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| Association of advanced glycation end-product accumulation with overactive bladder in community-dwelling elderly: A cross-sectional Sukagawa study |
Kenji Omaea,b,c,d,Noriaki Kuritab,c,e,*( ),Sei Takahashia,b,Shingo Fukumab,f,Yosuke Yamamotoa,Shunichi Fukuharaa,b,The Sukagawa Study Group
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a Kyoto University, School of Public Health in the Graduate School of Medicine, Department of Healthcare Epidemiology, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
b Fukushima Medical University, Center for Innovative Research for Communities and Clinical Excellence, 1 Hikarigaoka, Fukushima City, Fukushima, Japan
c Fukushima Medical University Hospital, Department of Innovative Research and Education for Clinicians and Trainees, 1 Hikarigaoka, Fukushima City, Fukushima, Japan
d Tokyo Women’s Medical University, Department of Urology, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
e Fukushima Medical University, Graduate School of Medicine, Department of Clinical Epidemiology, 1 Hikarigaoka, Fukushima City, Fukushima, Japan
f Kyoto University, Graduate School of Medicine, Human Health Sciences, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan |
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Abstract Objective This study aimed to evaluate the influence of advanced glycation end-product (AGE) accumulation on the prevalence and severity of overactive bladder (OAB) in community-dwelling elderly adults.
Methods We conducted a cross-sectional study involving 269 Japanese community dwellers aged ≥75 years in 2015. AGE accumulation was non-invasively measured via skin autofluorescence (SAF) values using AGE Reader. The primary and secondary outcomes were the presence and severity of OAB evaluated using the Overactive Bladder Symptom Score (OABSS). Individuals with an urgency score of ≥2 and sum score of ≥3 were considered to have OAB. The associations of SAF with the prevalence and severity of OAB were assessed using logistic and linear regression models, respectively, adjusted for clinically important confounders.
Results The median age of participants was 78 years. Of 269 participants, 110 (40.9%) were men and 75 (27.9%) had OAB. The median SAF was 2.2 arbitrary units (AUs). Increasing median SAF was observed with increasing age. Multivariable analysis revealed that SAF was not associated with either the likelihood of having OAB (odds ratio per AU=0.77, 95% confidence interval: 0.37-1.62) or the natural log-transformed OABSS (β per AU=-0.07, 95% confidence interval: -0.26-0.12).
Conclusions In this study, AGE accumulation, as assessed by SAF, was not associated with the prevalence and severity of OAB in Japanese community-dwelling elderly people aged ≥75 years.
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Received: 01 April 2019
Available online: 27 March 2020
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Corresponding Authors:
Noriaki Kurita
E-mail: kuritanoriaki@gmail.com
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Flowchart of the study participants. OABSS, Overactive Bladder Symptom Score; SAF, skin autofluorescence.
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| Characteristics | All participants (n=269) | Participants with OAB (n=75) | Participants without OAB (n=194) | Number of participants with missing data | | Age (year) | 79.4, 78 (76, 82) | 80.1, 79 (77, 83) | 79.1, 78 (76, 81) | 0 | | Male sex, % | 40.9 | 46.7 | 38.7 | 0 | | BMI, kg/m2 | 22.8, 22.7 (20.3, 25.1) | 22.9, 23 (21, 25.6) | 22.7, 22.7 (20.2, 24.6) | 0 | | Smoking, % | 31.2 | 41.3 | 27.3 | 19 | | Hypertension, % | 36.8 | 33.3 | 38.1 | 0 | | Diabetes, % | 8.6 | 9.3 | 8.3 | 86 | | Overweight, % | 26 | 33.3 | 23.2 | 0 | | SAF (AU) | 2.3, 2.2 (2.0, 2.5) | 2.3, 2.3 (1.9, 2.6) | 2.3, 2.2 (2.0, 2.5) | 0 | | OABSS | | Total | 3.6, 3 (2, 5) | 6.9, 7 (5, 8) | 2.3, 2 (1, 3) | 0 | | Daytime frequency | 0.5, 1 (0, 1) | 0.7, 1 (0, 1) | 0.5, 0 (0, 1) | 0 | | Nighttime frequency | 1.5, 1 (1, 2) | 2.0, 2 (1, 3) | 1.3, 1 (1, 2) | 0 | | Urgency | 1.0, 0 (0, 2) | 2.9, 3 (2, 3) | 0.2, 0 (0, 0) | 0 | | Urgency incontinence | 0.6, 0 (0, 1) | 1.4, 1 (0, 3) | 0.2, 0 (0, 0) | 0 |
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Baseline characteristics of the participants.
