Mental health and lower urinary tract symptoms: Results from the NHANES and Mendelian randomization study

Xiaotian Zhang; Leilei Ma; Jing Li; Wei Zhang; Yiran Xie; Yaoguang Wang

doi:10.1016/j.jpsychores.2024.111599

Mental health and lower urinary tract symptoms: Results from the NHANES and Mendelian randomization study

J Psychosom Res. 2024 Mar:178:111599. doi: 10.1016/j.jpsychores.2024.111599. Epub 2024 Jan 30.

Authors

Xiaotian Zhang¹, Leilei Ma¹, Jing Li¹, Wei Zhang¹, Yiran Xie¹, Yaoguang Wang²

Affiliations

¹ Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
² Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China. Electronic address: wangyaoguang1012@126.com.

PMID: 38309129
DOI: 10.1016/j.jpsychores.2024.111599

Abstract

Background: The clinical observations suggest a correlation between lower urinary tract symptoms (LUTSs) and mental health problems. Nonetheless, establishing a direct causal relationship between them remains challenging.

Methods: We initially conducted a cross-sectional study using 2005-2018 the National Health and Nutrition Examination Survey (NHANES) data. Multivariable-adjusted logistic regression was the primary statistical approach. Additionally, we employed Mendelian randomization (MR) to reducing confounding and reverse causation. Genetic instruments were obtained from publicly available genome-wide association study (GWAS) databases. Inverse Variance Weighted was the primary statistical method.

Results: The cross-sectional study involved 29,439 participants. Individuals with mental health problems had a higher risk of urinary incontinence (OR:4.38; 95%CI:3.32-5.76; P < 0.01) and overactive bladder (OR:2.31; 95%CI:2.02-2.63; P < 0.01). MR analysis then indicated a potential causal relationship between mental health problems and LUTSs. Depression symptoms was linked with urinary tract infection (UTI) (OR:1.005; 95%CI:1.003-1.008; P_FDR < 0.01). Anxiety symptoms was related to the occurrence of UTI (OR:1.024; 95%CI:1.011-1.037; P_FDR < 0.01) and bladder calcified/ contracted/ overactive (OR:1.017; 95%CI:1.007-1.027; P_FDR < 0.01). The personality trait of neuroticism was related to the occurrence of cystitis (OR:1.072; 95%CI:1.022-1.125; P_FDR = 0.02), extravasation of urine and difficulties with micturition (OR:1.001; 95%CI:1.001-1.002; P_FDR < 0.01), and urinary frequency and incontinence (OR: 1.001; 95%CI:1.000-1.001; P_FDR < 0.01).

Conclusions: Our study provides various evidence for the correlation between mental health and LUTSs, emphasizing the significance of adopting a holistic approach to LUTSs management that incorporates both physical and psychological factors.

Keywords: Cross-sectional study; Lower urinary tract symptoms; Mendelian randomization; Mental health; NHANES.

MeSH terms

Cross-Sectional Studies
Genome-Wide Association Study
Humans
Lower Urinary Tract Symptoms* / genetics
Mendelian Randomization Analysis
Mental Health
Nutrition Surveys
Urinary Incontinence*