Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.
Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
J Gerontol A Biol Sci Med Sci. 2024 Jun 1;79(6). doi: 10.1093/gerona/glae008.
Lower urinary tract symptoms (LUTS) in older men are associated with an increased risk of mobility limitations. Lower extremity muscle quality may represent a novel shared mechanism of both LUTS and mobility limitations.
We evaluated associations of thigh skeletal muscle measures (strength, area, and specific force) with total LUTS severity (American Urologic Association Symptom Index; AUASI) and voiding and storage subscores among 352 men aged ≥60 years enrolled in the Baltimore Longitudinal Study of Aging. Thigh muscle strength (Nm) was defined as maximum concentric 30°/s knee extensor torque, area (cm2), and specific force (Nm/cm2) defined as strength/area. Associations with AUASI score were estimated using multivariable linear regression and linear mixed models.
Mean thigh muscle strength at baseline was 139.7Nm. In cross-sectional multivariable models, each 39Nm increment in thigh muscle strength and 0.28Nm/cm2 increment in specific force was associated with -1.17 point (95% CI: -1.93 to -.41) and -0.95 point (95% CI: -1.63 to -0.27) lower AUASI score, respectively. Similar associations were observed for voiding and storage subscores, although somewhat attenuated. In longitudinal analyses, baseline muscle measures were not associated with annual change in AUASI, and current changes in muscle measures and AUASI were unrelated.
Cross-sectionally, higher thigh muscle strength and specific force were associated with decreased LUTS severity in older men. However, we did not observe concurrent worsening LUTS severity with declining thigh muscle strength, area, or specific force in longitudinal analyses.
老年男性下尿路症状（LUTS）与活动能力受限的风险增加有关。下肢肌肉质量可能是 LUTS 和活动能力受限的共同新机制。
我们评估了大腿骨骼肌测量（力量、面积和比力量）与总 LUTS 严重程度（美国泌尿科协会症状指数；AUASI）以及排尿和储存亚评分之间的关系，共纳入 352 名年龄≥60 岁的巴尔的摩纵向老龄化研究参与者。大腿肌肉力量（Nm）定义为最大向心 30°/s 膝关节伸肌扭矩，面积（cm2）和比力量（Nm/cm2）定义为力量/面积。使用多变量线性回归和线性混合模型估计与 AUASI 评分的关系。
基线时大腿肌肉力量的平均值为 139.7Nm。在横断面多变量模型中，大腿肌肉力量每增加 39Nm 和比力量增加 0.28Nm/cm2 分别与 AUASI 评分降低 1.17 分（95%CI：-1.93 至-.41）和 0.95 分（95%CI：-1.63 至-.07）相关。在排尿和储存亚评分方面也观察到类似的关联，尽管有所减弱。在纵向分析中，基线肌肉测量值与 AUASI 的年度变化无关，肌肉测量值和 AUASI 的当前变化也无关。
在横断面研究中，大腿肌肉力量和比力量越高，老年男性的 LUTS 严重程度越低。然而，在纵向分析中，我们没有观察到大腿肌肉力量、面积或比力量下降与 LUTS 严重程度同时恶化。
