The association between solid fuel use and lower urinary tract symptoms suggestive of benign prostatic hyperplasia: Results from the West China Natural Population Cohort Study (WCNPCS) (Preprint)

BACKGROUND Benign prostatic hyperplasia (BPH) is a global age-related disease. It has been reported that over half of Chinese males aged 70 years or older are suffering from BPH. Solid fuel, which is the major source of household air pollution, has been reportedly associated with several advent events, including sex hormone disorders. Due to the certain relationship between sex hormone levels and prostate disease, the relationship between solid fuel use and lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) deserves further exploration. OBJECTIVE This study mainly aimed to investigate the association between solid fuel use and LUTS/BPH. METHODS Data used in this study were obtained from the West China Natural Population Cohort Study. Household energy sources were assessed using a questionnaire, which divided participants into the clean fuel and solid fuel groups. LUTS/BPH was evaluated based on participant self-reports. To calculate the odds ratio (OR) and 95% confidence interval (CI) of LUTS/BPH for the solid fuel group compared with the clean fuel group, logistic regression models were performed. We further performed propensity score matching (PSM) to reduce the influence of bias and unmeasured confounders. RESULTS A total of 5,463 participants were included in this study, including 399 solid fuel users and 5,064 clean fuel users. Solid fuel use was positively correlated with LUTS/BPH before and after PSM (OR 1.68, 95% CI 1.31–2.15, and OR 1.81, 95% CI 1.35–2.44, respectively). In stratified analyses, the ORs of nondrinking group and nonsmoking group were higher than drinking group and smoking group, and the interactions were significant. CONCLUSIONS In this study, a positive correlation between solid fuel use and LUTS/BPH was observed. The results suggest that improving fuel structure for household cooking and other household needs can possibly help reduce the risk of LUTS/BPH. CLINICALTRIAL This trial was registered in the China Clinical Trial Registration Center (Registration No. ChiCTR1900024623) on 19/07/2019.