TY - JOUR
T1 - A prospective study of obesity, and the incidence and progression of lower urinary tract symptoms
AU - Mondul, Alison M.
AU - Giovannucci, Edward
AU - Platz, Elizabeth A.
N1 - Funding Information:
Supported by Urological Diseases in America Project N01 DK70003 , and Department of Health and Human Services, National Institutes of Health Public Health Service Grants R01 DK45779 , P01 CA55075 and P50 DK082998 .
PY - 2014/3
Y1 - 2014/3
N2 - Purpose We prospectively evaluated the association between adiposity and the risk of lower urinary tract symptoms incidence and progression in the Health Professionals Followup Study (HPFS). Materials and Methods At baseline participants reported current height and weight, and weight at age 21 years. A year later they reported waist and hip circumferences, and every 2 years thereafter they reported weight. Participants periodically completed the International Prostate Symptom Score (I-PSS) and reported surgery or medication use for lower urinary tract symptoms. We used Cox proportional hazards regression to estimate the multivariable adjusted association between adiposity and lower urinary tract symptoms incidence and progression. The incidence analytical cohort of 18,055 men had no lower urinary tract symptoms at baseline. A total of 6,461 men entered the progression analytical cohort when they first experienced lower urinary tract symptoms. Results The risk of lower urinary tract symptoms in 4,088 cases increased with increasing body mass index (35 kg/m2 or greater vs 23 to less than 25 HR 1.61, 95% CI 1.31-1.99), waist circumference (greater than 42 inches vs 33 or less HR 1.39, 95% CI 1.19-1.63) and weight gain since age 21 years (50 pounds or greater vs stable weight HR 1.31, 95% CI 1.17-1.46, each p trend <0.0001). The risk of lower urinary tract symptom progression in 1,691 cases increased with body mass index (35 kg/m2 or greater vs 23 to less than 25 HR 1.44, 95% CI 1.04-2.00, p trend <0.0001), weight gain since age 21 years (50 pounds or greater vs stable weight HR 1.35, 95% CI 1.14-1.60, p trend <0.0001) and waist circumference (greater than 42 inches vs 33 or less HR 1.32, 95% CI 0.95-1.85, p trend 0.005). Conclusions Men with higher total and abdominal adiposity and those who gained weight were more likely to have lower urinary tract symptoms develop or progress. Our findings support the notion that obesity may be an important target for lower urinary tract symptom prevention and intervention.
AB - Purpose We prospectively evaluated the association between adiposity and the risk of lower urinary tract symptoms incidence and progression in the Health Professionals Followup Study (HPFS). Materials and Methods At baseline participants reported current height and weight, and weight at age 21 years. A year later they reported waist and hip circumferences, and every 2 years thereafter they reported weight. Participants periodically completed the International Prostate Symptom Score (I-PSS) and reported surgery or medication use for lower urinary tract symptoms. We used Cox proportional hazards regression to estimate the multivariable adjusted association between adiposity and lower urinary tract symptoms incidence and progression. The incidence analytical cohort of 18,055 men had no lower urinary tract symptoms at baseline. A total of 6,461 men entered the progression analytical cohort when they first experienced lower urinary tract symptoms. Results The risk of lower urinary tract symptoms in 4,088 cases increased with increasing body mass index (35 kg/m2 or greater vs 23 to less than 25 HR 1.61, 95% CI 1.31-1.99), waist circumference (greater than 42 inches vs 33 or less HR 1.39, 95% CI 1.19-1.63) and weight gain since age 21 years (50 pounds or greater vs stable weight HR 1.31, 95% CI 1.17-1.46, each p trend <0.0001). The risk of lower urinary tract symptom progression in 1,691 cases increased with body mass index (35 kg/m2 or greater vs 23 to less than 25 HR 1.44, 95% CI 1.04-2.00, p trend <0.0001), weight gain since age 21 years (50 pounds or greater vs stable weight HR 1.35, 95% CI 1.14-1.60, p trend <0.0001) and waist circumference (greater than 42 inches vs 33 or less HR 1.32, 95% CI 0.95-1.85, p trend 0.005). Conclusions Men with higher total and abdominal adiposity and those who gained weight were more likely to have lower urinary tract symptoms develop or progress. Our findings support the notion that obesity may be an important target for lower urinary tract symptom prevention and intervention.
KW - life style
KW - lower urinary tract symptoms
KW - male
KW - obesity
KW - urinary bladder
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U2 - 10.1016/j.juro.2013.08.110
DO - 10.1016/j.juro.2013.08.110
M3 - Article
C2 - 24076306
AN - SCOPUS:84893850693
SN - 0022-5347
VL - 191
SP - 715
EP - 721
JO - Journal of Urology
JF - Journal of Urology
IS - 3
ER -