Association between coronary artery calcium score and prostate volume

Benign prostatic hyperplasia (BPH) and coronary artery disease share common risk factors, including aging, metabolic syndrome, and chronic inflammation. The coronary artery calcium score (CACS) is a noninvasive and useful indicator of atherosclerosis. This study aimed to evaluate the correlation between the CACS and prostate volume. We retrospectively analyzed 1,263 men who underwent transrectal ultrasonography and the coronary calcium scoring test during health screening. The total prostate volume (TPV), transition zone volume (TZV), and transition zone index (TZI) were calculated. Participants were categorized into three groups according to CACS (<100, 100-399, ≥400). Associations among prostate parameters, lower urinary tract symptoms, and CACS were evaluated. The prevalence of BPH (≥30 mL) increased across CACS groups (28.6%, 37.3%, and 41.3%; P=0.006, P for trend 0.001). Storage symptom scores (P=0.006, P for trend 0.001), particularly urgency (P=0.027, P for trend 0.008) and nocturia (P<0.001, P for trend <0.001), were significantly higher in subjects with an elevated CACS. CACS was positively correlated with TPV, TZV, and TZI (r=0.201, P=0.028; r=0.281, P=0.002; r=0.180, P=0.050, respectively). After adjusting for covariates, the correlation between CACS and TZV remained significant (r=0.219, P=0.018). A higher CACS was associated with increased prostate volume, particularly central enlargement, and more severe storage symptoms. These findings suggest a link between prostate enlargement and subclinical coronary atherosclerosis, supporting shared vascular and metabolic mechanisms.