Relationship Between Lower Urinary Tract Symptoms And Components Of Metabolic Syndrome

Research Background and Objectives: Increasing evidence from epidemiological and clinical studies implied a potential link between Lower Urinary Tract Symptoms (LUTS) and Metabolic Syndrome (MetS) and its components. However, results from different research were controversial. In order to demonstrate the hypothesis that MetS playes a key role in the genesis of LUTS, we employed the methodology of epidemiological cross-sectional survey, to study the relationship between the five components of MetS and the severity of LUTS diagnosed through the International Prostate Symptom Score (IPSS).Study design and Statistical Methods: Fangchenggang Area Male Health and Examination Survey (FAMHES) was a community-based cross-sectional study involving male adult residents in Guangxi, China. Using standard design lifestyle questionnaire, the initial research cohort was established and the research data were collected and assessed in the participants of routine healthy check-up. Basically, individuals continuous joined in this survey were included. Physical examinations were performed in the medical center of Fangchenggang First People's Hospital, from September 2009 to December 2009. Finally, in total 4303 individuals were included, aged from 17 to 88 years old. The study samples were restrained in FAMHES participants with complete information on self-administrated IPSS. Data collection including IPSS score, Voiding/Obstructive symptoms subscores, Storage/Irritative symptoms subscores and Postmicturition symptoms subscores. Baseline information such as demographic characteristics, lifestyle factors, history of surgeries and medication were also assessed. The anthropometric measurements of subjects were conducted by trained personnel using a standardized protocol. We obtained data including height, weight, Waist Circumference (WC), blood pressure. Overnight fasting venous blood specimens were drawn. Triglycerides (TG), high-density lipoprotein cholesterol (HDL-c) and serum glucose were measured enzymatically on an automatic analyzer. Statistical processing and analyzing were performed using Stata 11.0 statistical software. For comparison of numeric variables between multi groups, according to status of normalization and homogeneity of variance, single factor analysis of variance (ANOVA) or Kruskal-Wallis (K-W) rank-sum test was used, respectively. For comparison of category variables between multi groups, the Pearson Chi-square (χ2) test or Fisher exact test was used, respectively. All hypotheses testing were two-tailed, probability of type I errorαwas 0.05. The estimates of association of severity of general LUTS symptoms, Voiding symptoms, Storage symptoms and Postmicurition symptoms with MetS each, were expressed as Odds Ratio and corresponding 95% Confidence Intervals (95% CI). Firstly, univariate logistics regression was conducted to identify the relationship; further adjustment for confounding factors (such as age, obesity, smoking, alcohol consumption, sports activities) was conducted in multivariate logistic regression.Results: This study included 3103 eligible individuals, aged range from 19 to 84 years old (Median 36 yr). The prevalence of hypertension, increasing FBG or diabetes, central obesity (WC > 90), TG abnormalities, abnormal hdl-c was, 1006 (32.4%), 836 (26.9%), 619 (19.9%), 967 (31.2%), 233 (7.5%), respectively. With three or more components of MetS diagnosed criteria mentioned above, the prevalence of MetS was 14.9% (464 in 3103), while the non-Mets group were 1136. Among all participants, the prevalence of general LUTS was 73.3 %. The prevalence of moderate to severe LUTS (>7) IPSS, however, was 7.9%. No statistically significant of total IPSS score, Voiding symptoms subscore, Storage symptoms subscore, Postmicturtion symptoms subscore, QOL score was found between the severities of LUTS (P<0.001). Meanwhile, in the patients diagnosed MetS, the proportion of light, medium, severe LUTS accounted for 91.2%, 7.8%, 1%, respectively. Compared to the non-MetS patients, the difference of severities of LUTS was not statistically significant (P>0.1). The severities of Voiding symptoms, Storage symptoms, Postmicturition symptoms and QOL, were also implied statistically non-significant between MetS and non-MetS (P>0.1). After stratification by age, an increased trend was found, since the prevalence of moderate to severe LUTS in≤29, 30-39, 40-49 years, 50-59, > 60 years old group, was 6.0%, 6.9%, 8.6%, 11% and 16.1% respectively. With aging, the prevalence of moderate to severe LUTS increased gradually while the satisfaction of life were trend to decrease (P<0.001 for trend). In moderate to severe LUTS patients, aging is an important risk factors (≥60yr vs≤29yr, OR = 3.02, 95% CI: 1.87, 4.88; 50-59yr vs≤29yr, OR = 1.46, 95% CI: 121, 3.13). The prevalence of moderate to severe Voiding symptoms in overweight people, was significantly higher than normal weight people (OR = 1.73, 95% CI: 1.03, 2.90). Adjustment for variable as age, smoking status, alcohol consumption, and sports activities, no statistically significance could be found between the connection of MetS and/or its five components and the severity of the LUTS. Except for a lower probability of moderate to severe Storage symptoms in MetS patients versus non-MetS patients (OR = 0.62, 95% CI: 0.43, 0.89).Conclusion: The results suggested a relationship between age and LUTS severity. However, and the MetS did not turn out to be significantly and independently risk factor involved in the genesis of LUTS in men. To reveal the connection between MetS and provide more powerful evidence, further longitudinal cohort studies and follow-up investigation are needed.