Zhang Xiaotian, Ma Leilei, Li Jing, Zhang Wei, Xie Yiran, Wang Yaoguang
Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
J Psychosom Res. 2024 Mar;178:111599. doi: 10.1016/j.jpsychores.2024.111599. Epub 2024 Jan 30.
The clinical observations suggest a correlation between lower urinary tract symptoms (LUTSs) and mental health problems. Nonetheless, establishing a direct causal relationship between them remains challenging.
We initially conducted a cross-sectional study using 2005-2018 the National Health and Nutrition Examination Survey (NHANES) data. Multivariable-adjusted logistic regression was the primary statistical approach. Additionally, we employed Mendelian randomization (MR) to reducing confounding and reverse causation. Genetic instruments were obtained from publicly available genome-wide association study (GWAS) databases. Inverse Variance Weighted was the primary statistical method.
The cross-sectional study involved 29,439 participants. Individuals with mental health problems had a higher risk of urinary incontinence (OR:4.38; 95%CI:3.32-5.76; P < 0.01) and overactive bladder (OR:2.31; 95%CI:2.02-2.63; P < 0.01). MR analysis then indicated a potential causal relationship between mental health problems and LUTSs. Depression symptoms was linked with urinary tract infection (UTI) (OR:1.005; 95%CI:1.003-1.008; P < 0.01). Anxiety symptoms was related to the occurrence of UTI (OR:1.024; 95%CI:1.011-1.037; P < 0.01) and bladder calcified/ contracted/ overactive (OR:1.017; 95%CI:1.007-1.027; P < 0.01). The personality trait of neuroticism was related to the occurrence of cystitis (OR:1.072; 95%CI:1.022-1.125; P = 0.02), extravasation of urine and difficulties with micturition (OR:1.001; 95%CI:1.001-1.002; P < 0.01), and urinary frequency and incontinence (OR: 1.001; 95%CI:1.000-1.001; P < 0.01).
Our study provides various evidence for the correlation between mental health and LUTSs, emphasizing the significance of adopting a holistic approach to LUTSs management that incorporates both physical and psychological factors.
临床观察表明下尿路症状（LUTSs）与心理健康问题之间存在关联。尽管如此，确立它们之间的直接因果关系仍具有挑战性。
我们最初使用2005 - 2018年美国国家健康与营养检查调查（NHANES）数据进行了一项横断面研究。多变量调整逻辑回归是主要的统计方法。此外，我们采用孟德尔随机化（MR）来减少混杂因素和反向因果关系。遗传工具来自公开可用的全基因组关联研究（GWAS）数据库。逆方差加权是主要的统计方法。
横断面研究涉及29439名参与者。有心理健康问题的个体患尿失禁的风险更高（比值比：4.38；95%置信区间：3.32 - 5.76；P < 0.01）以及膀胱过度活动症（比值比：2.31；95%置信区间：2.02 - 2.63；P < 0.01）。MR分析随后表明心理健康问题与LUTSs之间存在潜在因果关系。抑郁症状与尿路感染（UTI）相关（比值比：1.005；95%置信区间：1.003 - 1.008；P < 0.01）。焦虑症状与UTI的发生相关（比值比：1.024；95%置信区间：1.011 - 1.037；P < 0.01）以及膀胱钙化/收缩/过度活动（比值比：1.017；95%置信区间：1.007 - 1.027；P < 0.01）。神经质人格特质与膀胱炎的发生相关（比值比：1.072；95%置信区间：1.022 - 1.125；P = 0.02）、尿液外渗和排尿困难（比值比：1.001；95%置信区间：1.001 - 1.002；P < 0.01）以及尿频和尿失禁（比值比：1.001；95%置信区间：1.000 - 1.001；P < 0.01）。
我们的研究为心理健康与LUTSs之间的关联提供了多种证据，强调了采用综合身体和心理因素的整体方法来管理LUTSs的重要性。
