Association between serum concentrations of micronutrients and lower urinary tract symptoms in older men in the Third National Health and Nutrition Examination Survey

Objectives To evaluate the association of serum micronutrients with lower urinary tract symptoms (LUTS). Methods We included 2497 men, 60 years old and older, who participated in the Third National Health and Nutrition Examination Survey from 1988 to 1994 and for whom serum concentrations of vitamins A, C, and E, carotenoids, and selenium had been measured previously. Cases were men with three or four of the following symptoms: nocturia, hesitancy, incomplete emptying, and weak stream, but who had never undergone noncancer prostate surgery. Controls were men without symptoms, who had never undergone noncancer prostate surgery. We adjusted for age and race in logistic regression models and used sampling weights. Results Serum concentrations of vitamin E (P = 0.03), lycopene (P = 0.06), and selenium (P = 0.03) were lower in men with LUTS compared with controls. Men in the top four quintiles of vitamin E, lycopene, and selenium had a nonstatistically significant 25% to 50% reduced odds of LUTS compared with men in the bottom quintile. Inverse associations were not seen for the other carotenoids or vitamin A. A high serum vitamin C concentration was associated with a lower odds of LUTS in current smokers, but with a nonstatistically significant greater odds in those who never smoked and in former smokers. Conclusions Greater circulating concentrations of vitamin E, lycopene, and selenium, antioxidant micronutrients that are supported in published reports as protecting against prostate cancer, were observed also to be inversely associated with LUTS. The effect modification of the association with vitamin C by cigarette smoking warrants additional examination.