Group Health Research Institute, Group Health Cooperative, Seattle, Washington 98101, USA.
J Urol. 2010 Aug;184(2):564-9. doi: 10.1016/j.juro.2010.03.139. Epub 2010 Jun 19.
Recurrent urinary tract infections and pyelonephritis have risk factors suggesting genetic sources. Family history variables indicative of genetic risk merit further investigation. We evaluated the risk of recurrent cystitis and pyelonephritis in women with and those without a family history of urinary tract infection.
We conducted a population based case-control study of 1,261 women 18 to 49 years old enrolled in a Northwest health plan. Participants were cases identified from plan databases with documented recurrent cystitis (431) or pyelonephritis (400). Shared controls (430) were similar age women with no urinary tract infection history. We evaluated the history of urinary tract infection and pyelonephritis in first-degree female relatives (mother, sister[s], daughter[s]) and other covariates, ascertained through questionnaires and computerized databases.
Of the cases 70.9% with recurrent cystitis and 75.2% with pyelonephritis, and of the controls 42.4% reported a urinary tract infection history in 1 or more female relative (p <0.001 for each case group vs controls). In both case groups odds ratios were significantly increased for women reporting a urinary tract infection history in their mother, sister(s) or daughter(s). Risk increased with a greater number of affected relatives. In women with 1 vs 2 or more relatives the ORs for recurrent cystitis were 3.1 (95% CI 2.1, 4.7) and 5.0 (3.1, 8.1), and the ORs for pyelonephritis were 3.3 (2.2, 5.0) and 5.5 (3.4, 9.0), respectively.
In these community dwelling women a urinary tract infection history in female relatives was strongly and consistently associated with urinary tract infection recurrence and pyelonephritis. Risk estimates increased with stronger family history indices, suggesting a genetic component for increased susceptibility to these infections.
复发性尿路感染和肾盂肾炎有提示遗传来源的危险因素。提示遗传风险的家族史变量值得进一步研究。我们评估了有和没有尿路感染家族史的女性中复发性膀胱炎和肾盂肾炎的风险。
我们对参加西北健康计划的 1261 名 18 至 49 岁的女性进行了基于人群的病例对照研究。通过计划数据库确定病例，这些病例有记录的复发性膀胱炎（431 例）或肾盂肾炎（400 例）。年龄相似且无尿路感染史的共享对照者（430 例）。我们通过问卷调查和计算机数据库评估了一级女性亲属（母亲、姐妹、女儿）的尿路感染和肾盂肾炎病史以及其他混杂因素。
70.9%的复发性膀胱炎病例和 75.2%的肾盂肾炎病例以及 42.4%的对照组报告在 1 个或多个女性亲属中发生尿路感染（每个病例组与对照组相比均为 p<0.001）。在两个病例组中，报告母亲、姐妹或女儿有尿路感染史的女性的比值比均显著增加。风险随受影响亲属数量的增加而增加。在有 1 个或更多亲属的女性中，复发性膀胱炎的 OR 分别为 3.1（95%CI 2.1，4.7）和 5.0（3.1，8.1），肾盂肾炎的 OR 分别为 3.3（2.2，5.0）和 5.5（3.4，9.0）。
在这些居住在社区的女性中，女性亲属的尿路感染史与尿路感染复发和肾盂肾炎强烈且一致相关。风险估计值随家族史指数的增强而增加，表明易感性增加与遗传因素有关。
