Abstract
Arthritis and Lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH) are both common chronic conditions among middle-aged and elderly men in China. Currently, evidence regarding the association between these two conditions remains limited. This study utilized data from the 2011 China Health and Retirement Longitudinal Study (CHARLS), including 4,446 Chinese men aged 40 years and older, among whom 3,136 participants completed follow-up assessments in 2018. In the 2011 cross-sectional analysis, multivariable logistic regression prior to propensity score matching (PSM) indicated that individuals with arthritis had a higher risk of LUTS/BPH than those without arthritis (OR = 1.483, P < 0.001). Univariate logistic regression analysis after PSM further demonstrated that patients with arthritis had a significantly increased risk of developing LUTS/BPH compared to matched controls (OR = 1.530, P = 0.002). In the longitudinal cohort study, multivariable logistic regression before PSM showed that arthritis patients had a significantly increased risk of incident LUTS/BPH after seven years of follow-up (OR = 1.531, P < 0.001). Univariate logistic regression after PSM similarly showed an elevated risk of incident LUTS/BPH in arthritis patients compared to controls (OR = 1.634, P < 0.001). Arthritis significantly increases the risk of developing LUTS/BPH among middle-aged and elderly men in China. Prospective cohort studies and mechanistic investigations are urgently needed to further validate the association between the two. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-025-28671-6.