Lower Urinary Tract Symptoms and Risk of Nonspine Fractures among Older Community Dwelling U.S. Men.
Lower Urinary Tract Symptoms and Risk of Nonspine Fractures among Older Community Dwelling U.S. Men.
复制标题
较低的社区住宅中，较低的尿路症状和非胸骨骨折的风险。
DOI：
10.1016/j.juro.2016.02.081
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发表时间：
2016-07
期刊：
影响因子：
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通讯作者：
Osteoporotic Fractures in Men (MrOS) Research Group
中科院分区：
文献类型：
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作者：
Marshall LM;Lapidus JA;Wiedrick J;Barrett-Connor E;Bauer DC;Orwoll ES;Parsons JK;Osteoporotic Fractures in Men (MrOS) Research Group
在老年男性中，与轻度下尿路症状相比，中度和重度下尿路症状（LUTS）与跌倒风险增加相关。福尔斯是骨折的主要危险因素。因此，我们评估了LUTS与社区居住的65岁或以上美国男性骨折风险的相关性。我们在男性骨质疏松性骨折（MrOS）队列中进行了一项前瞻性研究。男性在6个美国研究中心入组。在基线和此后每两年记录一次美国泌尿外科协会症状指数（AUA-SI）、LUTS药物使用、骨折风险因素和潜在混杂因素，共进行4次评估。根据AUA-SI将LUTS严重程度分类为轻度（0-7分）、中度（8-19分）或重度（≥20分）。LUTS严重程度与骨折发生率的相关性通过扩展比例风险回归的风险比（HR）和95%置信区间（CI）进行估计。在5，989名具有基线AUA-SI评分和髋部骨矿物质密度（BMD）测量的男性中，在43，807人年的随访期间发生了745例非脊柱骨折事件。在校正了年龄、入组地点、基线髋部BMD、过去一年的福尔斯和基线前骨折的多变量模型中，中度（HR 0.9，95% CI 0.8-1.1）或重度（HR 1.0，95% CI 0.8-1.3）LUTS与骨折风险无显著相关性。AUA-SI评估的个体LUTS（包括尿急和尿急）均与骨折风险增加无关。在这个美国老年男性队列中，LUTS与骨折风险无关。
Among older men, moderate and severe lower urinary tract symptoms (LUTS) are associated with increased fall risk compared to mild LUTS. Falls are a major risk factor for fractures. Therefore, we assessed associations of LUTS with fracture risk in community dwelling U.S. men aged 65 years or older. We conducted a prospective study in the Osteoporotic Fractures in Men (MrOS) cohort. Men were enrolled at six U.S. sites. The American Urological Association Symptom Index (AUA-SI), LUTS medication use, fracture risk factors and potential confounders were recorded at baseline and every two years thereafter for a total of four assessments. LUTS severity was categorized from the AUA-SI as mild (0–7 points), moderate (8–19 points), or severe (≥20 points). Associations of LUTS severity with fracture rate were estimated with hazard ratios (HR) and 95% confidence intervals (CI) from extended proportional hazards regression. Among 5,989 men with baseline AUA-SI score and hip bone mineral density (BMD) measures, 745 incident non-spine fractures occurred during 43,807 person-years of follow-up. In a multivariable model adjusted for age, enrollment site, baseline hip BMD, falls in the past year, and prevalent fracture before baseline, there were no significant associations of moderate (HR 0.9, 95% CI 0.8–1.1) or severe (HR 1.0, 95% CI 0.8–1.3) LUTS with fracture risk. None of the individual LUTS assessed on the AUA-SI including nocturia and urgency was associated with increased fracture risk. In this cohort of older US men, LUTS were not independently associated with fracture risk.