中老年男性虚弱指数与下尿路症状/前列腺增生之间的关联

Association between Frailty Index and Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia in Middle-Aged and Elderly Men

摘要: 目的：评估虚弱指数(FI)与中国中老年男性下尿路症状/良性前列腺增生(LUTS/BPH)之间的关联。方法：采用中国健康与养老追踪调查(CHARLS) 2011~2020年的数据，纳入15,847名45岁及以上男性受试者，分析FI与LUTS/BPH的关联。以多维度健康缺陷计算FI，并将其按四分位进行分组；LUTS/BPH采用问卷进行主观诊断。在控制年龄、居住地、婚姻状况、BMI、吸烟、饮酒及慢性疾病等协变量后，通过多因素logistic回归分析估计比值比(OR)及95%置信区间(CI)，并检验线性趋势与分层异质性。结果：本研究共纳入平均年龄为60.74 ± 9.46岁的受试者，其中1745人(11.01%)存在LUTS/BPH；高龄、低教育程度、农村居住、高血压、糖尿病、血脂异常等因素与虚弱程度升高相关。多变量logistic回归分析显示，FI升高与LUTS/BPH发生风险呈显著正相关，各模型对应的OR值分别为1.56、1.47、1.46、1.43 (均P < 0.0001)。FI四分位分析结果显示，与Q1相比，Q2、Q3、Q4受试者发生LUTS/BPH的OR值依次为1.48、1.99、3.08 (均P < 0.0001)。线性回归及限制性立方样条(RCS)分析均证实，虚弱程度加重与LUTS/BPH患病风险升高呈显著相关。结论：本研究证实，FI与LUTS/BPH的发生呈显著正相关，虚弱是中国中老年男性患LUTS/BPH的独立危险因素。

Abstract: Objective: To evaluate the association between Frailty Index (FI) and lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) in Chinese middle-aged and elderly men. Methods: Data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020 were used, and 15,847 male participants aged 45 years and above were included to analyze the association between FI and LUTS/BPH. FI was calculated based on multidimensional health deficits and grouped by quartiles. LUTS/BPH was subjectively diagnosed by questionnaire. After adjusting for covariates including age, residence, marital status, BMI, smoking, drinking, and chronic diseases, multivariate logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI), and linear trends and stratified heterogeneity were tested. Results: A total of participants with a mean age of 60.74 ± 9.46 years were included, of whom 1745 (11.01%) had LUTS/BPH. Advanced age, low education level, rural residence, hypertension, diabetes, and dyslipidemia were associated with increased frailty. Multivariate logistic regression showed that elevated FI was significantly positively associated with the risk of LUTS/BPH, with OR values of 1.56, 1.47, 1.46, and 1.43 in each model (all P < 0.0001). Quartile analysis showed that compared with Q1, the OR values of LUTS/BPH in Q2, Q3, and Q4 were 1.48, 1.99, and 3.08, respectively (all P < 0.0001). Linear regression and restricted cubic spline (RCS) analyses confirmed that increased frailty was significantly associated with a higher risk of LUTS/BPH. Conclusion: This study confirms that FI is significantly positively correlated with the occurrence of LUTS/BPH, and frailty is an independent risk factor for LUTS/BPH in Chinese middle-aged and elderly men.