A NEW study from Ethiopia suggests that simple, routinely available blood tests could help doctors identify men at higher risk of severe symptoms from benign prostatic hyperplasia (BPH), a common condition affecting ageing men. The research highlights the role of systemic inflammation and lifestyle factors in the progression of BPH.
The cross-sectional study, carried out between August and October 2024, assessed 232 men diagnosed with BPH. More than one-third, 84 participants, had severe urinary symptoms. Researchers examined clinical, lifestyle, and laboratory data to determine which factors best predicted symptom severity. They also evaluated several immune–inflammation indices derived from routine blood counts to measure their diagnostic performance.
How Age and Lifestyle Shape Symptom Risk
The study found that men aged 65 and older were more than twice as likely to experience severe symptoms. Low levels of physical activity and central obesity also significantly increased risk. Beyond these factors, several inflammatory markers stood out as strong predictors. Elevated values of the Systemic Immune-Inflammation Index (SII), the Pan-Immune-Inflammation Index (PII), and the Neutrophil-to-Lymphocyte Ratio (NLR) each nearly tripled the odds of severe BPH symptoms.
Among all the blood-based indices evaluated, SII demonstrated the highest predictive accuracy, with an area under the curve (AUC) of 0.736 in receiver operating characteristic analysis, a result indicating moderate discriminative ability. An SII value above 564.92 × 10³ correctly identified severe cases with 69% sensitivity and 72% specificity. PII performed similarly, while NLR was somewhat less accurate. Two other markers, the Platelet-to-Lymphocyte Ratio (PLR) and the Lymphocyte-to-Monocyte Ratio (LMR), showed limited usefulness; LMR in particular had poor predictive value.
Statistical comparisons confirmed that SII outperformed NLR and PLR, though its accuracy was similar to PII. A LOESS curve analysis revealed a clear, nonlinear increase in the probability of severe BPH as SII levels rose, reinforcing the link between inflammation and symptom burden.
SII and PII Show the Strongest Predictive Performance as Inflammation Markers
The authors conclude that SII and PII, both inexpensive and routinely measured, may serve as accessible, non-invasive tools to support clinical decision-making. They recommend further research to validate these findings and explore how inflammatory markers might guide personalised treatment for BPH.
Reference
Kassaw AB et al. Predictors and predictive performance of immune–inflammation indices for symptom severity in benign prostatic hyperplasia. Sci Rep. 2025; DOI:10.1038/s41598-025-30765-0.
