Association of lower urinary tract syndrome with peripheral arterial occlusive disease

Wei-Yu Lin; Karl-Erik Andersson; Cheng-Li Lin; Chia-Hung Kao; Hsi-Chin Wu

doi:10.1371/journal.pone.0170288

Association of lower urinary tract syndrome with peripheral arterial occlusive disease

PLoS One. 2017 Mar 16;12(3):e0170288. doi: 10.1371/journal.pone.0170288. eCollection 2017.

Authors

Wei-Yu Lin^{1

2

3

4}, Karl-Erik Andersson⁵, Cheng-Li Lin^{6

7}, Chia-Hung Kao^{8

9

10}, Hsi-Chin Wu^{8

11}

Affiliations

¹ Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan.
² Department of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Chang Gung University of Science and Technology, Chia-Yi, Taiwan.
⁴ Department of Medicine and Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan.
⁵ Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America.
⁶ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
⁷ College of Medicine, China Medical University, Taichung, Taiwan.
⁸ Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
⁹ Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
¹⁰ Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
¹¹ Department of Urology, China Medical University Beigang Hospital, Taichung, Taiwan.

Abstract

Purpose: To describe atherosclerosis may lead to chronic bladder ischemia, eventually resulting in lower urinary tract syndrome (LUTS), and peripheral arterial occlusive disease (PAOD). We investigated the association of LUTS with PAOD.

Methods: This nationwide population-based cohort study was based on data from the Taiwan National Health Insurance Database from 2000 to 2010; follow-up lasted until the end of 2011. We identified patients with newly diagnosed LUTS by using International Classification of Diseases, Ninth Revision, Clinical Modification codes.

Results: In total, 36,042 and 36,042 patients were enrolled in LUTS and non-LUTS cohorts, respectively. After adjustment for age, sex, and comorbidities, the risk of subsequent PAOD was 1.36-fold higher [95% confidence interval (CI) = 1.26-1.46] in the LUTS cohort than in the non-LUTS cohort. The adjusted risk of PAOD was the highest in patients with LUTS without any comorbidity [adjusted hazard ratio (aHR) = 1.93, 95% CI = 1.54-2.41]. The age-specific relative risk of PAOD was significantly higher in all age groups, particularly in those aged <49 years (aHR = 1.80, 95% CI = 1.39-2.34], in the LUTS cohort than in the non-LUTS cohort.

Conclusion: LUTS is a risk factor for PAOD. Physicians should consider the possibility of underlying PAOD in patients with LUTS aged <49 years and without cardiovascular comorbidities. Additional studies developing strategies for decreasing the risk of PAOD are warranted.

MeSH terms

Aged
Cohort Studies
Female
Humans
Male
Middle Aged
Peripheral Arterial Disease / complications*
Urologic Diseases / complications*

Grants and funding

This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037), NRPB Stroke Clinical Trial Consortium (MOST 104-2325-B-039 -005), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan; and CMU under the Aim for Top University Plan of the Ministry of Education, Taiwan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.