A growing body of evidence suggests an inextricable relationship between lower urinary tract symptoms (LUTS) and chronic disease. A strong relationship between lower urinary tract symptoms and the development of type 2 diabetes and heart disease has been reported earlier. Recently, Varant et al. from the New England Institute in Massachusetts studied the relationship between lower urinary tract symptoms and type 2 diabetes and heart disease, suggesting that lower urinary tract symptoms in obese people increase the risk of type 2 diabetes and heart disease, and that lower urinary tract symptoms in young men and women (<50 years) predict the development of type 2 diabetes. Journal of Urology. The researchers used the American Urological Association Symptom Index (AUA-SI), urinary voiding and storage fractions to assess subjects' lower urinary tract symptoms, and type 2 diabetes and heart disease on the basis of patient self-report, while regression analysis was used to assess the corresponding ratio (OR) and to correct for potential confounders. The ORs for heart disease in subjects with a body mass index (BMI) ≥30 kg/m2 were 1.89 for those with an AUA-SI ≥8 and 2.32 for those with a urine storage fraction ≥4. The ORs for type 2 diabetes in subjects with abdominal obesity were 2.06 for those with an AUA-SI ≥8 and 1.81 for those with a urine storage fraction ≥4. The ORs for the occurrence of type 2 diabetes were 1.81. Lower urinary tract symptoms (AUA-SI ≥8) predicted the occurrence of type 2 diabetes in men and women aged <50 years (corrected OR of 2.37). Analysis of the BACH data showed that lower urinary tract symptoms increased the risk of type 2 diabetes and heart disease in obese men and women, whereas no such association was shown in the non-obese population. It also predicted the development of early type 2 diabetes in people younger than 50 years of age. In lower urinary tract symptoms, altered urinary storage function (rather than voiding-related symptoms) can contribute to the development of type 2 diabetes and heart disease. These results suggest that lower urinary tract symptoms, especially urinary storage-related symptoms, can be a "sentinel" for increased risk of obesity-related cardiometabolic disease. Lower urinary tract symptoms may provide richer information for early intervention and assessment of altered risk factors for these diseases, such as fasting glucose and lipid levels.