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美国华裔老年人下尿路症状的性别差异

Gender differences of lower urinary tract symptoms in older Chinese Americans.

作者信息

Mou Tsung, Brown Oluwateniola, Hua Yingxiao, Simon Melissa, Dong XinQi, Kenton Kimberly, Bretschneider C Emi

机构信息

Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA.

出版信息

Asian J Urol. 2023 Oct;10(4):526-533. doi: 10.1016/j.ajur.2021.12.002. Epub 2021 Dec 6.

Abstract

OBJECTIVE

To describe whether or not there are gender differences in lower urinary tract symptoms (LUTS) prevalence and risk factors in community-dwelling older Chinese Americans.

METHODS

We performed a secondary analysis of a prospective cross-sectional population-based survey of Chinese Americans aged 60 years and older between January 2011 and December 2013 in English, Mandarin, Cantonese, Taishanese, or Teochew. A clinical review of systems was used to assess LUTS, which included urinary frequency, urgency, burning and/or pain, blood in urine, and urinary incontinence.

RESULTS

Of the total 3157 people queried, 42% were men and 58% were women. More men reported LUTS compared to women (32.9% 28.6%, =0.01). In a multivariable analysis, female gender (adjusted odds ratio [aOR] 0.60, 95% confidence interval [CI] 0.49-0.73), being married (aOR 0.79, 95% CI 0.65-0.97), and smoking (aOR 0.66, 95% CI 0.49-0.88) were found to be protective, while traditional Chinese medicine use (aOR 1.51, 95% CI 1.28-1.78), heart disease (aOR 1.54, 95% CI 1.24-1.91), and anxiety (aOR 1.69, 95% CI 1.25-2.28) were most strongly associated with increased odds of LUTS. When examining genders separately, being married was found to be protective only in women. Meanwhile, unique factors found in men were hypertension, heart disease, and practice of Tai Chi.

CONCLUSION

In this large population-based study, LUTS were more prevalent in older Chinese American men than women. We also found gender-specific factors that influenced the odds of reporting LUTS; however, traditional Chinese medicine use was the only factor that was shared by both genders. Future longitudinal investigations are needed to elucidate these underlying mechanisms to provide evidence-based and culture-specific guidelines for this rapidly growing population.

摘要

目的

描述美国华裔社区老年人下尿路症状(LUTS)的患病率及危险因素是否存在性别差异。

方法

我们对2011年1月至2013年12月期间以英语、普通话、粤语、台山话或潮州话对60岁及以上美国华裔进行的一项前瞻性横断面人群调查进行了二次分析。采用系统临床回顾来评估LUTS,包括尿频、尿急、烧灼感和/或疼痛、血尿和尿失禁。

结果

在总共3157名被调查者中,42%为男性,58%为女性。与女性相比,报告有LUTS的男性更多(32.9%对28.6%,P=0.01)。在多变量分析中,女性(调整优势比[aOR]为0.60,95%置信区间[CI]为0.49 - 0.73)、已婚(aOR为0.79,95%CI为0.65 - 0.97)和吸烟(aOR为0.66,95%CI为0.49 - 0.88)被发现具有保护作用,而使用中药(aOR为1.51,95%CI为1.28 - 1.78)、心脏病(aOR为1.54,95%CI为1.24 - 1.9)和焦虑(aOR为1.69,95%CI为1.25 - 2.28)与LUTS发生几率增加的关联最为强烈。当分别检查性别时,发现已婚仅对女性具有保护作用。同时,在男性中发现的独特因素是高血压、心脏病和打太极拳。

结论

在这项基于人群的大型研究中,美国华裔老年男性的LUTS比女性更普遍。我们还发现了影响报告LUTS几率的性别特异性因素;然而,使用中药是两性共有的唯一因素。未来需要进行纵向研究以阐明这些潜在机制,为这一快速增长的人群提供基于证据和特定文化的指导方针。

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