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Non-linear Relationship Between Body Mass Index and Lower Urinary Tract Symptoms in Korean Males

  • Choi, Chang Kyun (Department of Preventive Medicine, Chonnam National University Medical School) ;
  • Kim, Sun A (Department of Preventive Medicine, Chonnam National University Medical School) ;
  • Jeong, Ji-An (Department of Preventive Medicine, Chonnam National University Medical School) ;
  • Kweon, Sun-Seog (Department of Preventive Medicine, Chonnam National University Medical School) ;
  • Shin, Min-Ho (Department of Preventive Medicine, Chonnam National University Medical School)
  • Received : 2018.11.09
  • Accepted : 2019.02.14
  • Published : 2019.05.31

Abstract

Objectives: The purpose of this study was to evaluate the association between body mass index (BMI) and severe lower urinary tract symptoms (LUTS) in Korean males. Methods: This study was conducted on males aged ${\geq}50years$ who participated in the 2011 Korean Community Health Survey. LUTS severity was assessed using the Korean version of the International Prostate Symptom Score (IPSS) questionnaire, and was dichotomized as severe (IPSS >19) and non-severe ($IPSS{\leq}19$). BMI was divided into 6 categories: <18.5, 18.5-22.9, 23.0-24.9, 25.0-27.4, 27.5-29.9, and ${\geq}30.0kg/m^2$. To evaluate the relationship between BMI and LUTS, a survey-weighted multivariate Poisson regression analysis was performed to estimate prevalence rate ratios (PRRs). Age, smoking status, alcohol intake, physical activity, educational level, household income, and comorbidities were adjusted for in the multivariate model. Results: A U-shaped relationship was detected between BMI and severe LUTS. Compared with a BMI of $23.0-24.9kg/m^2$, the PRR for a BMI < $18.5kg/m^2$ was 1.65 (95% confidence interval [CI], 1.35 to 2.02), that for a BMI of $18.5-22.9kg/m^2$ was 1.25 (95% CI, 1.09 to 1.44), that for a BMI of $25.0-27.4kg/m^2$ was 1.20 (95% CI, 1.00 to 1.45), that for a BMI of $27.5-29.9kg/m^2$ was 1.11 (95% CI, 0.83 to 1.47), and that for a BMI ${\geq}30.0kg/m^2$ was 1.85 (95% CI, 1.18 to 2.88). Conclusions: This study showed that both high and low BMI were associated with severe LUTS.

