Relationship of Growth Differentiation Factor-15, E-Cadherin, Galectin-3, and Psychological Stress with Quality of Life and Prostate Size in Benign Prostatic Hyperplasia

Sep 29, 2026

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Inflammation and oxidative stress contribute to benign prostatic hyperplasia (BPH) pathogenesis, yet the interplay among psychological stress, oxidative stress, and inflammation in prostate enlargement remains insufficiently defined. This study evaluates how growth differentiation factor-15 (GDF-15), E-cadherin, galectin-3, and psychological stress relate to quality of life (QOL) and prostate size in BPH patients. Data from 82 cases link cell adhesion/inflammation markers and stress measures with symptom burden and QOL.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Objective

Methods

Results

Conclusion

Introduction

Background on BPH and QOL

Role of psychological stress and inflammation

Rationale for GDF-15, galectin-3, and E-cadherin

Study aim

UROLOGY RESEARCH & PRACTICE ORIGINAL ARTICLE General Urology Urology Research and Practice 2025;51(5):173-178 DOI: 10.5152/tud.2025.24189 Relationship of Growth Differentiation Factor-15, E-Cadherin, Galectin-3, and Psychological Stress with Quality of Life and Prostate Size in Benign Prostatic Hyperplasia ABSTRACT Objective: Inflammation and oxidative stress are involved in the pathogenesis of benign prostatic hyperplasia (BPH). The relationship of psychological stress, oxidative stress, and inflammation with prostate enlargement is unclear. The objective of the study was to investigate the relationship of growth differentiation factor-15 (GDF-15), E-cadherin, galectin-3 and psychological stress with quality of life (QOL) and prostate size in BPH patients. Methods: Eighty-two BPH cases were included in the study. Growth differentiation factor-15, galectin-3, and E-cadherin were analyzed in all the subjects. Perceived Stress Scale-10 (PSS-10) was used to analyse psychological stress. Quality of life score due to urinary symptoms was based on a single question recommended by the International Consensus Committee, and its answer range from delighted (score-0) to terrible (score-6) Results: E-cadherin (P = .014), galectin-3 (P = .004), QOL score (P = .024) and PSS-10 score (P = .001) were higher in BPH cases with increased prostate size. Growth differentiation factor-15 was lower in BPH patients with higher PSS-10 score (P = .036) and higher QOL score (P = .016) . Growth differentiation factor-15 was negatively associated with International Prostate Symptom Score (IPSS) score (r = −0.314, P = .004), QOL (r = −0.284, P = .009), and PSS-10 score (r = −0.031, P = .001) . Prostate size was positively associated with E-cadherin (r =0.317, P = .003), galectin-3 (r =0.243, P = .026), IPSS (r =0.301, P = .005) and QOL score (r =0.237, P = .030). Also, a significant correlation was observed between E-cadherin and galectin-3 (r =0.292, P = .007). Growth differentiation factor-15 (P = .018) and E-cadherin (P = .029) were found to predict QOL and E-cadherin (P = .013) was found to predict prostate size in BPH. Conclusion: E-cadherin can predict prostate enlargement and along with GDF-15, can predict QOL in BPH. Keywords: Benign prostatic hyperplasia, growth differentiation factor, inflammation, perceived stress Introduction Benign prostatic hyperplasia (BPH), a prevalent disorder among men with advanced age, significantly impacts the quality of life (QOL) .1 Earlier researchers have documented an inverse relation between BPH symptoms and QOL and concluded that BPH affects QOL by inducing psychological stress.2 Psychological stress was reported to be involved in the development of tumors through alteration of endocrine mechanisms.3 Earlier studies have found that stress was associated with BPH.4 Inflammation is known to be involved in prostate enlargement.5 Copyright @ Author(s)– Available online at [http://urologyresearchandpractice.org/](http://urologyresearchandpractice.org/) Content of this journal is licensed under a Creative Commons Attribution (CC BY) 4.0 International License. Palani Balamurali Hanumanthappa Nandeesha Sreerag K Sreenivasan Department of Biochemistry and Urology, JIPMER, Puducherry, India Corresponding author: Hanumanthappa Nandeesha 􀀍 [nandijipmer@gmail.com](nandijipmer@gmail.com) [Received:](Received: December 21)[ December 21](Received: December 21), 2024 Revision Requested: August 13, 2025 Last Revision Received: October 9, 2025 Accepted: October 13, 2025 Publication Date: December 5, 2025 Cite this article as: Balamurali P, Nandeesha H, Sreenivasan SK. Relationship of growth differentiation factor-15, E-cadherin, galectin-3, and psychological stress with quality of life and prostate size in benign prostatic hyperplasia. Urol Res Pract. 2025;51(5):173-178 . 173 Urology Research and Practice 2025;51(5):173-178 Balamurali et al. Stress and Inflammation in BPH

FAQs

What was the objective of the study in BPH patients?

To investigate how growth differentiation factor-15 (GDF-15), E-cadherin, galectin-3, and psychological stress relate to quality of life (QOL) and prostate size in benign prostatic hyperplasia.

How were psychological stress and quality of life measured?

Psychological stress was assessed using the Perceived Stress Scale-10 (PSS-10). QOL related to urinary symptoms used a single question with a score range from delighted (0) to terrible (6).

What associations were found between prostate size, biomarker levels, and symptoms?

Prostate size showed positive associations with E-cadherin, galectin-3, International Prostate Symptom Score (IPSS), and QOL score. A significant correlation was also observed between E-cadherin and galectin-3.

Sep 29, 2026

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