Bouwman Inge I, Blanker Marco H, Schouten Boris W V, Bohnen Arthur M, Nijman Rien J M, van der Heide Wouter K, Bosch J L H Ruud
Department of General Practice, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands,
World J Urol. 2015 May;33(5):669-76. doi: 10.1007/s00345-014-1398-y. Epub 2014 Sep 25.
To describe the association between lower urinary tract symptoms (LUTS) and cardiovascular diseases (CVD), with adjustment for age and other confounders. We were specifically interested in the possible predictive value of LUTS to the incidence of CVD in the future in the general population.
We performed post hoc analyses using data from the Krimpen study, a large community-based study in the Netherlands. All men aged 50-75 years, without prostate or bladder cancer, a history of radical prostatectomy, or neurogenic bladder disease, were invited to participate for a response rate of 50%. At baseline, 1,610 men were included. CVD status was compared to LUTS category, using logistic regression, providing odds ratios with 95% confidence intervals (OR 95% CI). For the longitudinal analyses in men without CVD at baseline, hazard ratios (HR) and 95% CI were estimated using Cox proportional hazard models with the occurrence of a CVD as outcome variable.
At baseline, 362 men (22%) had a history of CVD. The ORs for CVD for men with moderate to severe LUTS were 2.04 (unadjusted, 95% CI 1.58-2.63), 1.86 (1.43-2.41, adjusted for age), and 1.81 (1.38-2.37, adjusted for age and other confounders). Of the 1,248 CVD-free men, 58 (4.6%) had a CVD event. HRs for moderate to severe LUTS were 0.98 (95% CI 0.52-1.86, unadjusted) and 1.08 (0.57-2.07, adjusted for age, obesity, hypertension, and erectile dysfunction).
The cross-sectional analyses revealed a clear correlation between moderate to severe LUTS and CVD. In longitudinal analyses, however, no significant association was shown.
描述下尿路症状(LUTS)与心血管疾病(CVD)之间的关联,并对年龄和其他混杂因素进行校正。我们特别关注LUTS对未来一般人群中CVD发病率的可能预测价值。
我们使用来自荷兰一项大型社区研究——克林彭研究的数据进行事后分析。邀请所有年龄在50 - 75岁、无前列腺癌或膀胱癌、无根治性前列腺切除术史或神经源性膀胱疾病的男性参与,应答率为50%。基线时,纳入了1610名男性。使用逻辑回归将CVD状态与LUTS类别进行比较,提供比值比及95%置信区间(OR 95% CI)。对于基线时无CVD的男性进行纵向分析,以CVD的发生作为结局变量,使用Cox比例风险模型估计风险比(HR)和95% CI。
基线时,362名男性(22%)有CVD病史。中重度LUTS男性患CVD的未校正OR为2.04(95% CI 1.58 - 2.63),校正年龄后的OR为1.86(1.43 - 2.41),校正年龄和其他混杂因素后的OR为1.81(1.38 - 2.37)。在1248名无CVD的男性中,58名(4.6%)发生了CVD事件。中重度LUTS的未校正HR为0.98(95% CI 0.52 - 1.86),校正年龄、肥胖、高血压和勃起功能障碍后的HR为1.08(0.57 - 2.07)。
横断面分析显示中重度LUTS与CVD之间存在明显相关性。然而,纵向分析未显示出显著关联。