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盧令一 由EpiLUTS統計資料看身體質量指數(BMI)與各類尿失禁之關聯性 2014/4/29 上午 10:40:10 0
原 文 題  目 The Relationship Between BMI and Urinary Incontinence Subgroups: Results From EpiLUTS
作  者 Vik Khullar, Chris C. Sexton, Christine L. Thompson, Ian Milsom, Caty Ebel Bitoun, and Karin S. Coyne
出  處 Neurourology and Urodynamics 33:392–399
出版日期 April, 2014
評 論 已經有很多醫學研究指出,身體質量指數(BMI)愈高的女性,發生尿失禁的風險與機率就愈高。但是BMI與各種尿失禁的關聯性都一樣嗎?對男性也一樣適用嗎?EpiLUTS是由輝瑞藥廠贊助的大型跨國性調查,針對美國英國以及瑞典將近30000位40歲以上的男女藉由網路問卷,統計BMI與各類尿失禁的關係(UUI、SUI、及MUI)。結果顯示,女性方面有尿失禁的群體中肥胖比例最高的是MUI 及 SUI;男性方面則是MUI 及UUI。體重過重(29.9≧BMI≧25)的女性,的確比較容易有SUI,但在同樣BMI的男性則不明顯。但對肥胖(BMI≧30)的女性來說,不只罹患SUI的風險增加,得到MUI的機會也增加;同樣BMI的男性則比較容易有UUI。作者的結論指出,BMI增加不僅增加UI的風險,對性別以及UI的種類則有不同程度的影響。個人認為,對於尿失禁病患的護理指導以及復健訓練上,無論男女,如何幫助病患有效的減重必須是不可忽略的一環,當然由文章的結論看來,男性似乎可以比女性稍微放肆一點。
abstract Aims: To evaluate the relationship between body mass index (BMI) and urinary incontinence (UI) in adults_40 from the United States, United Kingdom, and Sweden. Methods: This was a secondary analysis of EpiLUTS—a population representative, cross-sectional, Internet-based survey conducted to assess the prevalence and HRQL impact of urinary symptoms. UI was evaluated by the LUTS Tool and categorized by subgroups: no UI, urgency urinary incontinence (UUI), stress urinary incontinence (SUI), mixed urinary incontinence (MUI) (UUI + SUI), UUI + other UI (OI), SUI+ OI, and OI. Descriptive statistics were used. Logistic regressions examined the relationship of BMI to UI controlling for demographics and comorbid conditions. Results: Response rate was 59%; 10,070 men and 13,178 women were included. Significant differences in BMI were found across UI subgroups. Obesity rates were highest among those with MUI (men and women), SUI+ OI (women), UUI and UUI + OI (men). Logistic regressions of each UI subgroup showed that BMI ≧ 30 (obese) was associated with UI in general and MUI (women) and UUI + OI (men). Among women, being obese increased the odds of having SUI and SUI+ OI. Women with BMI 25–29.9 (overweight) were more likely to have UI in general and SUI with and without other incontinence (SUI, MUI, and SUI + OI). Being overweight was unrelated to any form of UI in men. Conclusions: Results were consistent with prior research showing BMI is associated with higher risk of UI. These findings indicate substantial differences in obesity by gender and UI subtype, suggesting different mechanisms for UI other than purely mechanical stress on the bladder.
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