Association of Lower Urinary Tract Symptoms and the Metabolic Syndrome: Results From the Boston Area Community Health Survey
Received 2 December 2008 published online 18 June 2009.
Purpose
In this study we investigated the relationship between lower urinary tract symptoms as defined by the American Urological Association symptom index and the metabolic syndrome, and determined the relationship between individual symptoms comprising the American Urological Association symptom index and the metabolic syndrome.
Materials and Methods
The Boston Area Community Health Survey used a 2-stage cluster design to recruit a random sample of 2,301 men 30 to 79 years old. Analyses were conducted on 1,899 men who provided blood samples. Urological symptoms comprising the American Urological Association symptom index were included in the analysis. The metabolic syndrome was defined using a modification of the Adult Treatment Panel III guidelines. The association between lower urinary tract symptoms and the metabolic syndrome was assessed using odds ratios and 95% confidence intervals estimated using logistic regression models.
Results
Increased odds of the metabolic syndrome were observed in men with mild to severe symptoms (American Urological Association symptom index 2 to 35) compared to those with an American Urological Association symptom index score of 0 or 1 (multivariate OR 1.68, 95% CI 1.21–2.35). A statistically significant association was observed between the metabolic syndrome and a voiding symptom score of 5 or greater (multivariate adjusted OR 1.73, 95% CI 1.06–2.80) but not for a storage symptom score of 4 or greater (multivariate adjusted OR 0.94, 95% CI 0.66–1.33). Increased odds of the metabolic syndrome were observed even with mild symptoms, primarily for incomplete emptying, intermittency and nocturia. These associations were observed primarily in younger men (younger than 60 years) and were null in older men (60 years old or older).
Conclusions
The observed association between urological symptoms and the metabolic syndrome provides further evidence of common underlying factors between lower urinary tract symptoms and chronic conditions outside the urinary tract.
ePfizer Ltd, Global Medical and Outcomes Research, Sandwich, United Kingdom
Correspondence: New England Research Institutes, 9 Galen St., Watertown, Massachusetts 02472 (telephone: 617- 923-7747 ext 293; FAX: 617-924-0968)
Study received institutional review board approval.
Supported by Pfizer, Inc.
The BACH survey is supported by DK 56842 from the National Institute of Diabetes and Digestive and Kidney Diseases. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the National Institutes of Health.
† Financial interest and/or other relationship with GlaxoSmithKline, Pfizer, Lilly/ICOS, Sanofi-Aventis, Allergan, and the National Institute of Diabetes and Digestive and Kidney Diseases.
‡ Financial interest and/or other relationship with Pfizer, Inc.
§ Financial interest and/or other relationship with Pfizer Inc., Eli Lilly, Bayer Schering, Sanofi Aventis and Boehringer Ingelheim.
∥ Requests for reprints: New England Research Institutes, 9 Galen St., Watertown, Massachusetts 02472 (telephone: 617-923-7747 ext. 512; FAX: 617-926-8246; e-mail: bach@neriscience.com).
ABSTRACT