Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA.
J Gen Intern Med. 2020 Aug;35(8):2281-2288. doi: 10.1007/s11606-020-05814-1. Epub 2020 Apr 28.
Lower urinary tract symptoms (LUTS), often secondary to benign prostatic hyperplasia, are a common problem for older men. Lifestyle factors, including physical activity and sedentariness, may be important LUTS risk factors and suitable targets for intervention.
To determine whether physical activity and sedentariness are associated with LUTS incidence and progression.
The Health Professionals Follow-up Study is a prospective cohort of men that began in 1986. Follow-up for LUTS is complete through 2008.
Men aged 40-75 years at enrollment and members of health professions.
Total weekly metabolic equivalent of task (MET)-hour scores were calculated and were categorized (< 9, 9 to < 21, 21 to < 42, 42 to < 63, ≥ 63 MET-hours/week). Participants reported their average time/week spent sitting watching television as a measure of sedentariness, which was categorized (< 1, 1-3, 4-10, 11-29, ≥ 30 h/week). Participants completed the International Prostate Symptom Score survey and reported treatments for LUTS periodically. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) of physical activity and television watching with LUTS incidence and progression.
After multivariable adjustment, including for body mass index (BMI), men with the highest physical activity were 19% (HR = 0.81, 95% CI = 0.74-0.89; p trend < 0.0001) less likely to develop incident moderate or worse LUTS than men in the lowest category. Men who watched television ≥ 30 h/week were 24% (HR = 1.24, 95% CI = 1.05-1.45; p trend = 0.004) more likely to develop incident moderate or worse LUTS than men who watched < 1 h/week. These associations persisted after mutual adjustment. We observed no associations with LUTS progression.
In this large prospective study, more activity and less sedentariness were associated with lower risk of incident LUTS independent of one another and BMI. Physical inactivity and sedentariness were not associated with LUTS worsening. Increasing physical activity and reducing sedentariness may be strategies for preventing LUTS in addition to their well-established benefits for other diseases.
下尿路症状（LUTS）常继发于良性前列腺增生，是老年男性的常见问题。生活方式因素，包括体力活动和久坐不动，可能是重要的 LUTS 危险因素，也是适合干预的目标。
确定体力活动和久坐不动与 LUTS 的发生和进展是否相关。
健康专业人员随访研究是一项针对男性的前瞻性队列研究，始于 1986 年。通过 2008 年完成了对 LUTS 的随访。
入组时年龄在 40-75 岁且为健康职业的男性。
计算总每周代谢当量任务（MET）小时数，并将其分类（<9、9 至 <21、21 至 <42、42 至 <63、≥63 MET 小时/周）。参与者报告他们每周平均花在看电视上的时间作为久坐不动的衡量标准，将其分为（<1、1-3、4-10、11-29、≥30 h/周）。参与者完成了国际前列腺症状评分调查，并定期报告 LUTS 的治疗情况。使用 Cox 比例风险回归估计多变量调整后的体力活动和看电视与 LUTS 发生和进展的风险比（HR）。
在多变量调整后，包括体重指数（BMI），体力活动最高的男性发生中重度 LUTS 的风险比最低组男性低 19%（HR=0.81，95%CI=0.74-0.89；p 趋势<0.0001）。每周看电视≥30 小时的男性发生中重度 LUTS 的风险比每周看电视<1 小时的男性高 24%（HR=1.24，95%CI=1.05-1.45；p 趋势=0.004）。这些关联在相互调整后仍然存在。我们没有观察到与 LUTS 进展相关的关联。
在这项大型前瞻性研究中，更多的活动和更少的久坐不动与独立于 BMI 的较低的 LUTS 发生风险相关。身体活动不足和久坐不动与 LUTS 恶化无关。增加体力活动和减少久坐不动可能是预防 LUTS 的策略，此外，它们对其他疾病也有明确的益处。
