Association of Lower Urinary Tract Symptoms and the Metabolic Syndrome: Results From the Boston Area Community Health Survey

No AccessJournal of UrologyVoiding Dysfunction1 Jan 2013Association of Lower Urinary Tract Symptoms and the Metabolic Syndrome: Results From the Boston Area Community Health Surveyis accompanied byAssociation of Lower Urinary Tract Symptoms and the Metabolic Syndrome: Results From the Boston Area Community Health Survey Varant Kupelian, Kevin T. McVary, Steven A. Kaplan, Susan A. Hall, Carol L. Link, Lalitha Padmanabhan Aiyer, Patrick Mollon, Nihad Tamimi, Raymond C. Rosen, and John B. McKinlay Varant KupelianVarant Kupelian New England Research Institutes, Watertown, Massachusetts More articles by this author , Kevin T. McVaryKevin T. McVary Department of Urology, Northwestern University, Chicago, Illinois 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. More articles by this author , Steven A. KaplanSteven A. Kaplan Cornell University, Weill Medical College, New York, New York More articles by this author , Susan A. HallSusan A. Hall New England Research Institutes, Watertown, Massachusetts More articles by this author , Carol L. LinkCarol L. Link New England Research Institutes, Watertown, Massachusetts More articles by this author , Lalitha Padmanabhan AiyerLalitha Padmanabhan Aiyer Pfizer Inc, New York, New York Financial interest and/or other relationship with Pfizer, Inc. More articles by this author , Patrick MollonPatrick Mollon Pfizer Ltd, Global Medical and Outcomes Research, Sandwich, United Kingdom More articles by this author , Nihad TamimiNihad Tamimi Pfizer Inc, New York, New York Financial interest and/or other relationship with Pfizer, Inc. More articles by this author , Raymond C. RosenRaymond C. Rosen New England Research Institutes, Watertown, Massachusetts Financial interest and/or other relationship with Pfizer Inc., Eli Lilly, Bayer Schering, Sanofi Aventis and Boehringer Ingelheim. More articles by this author , and John B. McKinlayJohn B. McKinlay New England Research Institutes, Watertown, Massachusetts 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: email protected). More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.11.026AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract 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. References 1 : Beyond the lower urinary tract: the association of urologic and sexual symptoms with common illnesses. Eur Urol2007; 52: 407. Google Scholar 2 : Risk factors for lower urinary tract symptoms in a population-based sample of African-American men. Am J Epidemiol2003; 157: 906. Google Scholar 3 : Effect of diabetes on lower urinary tract symptoms in patients with benign prostatic hyperplasia. J Urol2000; 163: 1725. Link, Google Scholar 4 : Association between markers of the metabolic syndrome and lower urinary tract symptoms in the Third National Health and Nutrition Examination Survey (NHANES III). Int J Obes (Lond)2005; 29: 310. Google Scholar 5 : Obesity and benign prostatic hyperplasia. Am J Epidemiol1994; 140: 989. Google Scholar 6 : Components of the metabolic syndrome-risk factors for the development of benign prostatic hyperplasia. Prostate Cancer Prostatic Dis1998; 1: 157. Google Scholar 7 : Metabolic factors associated with benign prostatic hyperplasia. J Clin Endocrinol Metab2006; 91: 2562. Google Scholar 8 : Associations of obesity with lower urinary tract symptoms and noncancer prostate surgery in the Third National Health and Nutrition Examination Survey. Am J Epidemiol2004; 159: 390. Google Scholar 9 : Association of anthropometric measures with the presence and progression of benign prostatic hyperplasia. Am J Epidemiol2006; 164: 41. Google Scholar 10 : Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. J Clin Epidemiol2001; 54: 935. Google Scholar 11 : Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Eur Urol2005; 47: 824. Google Scholar 12 : Physical activity and benign prostatic hyperplasia. Arch Intern Med1998; 158: 2349. Google Scholar 13 : Alcohol consumption, cigarette smoking, and risk of benign prostatic hyperplasia. Am J Epidemiol1999; 149: 106. Google Scholar 14 : Association of cigarette smoking, alcohol consumption and physical activity with lower urinary tract symptoms in older American men: findings from the third National Health And Nutrition Examination Survey. BJU Int2005; 96: 77. Google Scholar 15 : Clinical, anthropometric, metabolic and insulin profile of men with fast annual growth rates of benign prostatic hyperplasia. Blood Press1999; 8: 29. Google Scholar 16 : Hyperinsulinaemia as a risk factor for developing benign prostatic hyperplasia. Eur Urol2001; 39: 151. Google Scholar 17 : Measuring the urologic iceberg: design and implementation of the Boston Area Community Health (BACH) Survey. Eur Urol2007; 52: 389. Google Scholar 18 : The American Urological Association symptom index for benign prostatic hyperplasia: The Measurement Committee of the American Urological Association. J Urol1992; 148: 1549. Abstract, Google Scholar 19 : Validation of a harmonized Spanish version of the IPSS: evidence of equivalence with the original American scale: International Prostate Symptom Score. Urology1998; 52: 614. Google Scholar 20 : Validation of a new quality of life questionnaire for benign prostatic hyperplasia. J Clin Epidemiol1992; 45: 1431. Crossref, Medline, Google Scholar 21 Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA2001; 285: 2486. Google Scholar 22 : Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol2006; 176: 222. Link, Google Scholar 23 : The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol1993; 46: 153. Google Scholar 24 : Manual for scoring socioeconomic status for research on health behavior. Public Health Rep1970; 85: 815. Google Scholar 25 : Analysis of Incomplete Multivariate Data. London: Chapman and Hall1997. Google Scholar 26 : Increasing prevalence of the metabolic syndrome among U.S. adults. Diabetes Care2004; 27: 2444. Google Scholar 27 : The prevalence of lower urinary tract symptoms in men and women in four centres: The UrEpik study. BJU Int2003; 92: 409. Google Scholar 28 : Does America's expanding waistline increase the likelihood of urologic symptoms?: Results from the Boston Area Community Health (BACH) study. J Urol2008; 179: 141. abstract 398. Link, Google Scholar 29 : Selective nitrergic neurodegeneration in diabetes mellitus - a nitric oxide-dependent phenomenon. Br J Pharmacol1999; 128: 1804. Google Scholar 30 : Metabolic syndrome and lower urinary tract symptoms secondary to benign prostatic hyperplasia. Curr Urol Rep2006; 7: 288. Google Scholar 31 : Sildenafil citrate improves erectile function and urinary symptoms in men with erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized double-blind trial. J Urol2007; 177: 1071. Link, Google Scholar 32 : Tadalafil relieves lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol2007; 177: 1401. Link, Google Scholar 33 : Lower urinary tract symptoms and erectile dysfunction; links for diagnosis, management and treatment. Int J Impot Res2007; 19: 544. Google Scholar 34 : Do atherosclerosis and chronic bladder ischemia really play a role in detrusor dysfunction of old age?. Urology2005; 65: 181. Google Scholar 35 : Urologic complications of diabetes. Diabetes Care2005; 28: 177. Google Scholar 36 : Cystometric evaluation of bladder dysfunction in elderly diabetic patients. Arch Intern Med1990; 150: 810. Google Scholar 37 : Diabetic cystopathy: relationship to autonomic neuropathy detected by sympathetic skin response. J Urol1997; 157: 580. Link, Google Scholar © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byGriebling T (2016) Re: Challenging the Inevitability of Prostate Enlargement: Low Levels of Benign Prostatic Hyperplasia among Tsimane Forager-HorticulturalistsJournal of Urology, VOL. 197, NO. 3 Part 1, (773-773), Online publication date: 1-Mar-2017.Kaplan S (2016) Re: Impact of Metabolic Syndrome on Response to Medical Treatment of Benign Prostatic HyperplasiaJournal of Urology, VOL. 195, NO. 5, (1545-1547), Online publication date: 1-May-2016.Barbosa J, Muracca E, Nakano É, Assalin A, Cordeiro P, Paranhos M, Cury J, Srougi M and Antunes A (2013) Interactions between Lower Urinary Tract Symptoms and Cardiovascular Risk Factors Determine Distinct Patterns of Erectile Dysfunction: A Latent Class AnalysisJournal of Urology, VOL. 190, NO. 6, (2177-2182), Online publication date: 1-Dec-2013.Related articlesJournal of Urology18 Jun 2009Association of Lower Urinary Tract Symptoms and the Metabolic Syndrome: Results From the Boston Area Community Health Survey Volume 189Issue 1SJanuary 2013Page: S107-S116 Advertisement Copyright FAX: 617-926-8246; e-mail: email protected). More articles by this author Expand All Advertisement PDF downloadLoading ...