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饮用含咖啡因、碳酸或柑橘类饮料的类型与男性和女性下尿路症状的发展。

Intake of caffeinated, carbonated, or citrus beverage types and development of lower urinary tract symptoms in men and women.

机构信息

Department of Epidemiology, New England Research Institutes, Watertown, Massachusetts 02472, USA.

出版信息

Am J Epidemiol. 2013 Jun 15;177(12):1399-410. doi: 10.1093/aje/kws411. Epub 2013 May 30.

Abstract

Evidence to substantiate recommendations for restriction of caffeinated or acidic beverages as self-management for lower urinary tract symptoms (LUTS) is limited. We examined longitudinal and acute associations between beverage intake and LUTS in the Boston Area Community Health (BACH) cohort (n = 4,144) between 2002 and 2010. Multivariable models tested associations between baseline intakes and progression of LUTS at 5-year follow-up, between follow-up intakes and International Prostate Symptom Scores at follow-up, and between 5-year intake changes and LUTS progression. Greater coffee or total caffeine intake at baseline increased the odds of LUTS progression in men (coffee: >2 cups/day vs. none, odds ratio = 2.09, 95% confidence interval: 1.29, 3.40, P-trend = 0.01; caffeine: P-trend < 0.001), particularly storage symptoms. Women who increased coffee intake by at least 2 servings/day during follow-up (compared with categories of decreased or unchanged intakes) had 64% higher odds of progression of urgency (P = 0.003). Women with recently increased soda intake, particularly caffeinated diet soda, had higher symptom scores, urgency, and LUTS progression. Citrus juice intake was associated with 50% lower odds of LUTS progression in men (P = 0.02). Findings support recommendations to limit caffeinated beverage intake for LUTS, and in men, they suggest benefits of citrus juice consumption. Further clinical research is warranted, particularly of the precise role of sodas containing artificial sweeteners in bladder sensations and urological function.

摘要

没有证据表明限制饮用含咖啡因或酸性的饮料可以作为下尿路症状(LUTS)的自我管理方法。我们在 2002 年至 2010 年间,对波士顿地区社区健康(BACH)队列(n=4144)进行了纵向和急性研究,考察了饮料摄入与 LUTS 之间的关系。多变量模型检验了基线摄入与 5 年随访时 LUTS 进展、随访摄入与随访时国际前列腺症状评分(IPSS)之间的相关性,以及 5 年摄入变化与 LUTS 进展之间的相关性。与不喝咖啡相比,男性中较高的基线咖啡或总咖啡因摄入量(咖啡:>2 杯/天与无,比值比=2.09,95%置信区间:1.29,3.40,P 趋势=0.01;咖啡因:P 趋势<0.001),特别是储存症状,会增加发生 LUTS 进展的几率。与摄入减少或不变的组别相比,女性在随访期间增加至少 2 份咖啡摄入量(与减少或不变的摄入量相比),发生尿急进展的几率增加了 64%(P=0.003)。近期苏打水摄入增加,尤其是含咖啡因的苏打水,女性的症状评分、尿急和 LUTS 进展更高。与不喝或减少摄入的组别相比,男性中摄入更多橙汁会使发生 LUTS 进展的几率降低 50%(P=0.02)。研究结果支持限制含咖啡因饮料摄入以治疗 LUTS,且对于男性,建议饮用橙汁。需要进一步的临床研究,特别是研究含有人工甜味剂的苏打水对膀胱感觉和泌尿科功能的确切作用。

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