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泌尿系统症状在女性中会聚集出现吗?来自波士顿地区社区健康调查的结果。

Do urological symptoms cluster among women? Results from the Boston Area Community Health Survey.

作者信息

Hall Susan A, Cinar Amy, Link Carol L, Kopp Zoe S, Roehrborn Claus G, Kaplan Steven A, Rosen Raymond C

机构信息

New England Research Institutes, Watertown, MA 02472, USA.

出版信息

BJU Int. 2008 May;101(10):1257-66. doi: 10.1111/j.1464-410X.2008.07557.x.

Abstract

OBJECTIVES

To conduct a cluster analysis of urological symptoms among women in the Boston Area Community Health (BACH) Survey, to describe the distribution of urological symptoms within each cluster, and to determine whether comorbidities, demographic characteristics, and lifestyle factors were associated with cluster membership.

SUBJECTS AND METHODS

The BACH Survey is a racially and ethnically diverse random sample (3205 women) of community-dwelling residents of Boston, MA, USA, aged 30-79 years. Fourteen urological symptoms measured by participant self-report (using previously validated scales) were included in this analysis. Cluster analyses were conducted using hierarchical and non-hierarchical (k-means) methods. Within clusters, demographic characteristics, risk factors for urological symptoms and the interference of symptoms with daily activities were also assessed.

RESULTS

Three-quarters of the sample reported at least one urological symptom; four symptom clusters were identified. Most symptomatic women (54%) were assigned to Cluster 1, which was characterized by storage symptoms (nocturia and urinary frequency) with an accompanying low prevalence of other urological symptoms; a second cluster was distinguished by frequency symptoms. Clusters 3 and 4 were characterized by a high prevalence of urinary incontinence and had increased interference scores and more symptoms overall (including voiding and post-voiding symptoms) than the other two clusters. Cluster 4 (8% of symptomatic women) was characterized by a high prevalence of nearly all urological symptoms and the highest interference score. In this most symptomatic cluster, body size and waist circumference were markedly higher, as was the prevalence of diabetes, hypertension and cardiovascular disease than in the other cluster groups or asymptomatic women. Women in Cluster 4 were more likely to be surgically menopausal, or to have had other forms of urogynaecological surgeries than women in the other clusters.

CONCLUSION

Four distinct clusters of urological symptoms were identified among symptomatic women in the BACH Survey, two of which had a high prevalence of urinary incontinence. These cluster patterns provide a novel, empirically-based framework for investigating aetiological mechanisms and management outcomes for common urological symptoms in women.

摘要

目的

在波士顿地区社区健康(BACH)调查中对女性泌尿系统症状进行聚类分析,描述每个聚类中泌尿系统症状的分布情况,并确定合并症、人口统计学特征和生活方式因素是否与聚类归属相关。

对象与方法

BACH调查是对美国马萨诸塞州波士顿30 - 79岁社区居民进行的种族和民族多样化随机抽样(3205名女性)。本分析纳入了通过参与者自我报告(使用先前验证的量表)测量的14种泌尿系统症状。使用层次聚类法和非层次聚类法(k均值法)进行聚类分析。在聚类中,还评估了人口统计学特征、泌尿系统症状的危险因素以及症状对日常活动的干扰。

结果

四分之三的样本报告至少有一种泌尿系统症状;识别出四个症状聚类。大多数有症状的女性(54%)被归入聚类1,其特征为储尿症状(夜尿症和尿频),同时其他泌尿系统症状的患病率较低;第二个聚类以尿频症状为特征。聚类3和聚类4的特征是尿失禁患病率高,与其他两个聚类相比,干扰评分增加且总体症状更多(包括排尿和排尿后症状)。聚类4(占所有有症状女性的8%)的特征是几乎所有泌尿系统症状的患病率都很高,且干扰评分最高。在这个症状最严重的聚类中,体型和腰围明显更高,糖尿病、高血压和心血管疾病的患病率也高于其他聚类组或无症状女性。与其他聚类中的女性相比,聚类4中的女性更有可能接受手术绝经或进行其他形式的泌尿妇科手术。

结论

在BACH调查中有症状的女性中识别出了四个不同的泌尿系统症状聚类,其中两个聚类中尿失禁的患病率很高。这些聚类模式为研究女性常见泌尿系统症状的病因机制和管理结果提供了一个新的、基于实证的框架。

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