Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37203-1738, USA.
J Urol. 2011 Dec;186(6):2316-22. doi: 10.1016/j.juro.2011.07.067. Epub 2011 Oct 20.
Obesity and physical activity have been posited as modifiable risk factors to delay lower urinary tract symptom progression. In this study we determined the independent associations of physical activity and obesity with lower urinary tract symptoms at followup among white and African-American men.
Male participants 40 to 79 years old were identified from the Southern Community Cohort Study, a prospective cohort based in the southeastern United States. Baseline data collection included a validated physical activity questionnaire, height and weight, health history and other information. We excluded participants with a history of or medication use for benign prostatic hyperplasia or prostate cancer. Participants (7,318, 60% African-American) completed the International Prostate Symptom Score approximately 5 years after baseline. Patients with an International Prostate Symptom Score greater than 8 or 20 were classified as having moderate or severe lower urinary tract symptoms, respectively, at followup. Multivariable logistic regression was used to assess the relationships among obesity, physical activity and lower urinary tract symptoms.
Moderate to severe lower urinary tract symptom severity at followup was significantly associated with a body mass index of 35 kg/m(2) or more (OR 1.38, 95% CI 1.17-1.63). Similarly the lowest categories of physical activity were associated with the onset of severe lower urinary tract symptoms in men with a normal body mass index (OR 1.38, 95% CI 1.05-1.82). These associations were independent of race.
Severe obesity is associated with an increased risk of lower urinary tract symptoms at followup, while physical inactivity may permit progression of lower urinary tract symptoms in normal weight men regardless of race. These variables should be considered in future research into modifiable risk factors for lower urinary tract symptoms.
肥胖和身体活动已被认为是可改变的风险因素，可以延缓下尿路症状的进展。本研究旨在确定身体活动和肥胖与随访中白种人和非裔美国男性下尿路症状之间的独立相关性。
从南方社区队列研究中确定了 40 至 79 岁的男性参与者，这是一项在美国东南部进行的前瞻性队列研究。基线数据收集包括经过验证的身体活动问卷、身高和体重、健康史和其他信息。我们排除了患有或正在使用良性前列腺增生或前列腺癌药物的参与者。大约在基线后 5 年，参与者（7318 人，60%为非裔美国人）完成了国际前列腺症状评分。国际前列腺症状评分大于 8 或 20 的患者分别被归类为随访时存在中度或重度下尿路症状。多变量逻辑回归用于评估肥胖、身体活动与下尿路症状之间的关系。
随访时中度至重度下尿路症状严重程度与体重指数 35kg/m2 或更高显著相关（OR 1.38，95%CI 1.17-1.63）。同样，身体活动的最低类别与正常体重指数男性严重下尿路症状的发生相关（OR 1.38，95%CI 1.05-1.82）。这些关联与种族无关。
严重肥胖与随访时下尿路症状风险增加相关，而身体活动不足可能导致正常体重男性下尿路症状的进展，无论种族如何。这些变量应在下尿路症状的可改变风险因素的未来研究中加以考虑。
