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女性患者膀胱过度活动症与骨折风险的关系。

Relationship Between Overactive Bladder and Bone Fracture Risk in Female Patients.

机构信息

Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

出版信息

In Vivo. 2024 Jul-Aug;38(4):2031-2040. doi: 10.21873/invivo.13661.

Abstract

BACKGROUND/AIM: Overactive bladder (OAB) has recently been recognized as an independent risk factor for falls and fractures. This study aimed to predict fracture risk in female patients with OAB symptoms.

PATIENTS AND METHODS

We assessed and compared the fracture risk in newly diagnosed female patients with OAB to those without OAB using the Fracture Risk Assessment Tool (FRAX), and investigated the relationship between fracture risk and OAB severity.

RESULTS

The present single-center, cross-sectional study included 177 female participants (79 with OAB, 98 without OAB). The OAB group was older (p=0.033) and shorter (p=0.010) compared to the non-OAB group. Compared to the non-OAB group, the OAB group had more patients with hypertension (p<0.001) and diabetes mellitus (p=0.011), as well as higher risks for major fractures (non-OAB group: 15.2±13.2%; OAB group: 23.6±14.1%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%; OAB group: 10.6±10.0%; p=0.007). In addition, those with moderate/severe OAB had the most significantly elevated risks for both major fractures (non-OAB group: 15.2±13.2%, mild-OAB: 17.6±12.5%, moderate/sever-OAB: 26.4±14.0%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%, mild-OAB: 6.5±7.6%, moderate/sever-OAB: 12.5±10.4%; p<0.001). Among the OAB symptoms, nocturia had the strongest correlation with fracture risk (major fracture, ρ=0.534; hip fracture, ρ=0.449; all p<0.001).

CONCLUSION

Patients with severe OAB, and particularly severe nocturia, should be closely monitored with timely and aggressive symptom management; however, an interventional study incorporating the management of OAB symptoms is required to confirm whether the proactive management of OAB symptoms reduces the risk of fractures in older females.

摘要

背景/目的:近期,膀胱过度活动症(OAB)已被确认为跌倒和骨折的独立危险因素。本研究旨在预测患有 OAB 症状的女性患者的骨折风险。

患者与方法

我们使用骨折风险评估工具(FRAX)评估并比较了新诊断为 OAB 的女性患者与无 OAB 患者的骨折风险,并探讨了骨折风险与 OAB 严重程度之间的关系。

结果

本单中心、横断面研究纳入了 177 名女性参与者(79 名患有 OAB,98 名无 OAB)。OAB 组年龄较大(p=0.033)且身高较矮(p=0.010)。与非 OAB 组相比,OAB 组有更多的高血压(p<0.001)和糖尿病患者(p=0.011),且发生主要骨折的风险更高(非 OAB 组:15.2±13.2%;OAB 组:23.6±14.1%;p<0.001)和髋部骨折(非 OAB 组:6.3±11.0%;OAB 组:10.6±10.0%;p=0.007)。此外,中重度 OAB 患者发生主要骨折(非 OAB 组:15.2±13.2%,轻度 OAB:17.6±12.5%,中重度 OAB:26.4±14.0%;p<0.001)和髋部骨折(非 OAB 组:6.3±11.0%,轻度 OAB:6.5±7.6%,中重度 OAB:12.5±10.4%;p<0.001)的风险显著升高。在 OAB 症状中,夜尿症与骨折风险相关性最强(主要骨折,ρ=0.534;髋部骨折,ρ=0.449;均 p<0.001)。

结论

严重 OAB 患者,尤其是严重夜尿症患者,应密切监测并及时进行积极的症状管理;然而,需要进行一项纳入 OAB 症状管理的干预性研究,以确认积极管理 OAB 症状是否能降低老年女性的骨折风险。

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