Keywords

References

  1. Sarma AV, Parsons JK, McVary K, Wei JT. Diabetes and benign prostatic hyperplasia/lower urinary tract symptoms--what do we know? J Urol 2009;182(6 Suppl):S32-S37.
  2. Gibbons EP, Colen J, Nelson JB, Benoit RM. Correlation between risk factors for vascular disease and the American Urological Association Symptom Score. BJU Int 2007;99(1):97-100. https://doi.org/10.1111/j.1464-410X.2007.06548.x
  3. Park JH, Cho IC, Kim YS, Kim SK, Min SK, Kye SS. Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health. Korean J Urol 2015;56(5):386-392. https://doi.org/10.4111/kju.2015.56.5.386
  4. Chapple C, Castro-Diaz D, Chuang YC, Lee KS, Liao L, Liu SP, et al. Prevalence of lower urinary tract symptoms in China, Taiwan, and South Korea: results from a cross-sectional, population-based study. Adv Ther 2017;34(8):1953-1965. https://doi.org/10.1007/s12325-017-0577-9
  5. Han HH, Park JW, Na JC, Chung BH, Kim CS, Ko WJ. Epidemiology of prostate cancer in South Korea. Prostate Int 2015;3(3):99-102. https://doi.org/10.1016/j.prnil.2015.06.003
  6. Robertson C, Link CL, Onel E, Mazzetta C, Keech M, Hobbs R, et al. The impact of lower urinary tract symptoms and comorbidities on quality of life: the BACH and UREPIK studies. BJU Int 2007;99(2):347-354. https://doi.org/10.1111/j.1464-410X.2007.06609.x
  7. Coyne KS, Sexton CC, Irwin DE, Kopp ZS, Kelleher CJ, Milsom I. The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU Int 2008;101(11):1388-1395. https://doi.org/10.1111/j.1464-410X.2008.07601.x
  8. Gibson W, Hunter KF, Camicioli R, Booth J, Skelton DA, Dumoulin C, et al. The association between lower urinary tract symptoms and falls: forming a theoretical model for a research agenda. Neurourol Urodyn 2018;37(1):501-509. https://doi.org/10.1002/nau.23295
  9. Noguchi N, Chan L, Cumming RG, Blyth FM, Naganathan V. A systematic review of the association between lower urinary tract symptoms and falls, injuries, and fractures in community-dwelling older men. Aging Male 2016;19(3):168-174. https://doi.org/10.3109/13685538.2016.1169399
  10. Chen Y, Yu W, Zhou L, Wu S, Yang Y, Wang J, et al. Relationship among diet habit and lower urinary tract symptoms and sexual function in outpatient-based males with LUTS/BPH: a multiregional and cross-sectional study in China. BMJ Open 2016;6(8):e010863. https://doi.org/10.1136/bmjopen-2015-010863
  11. Maserejian NN, Chen S, Chiu GR, Araujo AB, Kupelian V, Hall SA, et al. Treatment status and progression or regression of lower urinary tract symptoms in a general adult population sample. J Urol 2014;191(1):107-113. https://doi.org/10.1016/j.juro.2013.07.005
  12. Parsons JK, Messer K, White M, Barrett-Connor E, Bauer DC, Marshall LM, et al. Obesity increases and physical activity decreases lower urinary tract symptom risk in older men: the Osteoporotic Fractures in Men Study. Eur Urol 2011;60(6):1173-1180. https://doi.org/10.1016/j.eururo.2011.07.040
  13. Bhindi B, Margel D, Trottier G, Hamilton RJ, Kulkarni GS, Hersey KM, et al. Obesity is associated with larger prostate volume but not with worse urinary symptoms: analysis of a large multiethnic cohort. Urology 2014;83(1):81-87. https://doi.org/10.1016/j.urology.2013.07.039
  14. Rohrmann S, Smit E, Giovannucci E, Platz EA. Associations of obesity with lower urinary tract symptoms and noncancer prostate surgery in the Third National Health and Nutrition Examination Survey. Am J Epidemiol 2004;159(4):390-397. https://doi.org/10.1093/aje/kwh060
  15. Kristal AR, Arnold KB, Schenk JM, Neuhouser ML, Weiss N, Goodman P, et al. Race/ethnicity, obesity, health related behaviors and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial. J Urol 2007;177(4):1395-1400. https://doi.org/10.1016/j.juro.2006.11.065
  16. Kang YW, Ko YS, Kim YJ, Sung KM, Kim HJ, Choi HY, et al. Korea Community Health Survey data profiles. Osong Public Health Res Perspect 2015;6(3):211-217. https://doi.org/10.1016/j.phrp.2015.05.003
  17. Choi HR, Chung WS, Shim BS, Kwon SW, Hong SJ, Chung BH, et al. Translation validity and reliability of I-PSS Korean version. Korean J Urol 1996;37(6):659-665 (Korean).
  18. D'Silva KA, Dahm P, Wong CL. Does this man with lower urinary tract symptoms have bladder outlet obstruction? The rational clinical examination: a systematic review. JAMA 2014;312(5):535-542. https://doi.org/10.1001/jama.2014.5555
  19. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363(9403):157-163. https://doi.org/10.1016/S0140-6736(03)15268-3
  20. Lumley T. Analysis of complex survey samples. J Stat Softw 2014;9(1);1-19.
  21. Smith DP, Weber MF, Soga K, Korda RJ, Tikellis G, Patel MI, et al. Relationship between lifestyle and health factors and severe lower urinary tract symptoms (LUTS) in 106,435 middle-aged and older Australian men: population-based study. PLoS One 2014;9(10):e109278. https://doi.org/10.1371/journal.pone.0109278
  22. Kim SY, Bang W, Choi HG. Analysis of the prevalence and associated factors of overactive bladder in adult Korean men. PLoS One 2017;12(4):e0175641. https://doi.org/10.1371/journal.pone.0175641
  23. Rohrmann S, Platz EA, Giovannucci E. Lifestyle and benign prostatic hyperplasia in older men: what do we know? J Mens Health Gend 2005;2(2):230-235. https://doi.org/10.1016/j.jmhg.2005.03.009
  24. Sayeed A, Alam N, Trerotola M, Languino LR. Insulin-like growth factor 1 stimulation of androgen receptor activity requires ${\beta}(1A)$ integrins. J Cell Physiol 2012;227(2):751-758. https://doi.org/10.1002/jcp.22784
  25. Vermeulen A, Kaufman JM, Giagulli VA. Influence of some biological indexes on sex hormone-binding globulin and androgen levels in aging or obese males. J Clin Endocrinol Metab 1996;81(5):1821-1826. https://doi.org/10.1210/jc.81.5.1821
  26. Ricke WA, McPherson SJ, Bianco JJ, Cunha GR, Wang Y, Risbridger GP. Prostatic hormonal carcinogenesis is mediated by in situ estrogen production and estrogen receptor alpha signaling. FASEB J 2008;22(5):1512-1520. https://doi.org/10.1096/fj.07-9526com
  27. Cussenot O, Azzouzi AR, Nicolaiew N, Fromont G, Mangin P, Cormier L, et al. Combination of polymorphisms from genes related to estrogen metabolism and risk of prostate cancers: the hidden face of estrogens. J Clin Oncol 2007;25(24):3596-3602. https://doi.org/10.1200/JCO.2007.11.0908
  28. Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol (1985) 2003;95(5):1851-1860. https://doi.org/10.1152/japplphysiol.00246.2003
  29. Roubenoff R. Sarcopenia and its implications for the elderly. Eur J Clin Nutr 2000;54 Suppl 3:S40-S47. https://doi.org/10.1038/sj.ejcn.1601024
  30. Hulman A, Ibsen DB, Laursen AS, Dahm CC. Body mass index trajectories preceding first report of poor self-rated health: a longitudinal case-control analysis of the English Longitudinal Study of Ageing. PLoS One 2019;14(2):e0212862. https://doi.org/10.1371/journal.pone.0212862
  31. Nuotio M, Tammela TL, Luukkaala T, Jylha M. Association of urgency symptoms with self-rated health, mood and functioning in an older population. Aging Clin Exp Res 2007;19(6):465-471. https://doi.org/10.1007/BF03324732
  32. Jeong JY, Kim DH, Kim KY, Ryu SY, Lee SY, Park YS. Accuracy of self-reported height, weight and body mass index in Community Health Survey in South Korea. J Health Info Stat 2017;42(3):241-249 (Korean). https://doi.org/10.21032/jhis.2017.42.3.241