput.val(), newUUId = "2e49b402-0870-4598-a2ea-ae87fe2bd4db"; uuidInput.val(newUUId); $("a[href*='article_uuid=']").each(function(index, el) { var newHref = $(el).attr("href").replace(oldUUId, newUUId); $(el).attr("href", newHref); }); }); An innovative open access publishing platform offering rapid publication and open peer review, whilst supporting data deposition and sharing. Browse Gateways Collections How it Works Contact For Developers Cookie Notice Privacy Notice RSS Submit Your Research Follow us © 2012-2026 F1000 Research Ltd. ISSN 2046-1402 | Legal | Partner of Research4Life • CrossRef • ORCID • FAIRSharing R.templateTests.simpleTemplate = R.template(' $text $text $text $text $text '); R.templateTests.runTests(); var F1000platform = new F1000.Platform({ name: "f1000research", displayName: "F1000Research", hostName: "f1000research.com", id: "1", editorialEmail: "[email protected]", infoEmail: "[email protected]", usePmcStats: true }); $(function(){R.ui.dropdowns('.dropdown-for-authors, .dropdown-for-about, .dropdown-for-myresearch');}); // $(function(){R.ui.dropdowns('.dropdown-for-referees');}); $(document).ready(function () { if ($(".cookie-warning").is(":visible")) { $(".sticky").css("margin-bottom", "35px"); $(".devices").addClass("devices-and-cookie-warning"); } $(".cookie-warning .close-button").click(function (e) { $(".devices").removeClass("devices-and-cookie-warning"); $(".sticky").css("margin-bottom", "0"); }); $("#tweeter-feed .tweet-message").each(function (i, message) { var self = $(message); self.html(linkify(self.html())); }); $(".partner").on("mouseenter mouseleave", function() { $(this).find(".gray-scale, .colour").toggleClass("is-hidden"); }); }); Sign In Remember me Forgotten your password? Sign In Cancel Email or password not correct. Please try again Please wait... $(function(){ // Note: All the setup needs to run against a name attribute and *not* the id due the clonish // nature of facebox... $("a[id=googleSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("GOOGLE"); $("form[id=oAuthForm]").submit(); }); $("a[id=facebookSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("FACEBOOK"); $("form[id=oAuthForm]").submit(); }); $("a[id=orcidSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("ORCID"); $("form[id=oAuthForm]").submit(); }); }); If you've forgotten your password, please enter your email address below and we'll send you instructions on how to reset your password. The email address should be the one you originally registered with F1000. Email address not valid, please try again You registered with F1000 via Google, so we cannot reset your password. To sign in, please click here . If you still need help with your Google account password, please click here . You registered with F1000 via Facebook, so we cannot reset your password. To sign in, please click here . If you still need help with your Facebook account password, please click here . Code not correct, please try again Reset password Cancel Email us for further assistance. Server error, please try again. If your email address is registered with us, we will email you instructions to reset your password. If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance. Please wait... Register $(document).ready(function () { signIn.createSignInAsRow($("#sign-in-form-gfb-popup")); $(".target-field").each(function () { var uris = $(this).val().split("/"); if (uris.pop() === "login") { $(this).val(uris.toString().replace(",","/")); } }); });