Wang Shih-Gang, Yang Stephen Shei-Dei, Chang Shang-Jen
Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Front Pediatr. 2021 Apr 13;9:609057. doi: 10.3389/fped.2021.609057. eCollection 2021.
Obesity is associated with lower urinary tract symptoms (LUTSs) and dysfunction in adults while its impact on children and adolescents remains unknown. This study aimed to explore the impact of obesity on LUTSs among children and adolescents through a large-scale community-based study. From July 2004 to April 2017, children and adolescents aged 5-15 years-old in Xin-Dian District, New Taipei City were invited to participate in our study. The exclusion criteria were a history of congenital genitourinary tract anomalies, neurological anomalies, or a presence of urinary tract infection. After providing informed consent the participant completed a questionnaire, which included their baseline characteristics and dysfunctional voiding symptom score (DVSS); a parent completed the questionnaire with the younger children. Urgency and daytime incontinence were defined as having positive statement for DVSS questions 7 and 1, respectively. Multivariate regression analysis was used to evaluate the predictors of urgency, daytime incontinence and enuresis. A -value of <0.05 was considered statistically significant. A total of 2,371 participants were enrolled in the study, and 1,599 were ultimately eligible for analysis. The prevalence of urgency, daytime incontinence, constipation, and enuresis were 37.6, 6.4, 26.1, and 7.7%, respectively. Multivariate analysis revealed that younger age ( = 0.01) and obesity ( = 0.04) were independent predictors for urgency. Younger age ( < 0.01) and constipation ( = 0.04) were independent predictors for daytime incontinence but obesity was not. Younger children were more likely to have nocturnal enuresis (95% CI = 0.77-0.88) and obesity did not have a significant impact on enuresis. Obesity was significantly associated with urgency but it was not significantly associated with daytime incontinence and enuresis in community dwelling children and adolescents.
肥胖与成人下尿路症状（LUTSs）及功能障碍相关，但其对儿童和青少年的影响尚不清楚。本研究旨在通过一项大规模的社区研究，探讨肥胖对儿童和青少年LUTSs的影响。2004年7月至2017年4月，邀请新北市新店区5至15岁的儿童和青少年参与我们的研究。排除标准为有先天性泌尿生殖道异常、神经异常病史或存在尿路感染。在获得知情同意后，参与者完成一份问卷，其中包括他们的基线特征和排尿功能障碍症状评分（DVSS）；年龄较小的儿童由家长完成问卷。尿急和日间尿失禁分别定义为DVSS问题7和问题1的回答为阳性。采用多因素回归分析评估尿急、日间尿失禁和遗尿的预测因素。P值<0.05被认为具有统计学意义。共有2371名参与者纳入研究，最终1599名符合分析条件。尿急、日间尿失禁、便秘和遗尿的患病率分别为37.6%、6.4%、26.1%和7.7%。多因素分析显示，年龄较小（P = 0.01）和肥胖（P = 0.04）是尿急的独立预测因素。年龄较小（P < 0.01）和便秘（P = 0.04）是日间尿失禁的独立预测因素，但肥胖不是。年龄较小的儿童夜间遗尿的可能性更大（95%CI = 0.77 - 0.88），肥胖对遗尿没有显著影响。在社区居住的儿童和青少年中，肥胖与尿急显著相关，但与日间尿失禁和遗尿无显著关联。