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Scatter plots of age and SAF, and SAF and OABSS. OABSS, Overactive Bladder Symptom Score; SAF, skin autofluorescence.
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| Variables | Log-transformed OABSS | | Coefficient, median (95% CI) | p-Value | | Model 2a | | SAF, per AU | 0.019 (-0.16-0.19) | 0.83 | | Model 4b | | SAF, per AU | -0.07 (-0.26-0.12) | 0.45 | | Age, per year | 0.02 (0.005-0.039) | 0.013 | | Female sex (vs. male) | -0.13 (-0.34-0.078) | 0.22 | | Overweight, yes (vs. no) | 0.15 (-0.011-0.31) | 0.067 | | Diabetes, yes (vs. no) | 0.12 (-0.14-0.39) | 0.35 | | Hypertension, yes (vs. no) | -0.18 (-0.33--0.036) | 0.015 | | Smoking, yes (vs. no) | -0.0005 (-0.22-0.22) | 1 |
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Association between SAF and the log-transformed total OABSS.
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| Variable | OAB | Daytime frequency | Nighttime frequency | Urgency | Urgency incontinence | | OR (95% CI) | p-Value | OR (95% CI) | p-Value | OR (95% CI) | p-Value | OR (95% CI) | p-Value | OR (95% CI) | p-Value | | Model 1a | | SAF, per AU | 1.05 (0.55-2.05) | 0.86 | 0.85 (0.47-1.54) | 0.59 | 1.23 (0.47-3.22) | 0.67 | 1.20 (0.66-2.18) | 0.56 | 0.98 (0.51-1.87) | 0.95 | | Model 2b | | SAF, per AU | 0.77 (0.37-1.62) | 0.49 | 1.11 (0.57-2.18) | 0.75 | 0.65 (0.21-2.01) | 0.46 | 0.86 (0.44-1.68) | 0.65 | 0.92 (0.44-1.89) | 0.81 | | Age, per year | 1.07 (1.00-1.14) | 0.061 | 1.02 (0.95-1.08) | 0.61 | 0.94 (0.86-1.04) | 0.22 | 1.06 (1.00-1.13) | 0.053 | 1.07 (1.00-1.15) | 0.039 | | Female sex (vs. male) | 1.26 (0.53-2.96) | 0.6 | 1.49 (0.70-3.15) | 0.3 | 0.08 (0.01-0.43) | 0.004 | 0.62 (0.29-1.32) | 0.22 | 1.55 (0.67-3.57) | 0.3 | | Overweight, yes (vs. no) | 1.84 (0.99-3.44) | 0.056 | 1.18 (0.66-2.11) | 0.58 | 0.89 (0.35-2.27) | 0.8 | 2.15 (1.20-3.86) | 0.01 | 1.82 (0.97-3.39) | 0.061 | | Diabetes, yes (vs. no) | 1.44 (0.53-3.90) | 0.47 | 0.33 (0.14-0.80) | 0.014 | 3.18 (0.46-21.75) | 0.24 | 1.69 (0.71-3.99) | 2.64 | 2.02 (0.86-4.78) | 0.11 | | Hypertension, yes (vs. no) | 0.69 (0.38-1.25) | 0.22 | 0.95 (0.56-1.61) | 0.85 | 0.56 (0.24-1.28) | 0.17 | 0.64 (0.37-1.10) | 0.11 | 0.49 (0.27-0.90) | 0.02 | | Smoking, yes (vs. no) | 2.37 (1.00-5.60) | 0.05 | 1.12 (0.52-2.44) | 0.77 | 0.37 (0.08-1.72) | 0.2 | 1.04 (0.48-2.25) | 0.93 | 1.09 (0.46-2.59) | 0.84 |
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Association between SAF and Overactive Bladder Symptom Score.
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