Obesity, physical activity and lower urinary tract symptoms: results from the Southern Community Cohort Study.
OBJECTIVE
Obesity and physical activity have been posited as modifiable risk factors to delay lower urinary tract symptom progression. In this study we determined the independent associations of physical activity and obesity with lower urinary tract symptoms at followup among white and African-American men.


METHODS
Male participants 40 to 79 years old were identified from the Southern Community Cohort Study, a prospective cohort based in the southeastern United States. Baseline data collection included a validated physical activity questionnaire, height and weight, health history and other information. We excluded participants with a history of or medication use for benign prostatic hyperplasia or prostate cancer. Participants (7,318, 60% African-American) completed the International Prostate Symptom Score approximately 5 years after baseline. Patients with an International Prostate Symptom Score greater than 8 or 20 were classified as having moderate or severe lower urinary tract symptoms, respectively, at followup. Multivariable logistic regression was used to assess the relationships among obesity, physical activity and lower urinary tract symptoms.


RESULTS
Moderate to severe lower urinary tract symptom severity at followup was significantly associated with a body mass index of 35 kg/m(2) or more (OR 1.38, 95% CI 1.17-1.63). Similarly the lowest categories of physical activity were associated with the onset of severe lower urinary tract symptoms in men with a normal body mass index (OR 1.38, 95% CI 1.05-1.82). These associations were independent of race.


CONCLUSIONS
Severe obesity is associated with an increased risk of lower urinary tract symptoms at followup, while physical inactivity may permit progression of lower urinary tract symptoms in normal weight men regardless of race. These variables should be considered in future research into modifiable risk factors for lower urinary tract symptoms.
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37203-1738, USA. david.penson@vanderbilt.edu
David F
DF
Penson
Heather M
HM
Munro
Lisa B
LB
Signorello
William J
WJ
Blot
Jay H
JH
Fowke
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D012720:Severity of Illness Index; D044465:White People / Q000706:statistics & numerical data*