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肥胖与膀胱过度活动症:这是体重、脂肪分布还是功能的问题?初步结果。

Obesity and Overactive Bladder: Is It a Matter of Body Weight, Fat Distribution or Function? A Preliminary Results.

机构信息

Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Urology Department, KafrELshiekh University, KafrELshiekh, Egypt.

出版信息

Urology. 2020 Sep;143:91-96. doi: 10.1016/j.urology.2020.04.115. Epub 2020 May 28.

Abstract

OBJECTIVE

To determine the relationship between subcutaneous fat, visceral fat surface area (VFA), bladder wall fat distribution, and visceral adiposity index (VAI) as risk factors for overactive bladder (OAB) occurrence.

PATIENTS AND METHODS

A cross-sectional study involved 157 participants was conducted. The participants were divided into 2 groups; study group (87 patients diagnosed with OAB) and control group (70 healthy participants). All participants were evaluated for OAB using short-form OABSS version. Physical examination including waist circumference (WC) measurement in addition to metabolic laboratory investigations (eg, High density lipoprotein (HDL), cholesterol, etc) were done. Study group underwent urodynamic testing. Using noncontrast spiral CT abdomen and pelvis, trunkal fat measurements and bladder wall fat distribution were detected. VAI was calculated for both females and males. Univariate and multivariate analyses were done to detect risk factors for OAB occurrence. Correlation between all factors and total OABSS and urodynamics was done.

RESULTS

The mean age ± SD was 40.4 ± 9 years. In multivariate analysis, increased VFA, higher cholesterol level, increased VAI and focal fat distribution at bladder wall were associated with 9.4, 1.98, 5.5, and 1.6 times higher risk for OAB occurrence. VAI and VFA were strongly correlated with total OABSS, DLPP, amplitude, and frequency of bladder detrusor contractions. On the other hand, WC and body mass index were not correlated significantly.

CONCLUSION

Body mass index and WC are crude inaccurate methods correlated with OAB presence. Focal bladder wall fat distribution, higher VAI, higher VFA are novel risk factors for OAB occurrence. Both VAI and VFA are correlated significantly to total OABSS and urodynamics findings in patients with OAB.

摘要

目的

确定皮下脂肪、内脏脂肪表面积(VFA)、膀胱壁脂肪分布和内脏脂肪指数(VAI)与膀胱过度活动症(OAB)发生的关系,作为 OAB 发生的危险因素。

患者和方法

进行了一项横断面研究,涉及 157 名参与者。参与者分为两组;研究组(87 例 OAB 患者)和对照组(70 名健康参与者)。所有参与者均采用 OABSS 短表进行 OAB 评估。进行体格检查,包括腰围(WC)测量,以及代谢实验室检查(如高密度脂蛋白(HDL)、胆固醇等)。研究组进行尿动力学检查。使用非对比螺旋 CT 腹部和骨盆,检测躯干脂肪测量值和膀胱壁脂肪分布。计算女性和男性的 VAI。进行单变量和多变量分析,以检测 OAB 发生的危险因素。检测所有因素与总 OABSS 和尿动力学之间的相关性。

结果

平均年龄±SD 为 40.4±9 岁。在多变量分析中,增加的 VFA、更高的胆固醇水平、更高的 VAI 和膀胱壁的局灶性脂肪分布与 OAB 发生的风险增加 9.4、1.98、5.5 和 1.6 倍相关。VAI 和 VFA 与总 OABSS、DLPP、膀胱逼尿肌收缩幅度和频率呈强相关性。另一方面,WC 和体重指数与 OAB 存在无显著相关性。

结论

体重指数和 WC 是与 OAB 存在相关的粗糙、不准确的方法。局灶性膀胱壁脂肪分布、更高的 VAI、更高的 VFA 是 OAB 发生的新危险因素。VAI 和 VFA 与 OAB 患者的总 OABSS 和尿动力学发现显著相关。

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