Objectives The objectives of this study were to: 1) investigate the relationship between LUTS as defined by the American Urologic Association Symptom Index (AUA-SI) and the metabolic syndrome (MetS); and 2) determine the relationship between individual symptoms comprising the AUA-SI and MetS. Methods The Boston Area Community Health (BACH) Survey used a two-stage cluster design to recruit a random sample of 2,301 men age 30-79. Analyses were conducted on 1,899 men who provided blood samples. Urologic symptoms comprising the American Urological Association symptom index were included in the analysis. MetS was defined using a modification of the Adult Treatment Panel (ATP) III guidelines. The association between LUTS and MetS was assessed using odds ratios and 95% confidence intervals estimated using logistic regression models. Results Increased odds of MetS were observed among men with mild to severe symptoms (AUA-SI 2-35) compared to men with an AUA-SI score of 0 or 1 (multivariate Odds Ratio (OR)=1.68, 95% confidence interval (CI): 1.21, 2.35). A statistically significant association was observed between MetS and voiding symptom score ≥5 (multivariate adjusted OR=1.73, 95%CI: 1.06, 2.80) but not for storage symptom score ≥4 (multivariate adjusted OR=0.94, 95%CI: 0.66, 1.33). Increased odds of MetS were observed even with mild symptoms, primarily for incomplete emptying, intermittency, and nocturia. These associations were observed primarily among younger men (age<60 years) and were null among older men (age≥60 years). Conclusions The observed association between urologic symptoms and MetS provides further evidence of common underlying factors between LUTS and chronic conditions outside the urinary tract.

Purpose-The objectives of this study were to: 1) investigate the association between lower urinary tract symptoms (LUTS) and chronic illnesses such as heart disease, diabetes, hypertension, and depression in men and women, and 2) to determine whether a dose-response relationship exists in the association between the severity and duration of urologic symptoms and major chronic illnesses. Materials and Methods-TheBoston Area Community Health (BACH) Survey used a multistage stratified design to recruit a random sample of 5,503 adults age 30-79. Urologic symptoms comprising the American Urological Association symptom index were included in the analysis.Results-Statistically significant associations, consistent by gender, were observed between depression and all urologic symptoms. Nocturia of any degree of severity or duration was associated with heart disease among men and with diabetes among women. Among men, a dose-response relationship was observed in the association of symptom severity and/or duration of urinary intermittency and frequency with heart disease, and in the association of urinary urgency with diabetes. Among women, a history of heart disease was associated with weak stream and straining, while a history of hypertension was associated with urgency and weak stream.Conclusions-Results indicate a dose-response relationship in the association of both severity and duration of urologic symptoms with major chronic illnesses. An association between urinary symptoms and depression was observed in both men and women. In contrast, the association between LUTS and heart disease, diabetes, or hypertension varied by gender, suggesting different mechanisms of association in men and women.

The observed association between urological symptoms and the metabolic syndrome provides further evidence of common underlying factors between lower urinary tract symptoms and chronic conditions outside the urinary tract.

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Objectives The objectives of this study were: 1) to determine whether there is an association between C-reactive protein (CRP) levels and lower urinary tract symptoms (LUTS) as assessed by the American Urological Association Symptom Index (AUA-SI) among both men and women, 2) to determine the association of CRP levels with individual urologic symptoms comprising the AUA-SI among both men and women. Methods The Boston Area Community Health (BACH) Survey used a multistage stratified design to recruit a random sample of 5,502 adults age 30–79. Blood samples were obtained on 3,752 participants. Analyses were conducted on 1,898 men and 1,854 women with complete data on C-Reactive Protein (CRP) levels. Overall LUTS was defined as an AUA-SI≥8 (moderate to severe LUTS). Urologic symptoms comprising the AUA-SI were included in the analysis as reports of fairly often to almost always vs. non/rarely/a few times. Results A statistically significant association was observed between CRP levels and overall LUTS among both men and women. The pattern of associations between individual symptoms and CRP levels varied by gender. Nocturia and straining were associated with higher CRP levels among men, while incomplete emptying and weak stream were associated with higher CRP levels among women. Conclusions This study demonstrates an association between CRP levels and LUTS in both men and women. The dose-response relationship between increased CRP levels and increased odds of LUTS supports the hypothesized role of inflammatory processes in the etiology of LUTS.