Obayashi Kenji, Saeki Keigo, Negoro Hiromitsu, Kurumatani Norio
Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
BJU Int. 2017 Aug;120(2):280-285. doi: 10.1111/bju.13791. Epub 2017 Feb 17.
To evaluate the association between nocturia and the incidence of depressive symptoms.
Of 1 127 participants in the HEIJO-KYO population-based cohort, 866 elderly individuals (mean age 71.5 years) without depressive symptoms at baseline were followed for a median period of 23 months. Nocturnal voiding frequency was logged using a standardized urination diary and nocturia was defined as a frequency of ≥2 voids per night. Depressive symptoms were assessed using the Geriatric Depression Scale.
During the follow-up period, 75 participants reported the development of depressive symptoms (score ≥6). The nocturia group (n = 239) exhibited a significantly higher hazard ratio (HR) for incident depressive symptoms than the non-nocturia group (n = 627) in the Cox proportional hazard model, which was adjusted for age, gender, alcohol consumption, day length and presence of hypertension and chronic kidney disease (HR 1.69, 95% confidence interval [CI] 1.05-2.72; P = 0.032]. The significance remained after adjustment for sleep disturbances (HR 1.68, 95% CI 1.02-2.75; P = 0.040). Analysis stratified by gender showed that the association between nocturia and the incidence of depressive symptoms was significant in men (HR 2.51, 95% CI 1.27-4.97; P = 0.008) but not in women (HR 1.12, 95% CI 0.53-2.44; P = 0.74).
Nocturia is significantly associated with a higher incidence of depressive symptoms in the general elderly population, and gender differences may underlie this association.
评估夜尿症与抑郁症状发生率之间的关联。
在基于平成京都市人群的队列研究中的1127名参与者里，866名基线时无抑郁症状的老年人（平均年龄71.5岁）被随访了23个月的中位数时间。使用标准化排尿日记记录夜间排尿频率，夜尿症定义为每晚排尿次数≥2次。使用老年抑郁量表评估抑郁症状。
在随访期间，75名参与者报告出现了抑郁症状（得分≥6）。在Cox比例风险模型中，夜尿症组（n = 239）发生抑郁症状的风险比（HR）显著高于非夜尿症组（n = 627），该模型对年龄、性别、饮酒量、日照时长以及高血压和慢性肾脏病的存在情况进行了调整（HR 1.69，95%置信区间[CI] 1.05 - 2.72；P = 0.032）。在对睡眠障碍进行调整后，该显著性仍然存在（HR 1.68，95% CI 1.02 - 2.75；P = 0.040）。按性别分层分析显示，夜尿症与抑郁症状发生率之间的关联在男性中显著（HR 2.51，95% CI 1.27 - 4.97；P = 0.008），而在女性中不显著（HR 1.12，95% CI 0.53 - 2.44；P = 0.74）。
夜尿症与普通老年人群中抑郁症状的较高发生率显著相关，性别差异可能是这种关联的基础。
