The Pelvic Floor Unit, Department of Urogynaecology, University of New South Wales at St. George Hospital, Kogarah, New South Wales, Australia.
National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, UNSW, Sydney, New South Wales, Australia.
Neurourol Urodyn. 2018 Nov;37(8):2827-2832. doi: 10.1002/nau.23784. Epub 2018 Aug 14.
The mechanisms leading to the development of detrusor overactivity (DO) are still relatively poorly understood, however, animal studies suggest that atherosclerosis and reduced blood flow to the bladder may be one etiological pathway. Thus, the aim of this study was to evaluate signs of atherosclerosis in a large cohort of women with detrusor overactivity, using two precise measures of atherosclerotic vascular impairment, Ankle Brachial Index (ABI), and Brachial-ankle Pulse Wave Velocity (baPWV).
A prospective cohort study measuring ABI and baPWV of women with DO and controls was conducted. The ABI and baPWV were measured using an automated oscillometric blood pressure machine, to evaluate the degree of atherosclerosis in patients with DO and controls. Associations between ABI and baPWV and important confounding variables were assessed by a linear regression model.
Ninety-eight women with DO, and 98 controls without any symptoms of DO were studied. Multivariate analysis showed an increase in left baPWV of approximately 96 cm/s units of velocity (95%CI 20.65-172.05, P = 0.01) is predicted significantly by the presence or absence of detrusor overactivity (as well by independent factors of age, diastolic blood pressure and body mass index). A similar effect was seen for right baPWV.
On linear regression modeling, the presence of DO was a strong predictor for an increased PWV when controlling for age, BMI and diastolic blood pressure (DBP), thus supporting the hypothesis that atherosclerosis may contribute to the etiology of DO.
导致膀胱过度活动症(DO)的机制仍知之甚少,然而,动物研究表明,动脉粥样硬化和膀胱血流减少可能是一种病因途径。因此,本研究旨在通过两种精确的血管损伤测量方法,即踝臂指数(ABI)和肱踝脉搏波速度(baPWV),评估大量膀胱过度活动症女性的动脉粥样硬化迹象。
进行了一项前瞻性队列研究,测量 DO 患者和对照组的 ABI 和 baPWV。使用自动示波血压计测量 ABI 和 baPWV,以评估 DO 患者和对照组的动脉粥样硬化程度。通过线性回归模型评估 ABI 和 baPWV 与重要混杂变量之间的相关性。
研究了 98 名 DO 患者和 98 名无 DO 症状的对照组。多变量分析显示,左 baPWV 约增加 96cm/s 速度单位(95%CI 20.65-172.05,P=0.01),这与 DO 的存在或不存在显著相关(以及独立因素年龄、舒张压和体重指数)。右 baPWV 也有类似的效果。
在线性回归模型中,当控制年龄、BMI 和舒张压(DBP)时,DO 的存在是 PWV 增加的一个强有力的预测因素,这支持了动脉粥样硬化可能导致 DO 病因的假设。