Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Departments of Family Medicine and Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan.
PLoS One. 2021 Mar 3;16(3):e0246653. doi: 10.1371/journal.pone.0246653. eCollection 2021.
Lower urinary tract symptoms (LUTS) result in morbidities; however, their association with the occurrence of hip fracture is relatively unknown in the context of Asian studies. The purpose of the study was to investigate this link with the hip fracture risk in Taiwanese men and women aged 50 years and above.
From 2000 through 2012, a population-based retrospective cohort study was conducted; claims data of 18,976 patients diagnosed with LUTS (dysuria, urinary retention, incontinence, and increased urinary frequency and urgency) were retrieved from Taiwan's National Health Insurance Research Database. The patients were compared with 1:2 age, sex, and index year-matched controls (comparison group, n = 37,952). The incidence and hazard ratios of the hip fracture risk were calculated by the Cox proportional hazard regression models.
The mean age was 66.2 ± 9.7 years, and the proportion of men was 58.1% in both study groups. Fractures occurred in 772 patients and 1,156 control subjects. The corresponding incidences were 7.0 and 5.0/1000 person-years. Compared to the control subjects, the patients with LUTS had an increased hip fracture risk [adjusted hazard ratio (aHR) = 1.29; 95% confidence interval (CI): 1.17-1.42]. LUTS was independently associated with an increased hip fracture risk in both men (aHR = 1.24; 95% CI: 1.08-1.42) and women (aHR = 1.34; 95% CI: 1.18-1.53) (p for interaction = 0.557). Similarly, the subgroup effect of age on hip fracture risks was not found (p for interaction = 0.665).
The study found LUTS was associated with an increased risk of hip fracture. Large-scale prospective studies in diverse populations are required to investigate causalities.
下尿路症状（LUTS）会导致多种疾病；然而，在亚洲研究中，其与髋部骨折发生的相关性尚不清楚。本研究旨在探讨台湾 50 岁及以上男性和女性的 LUTS 与髋部骨折风险之间的这种联系。
2000 年至 2012 年，进行了一项基于人群的回顾性队列研究；从台湾全民健康保险研究数据库中检索了 18976 例诊断为 LUTS（排尿困难、尿潴留、失禁以及尿频和尿急增加）患者的索赔数据。将这些患者与年龄、性别和指数年匹配的 1:2 对照组（对照组，n=37952）进行比较。使用 Cox 比例风险回归模型计算髋部骨折风险的发生率和风险比。
两组患者的平均年龄为 66.2±9.7 岁，男性比例均为 58.1%。772 例患者和 1156 例对照者发生骨折。相应的发生率分别为 7.0 和 5.0/1000 人年。与对照组相比，LUTS 患者髋部骨折风险增加[校正风险比（aHR）=1.29；95%置信区间（CI）：1.17-1.42]。LUTS 与男性（aHR=1.24；95%CI：1.08-1.42）和女性（aHR=1.34；95%CI：1.18-1.53）髋部骨折风险增加独立相关（p 交互=0.557）。同样，未发现年龄对髋部骨折风险的亚组效应（p 交互=0.665）。
本研究发现 LUTS 与髋部骨折风险增加相关。需要在不同人群中进行大规模前瞻性研究以探讨因果关系。
