Chan C K, Ng Chi Fai, Yuen Steffi K K, Lau B S Y, Yee C H, Teoh J Y C, Chiu P K F, Kwok S W
SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong, China.
Front Urol. 2023 Jan 26;3:1113054. doi: 10.3389/fruro.2023.1113054. eCollection 2023.
To study the association between nocturia and brachial-ankle pulse wave velocity (baPWV) [surrogate of central arterial stiffness (CAS)] in men and to explore this association on predicting major adverse cardiovascular events (MACE).
246 consecutive men (mean age:68.1 ± 8.4, range 36-88) newly referred to urology clinic for male-lower urinary tract symptoms(mLUTS)/nocturia were recruited. Their bilateral baPWV were measured by automatic pulse waveform analyzer. The associations between baseline characteristics, mLUTS/nocturia and baPWV(>1800cm/sec) [significant CAS] were analyzed by multivariate logistic regression. We followed the cohort for a median period of 27.5 months. Cox proportional hazard regression analysis and Kaplan-Meier method were used to study factors predicting MACE.
The mean ( ± SE) baPWV of our cohort was 1820 ± 16cm/sec. For comparison, the reported value of the general population of similar age structure was~1650cm/sec. IPSS (total) was not associated with baPWV, whereas IPSS-Question.7(nocturia) was significantly increased with baPWV in men<70yo [nocturia=1.6 ± 1.14, 2.1 ± 1.08, 2.67 ± 1.33) for baPWV(cm/sec) <1400, 1400-1800, >1800 respectively] (P-trend=0.002). Age≥70yo (OR:2.70, 95%CI:1.52-4.76), diabetes mellitus (OR:2.26, 95%CI:1.06-4.83), hypertension (OR:1.95, 95%CI:1.10-3.45) and nocturia≥3x/night (OR:1.75, 95%CI:1.02-3.12) independently determined baPWV>1800cm/sec. The cumulative incidence rate of MACE was 46.8/1000 man-years(95%CI:30.96-68.16/1000). The addition of nocturia≥3x/night and baPWV>1800 cm/sec to the basic model improved the prediction of the development of MACE (difference in -2 log likelihood value: 11.219, p<0.001). Past history of ischemic heart (HR:5.67, 95%CI:2.02-15.88), nocturia≥3x/night (HR:2.87, 95%CI: 0.94-8.76) and baPWV>1800cm/sec (HR:5.16, 95%CI:1.79-14.90) independently predicted MACE in men.
Men attending the urology clinic for male-LUTS/nocturia had higher baPWV. This association was more pronounced in men<70yo. Men presented with both nocturia≥3x/night and baPWV>1800cm/sec showed significant predilection for developing MACE.
研究男性夜尿症与臂踝脉搏波速度（baPWV）[中心动脉僵硬度（CAS）的替代指标]之间的关联，并探讨这种关联对预测主要不良心血管事件（MACE）的作用。
招募246例因男性下尿路症状（mLUTS）/夜尿症而新转诊至泌尿外科门诊的连续男性患者（平均年龄：68.1±8.4岁，范围36 - 88岁）。使用自动脉搏波形分析仪测量其双侧baPWV。通过多因素逻辑回归分析基线特征、mLUTS/夜尿症与baPWV（>1800cm/秒）[显著CAS]之间的关联。我们对该队列进行了为期27.5个月的中位数随访。采用Cox比例风险回归分析和Kaplan - Meier方法研究预测MACE的因素。
我们队列的平均（±SE）baPWV为1820±16cm/秒。作为对比，年龄结构相似的普通人群报告值约为1650cm/秒。国际前列腺症状评分（IPSS，总分）与baPWV无关，而IPSS第7项问题（夜尿症）在<70岁男性中随baPWV显著增加[对于baPWV（cm/秒）<1400、1400 - 1800、>1800，夜尿症分别为1.6±1.14、2.1±1.08、2.67±1.33]（P趋势 = 0.002）。年龄≥70岁（比值比：2.70，95%置信区间：1.52 - 4.76）、糖尿病（比值比：2.26，95%置信区间：1.06 - 4.83）、高血压（比值比：1.95，95%置信区间：1.10 - 3.45）和夜尿症≥3次/晚（比值比：1.75，95%置信区间：1.02 - 3.12）独立决定baPWV>1800cm/秒。MACE的累积发病率为46.8/1000人年（95%置信区间：30.96 - 68.16/1000）。在基本模型中加入夜尿症≥3次/晚和baPWV>1800cm/秒可改善对MACE发生发展的预测（-2对数似然值差异：11.219，p<0.001）。既往缺血性心脏病史（风险比：5.67，95%置信区间：2.02 - 15.88）、夜尿症≥3次/晚（风险比：2.87，95%置信区间：0.94 - 8.76）和baPWV>1800cm/秒（风险比：5.16，95%置信区间：1.79 - 14.90）独立预测男性MACE。
因男性LUTS/夜尿症就诊于泌尿外科门诊的男性baPWV较高。这种关联在<70岁男性中更为明显。同时出现夜尿症≥3次/晚和baPWV>1800cm/秒且有MACE发生发展的显著倾向。
