Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, USA.
Department of Urology, University of California, San Francisco, USA.
J Gerontol A Biol Sci Med Sci. 2022 Oct 6;77(10):2102-2109. doi: 10.1093/gerona/glab227.
Adiposity increases risk for male lower urinary tract symptoms (LUTS), although longitudinal studies have produced conflicting results. No prior studies have evaluated longitudinal associations of changes in adiposity with concurrent LUTS severity among older men.
We used repeated adiposity measurements from dual-energy x-ray absorptiometry (DXA), body mass index (BMI), and American Urological Association Symptom Index (AUASI) measured at 4 study visits over a 9-year period among 5 949 men enrolled in the Osteoporotic Fractures in Men (MrOS) study. Linear mixed effect models adjusted for age, health-related behaviors, and comorbidities were created to evaluate the association between baseline and change in visceral adipose tissue (VAT) area, total fat mass, and BMI with change in LUTS severity measured by the AUASI.
A nonlinear association was observed between baseline VAT area and change in AUASI: men in baseline VAT tertile (T) 2 had a lower annual increase in AUASI score compared to men in T1 and T3 (T2 vs T1: β = -0.07; 95% CI -0.12, -0.03; p = .008; T3 vs T1: NS) but differences were small. No significant associations were observed between change in VAT area and change in AUASI score. Neither baseline tertiles nor change in total fat mass or BMI were associated with change in AUASI score.
Changes in VAT area, total fat mass, and BMI were not associated with change in LUTS severity in this cohort. Thus, despite other health benefits, interventions targeting adiposity alone are unlikely to be effective for preventing or treating LUTS among older men.
肥胖会增加男性下尿路症状(LUTS)的风险,尽管纵向研究得出了相互矛盾的结果。之前没有研究评估过肥胖变化与老年男性同期 LUTS 严重程度之间的纵向关联。
我们使用来自双能 X 射线吸收法(DXA)、体重指数(BMI)和美国泌尿协会症状指数(AUASI)的重复肥胖测量值,这些数据是在 9 年期间的 4 次研究访视中测量的,共有 5949 名参加男性骨质疏松性骨折研究(MrOS)的男性。创建了线性混合效应模型,以调整年龄、与健康相关的行为和合并症,以评估基线和内脏脂肪组织(VAT)面积、总脂肪量和 BMI 的变化与 AUASI 测量的 LUTS 严重程度变化之间的关联。
观察到基线 VAT 面积与 AUASI 变化之间存在非线性关联:与 T1 和 T3 相比,T2 组的基线 VAT 三分位(T)2 的男性每年 AUASI 评分增加较低(T2 比 T1:β=-0.07;95%CI-0.12,-0.03;p=0.008;T3 比 T1:NS),但差异较小。VAT 面积变化与 AUASI 评分变化之间没有显著关联。基线三分位数或总脂肪量或 BMI 的变化与 AUASI 评分的变化均无关。
在该队列中,VAT 面积、总脂肪量和 BMI 的变化与 LUTS 严重程度的变化无关。因此,尽管有其他健康益处,仅针对肥胖的干预措施不太可能有效预防或治疗老年男性的 LUTS。