Association of lower urinary tract syndrome with peripheral arterial occlusive disease.

Wei-Yu Lin,Hsi-Chin Wu,Chia-Hung Kao,Karl-Erik Andersson,Cheng-Li Lin,Giovanni Li Volti

doi:10.1371/journal.pone.0170288

Abstract

PurposeTo 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.MethodsThis 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.ResultsIn 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.ConclusionLUTS 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.

Highlights

In 2008, approximately 45.2% of the worldwide population (4.3 billion) was affected by at least one lower urinary tract syndrome (LUTS) [1]
The adjusted risk of peripheral arterial occlusive disease (PAOD) was the highest in patients with LUTS without any comorbidity [adjusted hazard ratio = 1.93, 95% confidence interval (CI) = 1.54–2.41]
The age-specific relative risk of PAOD was significantly higher in all age groups, in those aged

Summary

Introduction

In 2008, approximately 45.2% of the worldwide population (4.3 billion) was affected by at least one lower urinary tract syndrome (LUTS) [1]. Atherosclerosis can lead to chronic bladder ischemia, which may be crucial in the development of LUTS [3,4,5,6,7]. Atherosclerosis can lead to peripheral arterial occlusive disease (PAOD), which affects >202 million people worldwide [7,8]. Because LUTS and PAOD share certain risk factors, such as metabolic syndromes (hypertension, hyperlipidemia, and diabetes), obesity, smoking, and advanced age, we hypothesized that LUTS is a sentinel symptom in patients with PAOD [6, 10,11,12,13,14,15]

Methods

Results

Conclusion