106435名澳大利亚中老年男性的生活方式、健康因素与严重下尿路症状（LUTS）之间的关系：基于人群的研究
Relationship between lifestyle and health factors and severe lower urinary tract symptoms (LUTS) in 106,435 middle-aged and older Australian men: population-based study.
作者信息
Smith David P, Weber Marianne F, Soga Kay, Korda Rosemary J, Tikellis Gabriella, Patel Manish I, Clements Mark S, Dwyer Terry, Latz Isabel K, Banks Emily
机构信息
Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia; Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia.
Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia; School of Public Health, Sydney University, Sydney, New South Wales, Australia.
出版信息
PLoS One. 2014 Oct 15;9(10):e109278. doi: 10.1371/journal.pone.0109278. eCollection 2014.
BACKGROUND
Despite growing interest in prevention of lower urinary tract symptoms (LUTS) through better understanding of modifiable risk factors, large-scale population-based evidence is limited.
OBJECTIVE
To describe risk factors associated with severe LUTS in the 45 and Up Study, a large cohort study.
DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional analysis of questionnaire data from 106,435 men aged ≥ 45 years, living in New South Wales, Australia.
OUTCOME MEASURES AND STATISTICAL ANALYSIS
LUTS were measured by a modified version of the International Prostate Symptom Score (m-IPSS). The strength of association between severe LUTS and socio-demographic, lifestyle and health-related factors was estimated, using logistic regression to calculate odds ratios, adjusted for a range of confounding factors.
RESULTS
Overall, 18.3% reported moderate, and 3.6% severe, LUTS. Severe LUTS were more common among men reporting previous prostate cancer (7.6%), total prostatectomy (4.9%) or having part of the prostate removed (8.2%). After excluding men with prostate cancer or prostate surgery, the prevalence of moderate-severe LUTS in the cohort (n = 95,089) ranged from 10.6% to 35.4% for ages 45-49 to ≥ 80; the age-related increase was steeper for storage than voiding symptoms. The adjusted odds of severe LUTS decreased with increasing education (tertiary qualification versus no school certificate, odds ratio (OR = 0.78 (0.68-0.89))) and increasing physical activity (high versus low, OR = 0.83 (0.76-0.91)). Odds were elevated among current smokers versus never-smokers (OR = 1.64 (1.43-1.88)), obese versus healthy-weight men (OR = 1.27 (1.14-1.41)) and for comorbid conditions (e.g., heart disease versus no heart disease, OR = 1.36 (1.24-1.49)), and particularly for severe versus no physical functional limitation (OR = 5.17 (4.51-5.93)).
CONCLUSIONS
LUTS was associated with a number of factors, including modifiable risk factors, suggesting potential targets for prevention.
背景
尽管通过更好地了解可改变的风险因素来预防下尿路症状（LUTS）的兴趣日益浓厚，但基于大规模人群的证据有限。
目的
在一项大型队列研究“45岁及以上研究”中描述与严重LUTS相关的风险因素。
设计、背景和参与者：对来自澳大利亚新南威尔士州106435名年龄≥45岁男性的问卷数据进行横断面分析。
结局指标和统计分析
使用国际前列腺症状评分（m-IPSS）的修订版测量LUTS。采用逻辑回归计算比值比，并针对一系列混杂因素进行调整，以估计严重LUTS与社会人口统计学、生活方式和健康相关因素之间的关联强度。
结果
总体而言，18.3%的人报告有中度LUTS，3.6%的人报告有严重LUTS。严重LUTS在报告既往有前列腺癌（7.6%）、全前列腺切除术（4.9%）或部分前列腺切除术（8.2%）的男性中更为常见。在排除患有前列腺癌或接受过前列腺手术的男性后，该队列（n = 95089）中中度至重度LUTS的患病率在45-49岁至≥80岁人群中为10.6%至35.4%；与储尿症状相比，排尿症状随年龄增长的增幅更大。严重LUTS的校正比值随教育程度提高（大专学历与无学历证书相比，比值比（OR）= 0.78（0.68-0.89））和体力活动增加（高与低相比，OR = 0.83（0.76-0.91））而降低。当前吸烟者与从不吸烟者相比（OR = 1.64（1.43-1.88））、肥胖男性与健康体重男性相比（OR = 1.27（1.14-1.41））以及患有合并症者（如心脏病与无心脏病相比，OR = 1.36（1.24-1.49））的比值升高，尤其是严重身体功能受限者与无身体功能受限者相比（OR = 5.17（4.51-5.93））。
结论
LUTS与多种因素相关，包括可改变的风险因素，提示有潜在的预防靶点。
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