Tsujimura Akira, Hiramatsu Ippei, Aoki Yusuke, Shimoyama Hirofumi, Mizuno Taiki, Nozaki Taiji, Shirai Masato, Kobayashi Kazuhiro, Kumamoto Yoshiaki, Horie Shigeo
Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.
Men's Health Clinic Tokyo, Marunouchi Chiyoda-ku, Tokyo, Japan.
Prostate Int. 2017 Jun;5(2):65-69. doi: 10.1016/j.prnil.2017.01.006. Epub 2017 Feb 13.
Atherosclerosis is a systematic disease in which plaque builds up inside the arteries that can lead to serious problems related to quality of life (QOL). Lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and late-onset hypogonadism (LOH) are highly prevalent in aging men and are significantly associated with a reduced QOL. However, few questionnaire-based studies have fully examined the relation between atherosclerosis and several urological symptoms.
The study comprised 303 outpatients who visited our clinic with symptoms of LOH. Several factors influencing atherosclerosis, including serum concentrations of triglyceride, fasting blood sugar, and total testosterone measured by radioimmunoassay, were investigated. We also measured brachial-ankle pulse wave velocity (baPWV) and assessed symptoms by specific questionnaires, including the Sexual Health Inventory for Men (SHIM), Erection Hardness Score (EHS), International Prostate Symptom Score (IPSS), QOL index, and Aging Male Symptoms rating scale (AMS). Stepwise associations between the ratio of measured/age standard baPWV and clinical factors including laboratory data and the scores of the questionnaires were compared using the Jonckheere-Terpstra test for trend. The associations between the ratio of measured/age standard baPWV and each IPSS score were assessed in a multivariate linear regression model after adjustment for serum triglyceride, fasting blood sugar, and total testosterone.
Regarding ED, a higher level of the ratio of measured/age standard baPWV was associated with a lower EHS, whereas no association was found with SHIM. Regarding LUTS, a higher ratio of measured/age standard baPWV was associated with a higher IPSS and QOL index. However, there was no statistically significant difference between the ratio of measured/age standard baPWV and AMS. A multivariate linear regression model showed only nocturia to be associated with the ratio of measured/age standard baPWV for each IPSS score.
Atherosclerosis is associated with erectile function and LUTS, especially nocturia.
动脉粥样硬化是一种系统性疾病，动脉内会形成斑块，这可能导致与生活质量（QOL）相关的严重问题。下尿路症状（LUTS）、勃起功能障碍（ED）和迟发性性腺功能减退（LOH）在老年男性中非常普遍，并且与生活质量下降显著相关。然而，很少有基于问卷的研究全面探讨动脉粥样硬化与几种泌尿系统症状之间的关系。
该研究纳入了303名因LOH症状前来我们诊所就诊的门诊患者。研究调查了影响动脉粥样硬化的几个因素，包括通过放射免疫法测量的甘油三酯血清浓度、空腹血糖和总睾酮。我们还测量了肱踝脉搏波速度（baPWV），并通过特定问卷评估症状，包括男性性健康量表（SHIM）、勃起硬度评分（EHS）、国际前列腺症状评分（IPSS）、生活质量指数和老年男性症状评定量表（AMS）。使用Jonckheere-Terpstra趋势检验比较测量的/年龄标准化baPWV比值与包括实验室数据和问卷分数在内的临床因素之间的逐步关联。在对血清甘油三酯、空腹血糖和总睾酮进行调整后，在多变量线性回归模型中评估测量的/年龄标准化baPWV比值与每个IPSS评分之间的关联。
关于勃起功能障碍，测量的/年龄标准化baPWV比值较高与较低的EHS相关，而与SHIM未发现关联。关于下尿路症状，测量的/年龄标准化baPWV比值较高与较高的IPSS和生活质量指数相关。然而，测量的/年龄标准化baPWV比值与AMS之间没有统计学上的显著差异。多变量线性回归模型显示，对于每个IPSS评分，仅夜尿症与测量的/年龄标准化baPWV比值相关。
动脉粥样硬化与勃起功能和下尿路症状相关，尤其是夜尿症。
