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01-12-2020 | Nutrition | Original Paper

Nocturia is an Independent Predictor of Abdominal Aortic Calcification in Women: Results from the National Health and Nutrition Examination Survey

Authors: Saad Ahmed Khan, Ebad U. Rahman, Muchi Ditah Chobufo, Aneeq Yasin, Thomas F. Monaghan, Jeffrey P. Weiss, Jason M. Lazar

Published in: Journal of Community Health | Issue 6/2020

Abstract

Nocturia is generally considered a urological condition, but may be an indicator of cardiovascular disease, as prior studies have found associations with cardiovascular risk factors as well as clinical and subclinical markers of coronary artery disease. This study aimed to explore potential associations between nocturia and abdominal aortic calcification (AAC). We analyzed 2013–2014 National Health and Nutrition Examination Survey dual energy x-ray absorptiometry-derived AAC data and concurrent interview data on kidney conditions from respondents aged 40–80 years. AAC was defined as a score ≥ 1 on the 24-point semi-quantitative AAC scale. Nocturia was defined as an average of ≥ 2 voids per night. Three incremental multivariate logistic regression models controlling for (1) age, (2) sex, race, and BMI, and (3) hypertension, diabetes mellitus, and smoking history were used to determine whether nocturia predicted AAC. These models were and modified to exclude age and/or sex to perform age- and/or sex-specific sub-analyses, respectively. Complete data were available from 2,945 participants (29.1% AAC, 31.4% nocturia). On univariate analysis, the association between nocturia and AAC was significant in women (OR 1.77 [95% CI 1.37–2.29], p < 0.001), but not in men (1.14 [0.74–1.76], p = 0.531). Multivariate analysis showed nocturia was an independent predictor of AAC in women in Models I-II (ORs 1.49–1.58, p ≤ 0.032) but not Model III (1.37 [0.90–2.09], p = 0.133). Stratification by age revealed a strong univariate association among women aged 50–59 (3.88 [1.97–7.61], p < 0.001), which persisted across all multivariate models (ORs 4.05–4.41, p ≤ 0.001). The presence of nocturia is an important clue of AAC in women, especially those middle-aged.

Irwin, D. E., Milsom, I., Hunskaar, S., et al. (2006). Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: Results of the EPIC study. European Urology, 50(6), 1306–1314. https://doi.org/10.1016/j.eururo.2006.09.019 (discussion 1314–1305).CrossRef

Andersson, F., Anderson, P., Holm-Larsen, T., Piercy, J., Everaert, K., & Holbrook, T. (2016). Assessing the impact of nocturia on health-related quality-of-life and utility: Results of an observational survey in adults. Journal of Medical Economics , 19(12), 1200–1206. https://doi.org/10.1080/13696998.2016.1211136CrossRef

Middelkoop, H. A., Smilde-van den Doel, D. A., Neven, A. K., Kamphuisen, H. A., & Springer, C. P. (1996). Subjective sleep characteristics of 1,485 males and females aged 50–93: EEffects of sex and age, and factors related to self-evaluated quality of sleep. Journals of Gerontology Series A-Biological Sciences and Medical Sciences , 51(3), M108–M115. https://doi.org/10.1093/gerona/51a.3.m108CrossRef

Pesonen, J. S., Vernooij, R. W. M., Cartwright, R., et al. (2020). The impact of nocturia on falls and fractures: A systematic review and meta-analysis. Journal of Urology, 203(4), 674–683. https://doi.org/10.1097/ju.0000000000000459CrossRef

Bosch, J. L., & Weiss, J. P. (2013). The prevalence and causes of nocturia. Journal of Urology, 189(1 Suppl), 86–92. https://doi.org/10.1016/j.juro.2012.11.033CrossRef

Kupelian, V., Link, C. L., Hall, S. A., & McKinlay, J. B. (2009). Are racial/ethnic disparities in the prevalence of nocturia due to socioeconomic status? Results of the BACH survey. The Journal of Urology, 181(4), 1756–1763. https://doi.org/10.1016/j.juro.2008.11.103CrossRefPubMedCentral

Feldstein, C. A. (2013). Nocturia in arterial hypertension: A prevalent, underreported, and sometimes underestimated association. Journal of the American Society of Hypertension, 7(1), 75–84. https://doi.org/10.1016/j.jash.2012.12.004CrossRef

Fitzgerald, M. P., Litman, H. J., Link, C. L., & McKinlay, J. B. (2007). The association of nocturia with cardiac disease, diabetes, body mass index, age and diuretic use: Results from the BACH survey. Journal of Urology, 177(4), 1385–1389. https://doi.org/10.1016/j.juro.2006.11.057CrossRef

Victor, R. G., Li, N., Blyler, C. A., et al. (2019). Nocturia as an unrecognized symptom of uncontrolled hypertension in black men aged 35 to 49 years. Journal of the American Heart Association , 8(5), e010794. https://doi.org/10.1161/jaha.118.010794CrossRefPubMedCentral

10.

Afsar, B., & Elsurer, R. (2015). Central hemodynamics, vascular stiffness, and nocturia in patients with type 2 diabetes. Renal Failure, 37(10), 359–365. https://doi.org/10.3109/0886022x.2015.1088335CrossRef

11.

Inci, M., Sarli, B., Davarci, M., et al. (2013). Relationship between endothelial dysfunction and nocturia with benign prostatic hyperplasia. Scandinavian Journal of Urology , 47(5), 384–389. https://doi.org/10.3109/21681805.2012.762038CrossRef

12.

Bursztyn, M., Jacob, J., & Stessman, J. (2006). Usefulness of nocturia as a mortality risk factor for coronary heart disease among persons born in 1920 or 1921. American Journal of Cardiology, 98(10), 1311–1315. https://doi.org/10.1016/j.amjcard.2006.06.024CrossRef

13.

Lightner, D. J., Krambeck, A. E., Jacobson, D. J., et al. (2012). Nocturia is associated with an increased risk of coronary heart disease and death. BJU International, 110(6), 848–853. https://doi.org/10.1111/j.1464-410X.2011.10806.xCrossRefPubMedCentral

14.

Cho, I. J., Chang, H. J., Park, H. B., et al. (2015). Aortic calcification is associated with arterial stiffening, left ventricular hypertrophy, and diastolic dysfunction in elderly male patients with hypertension. Journal of Hypertension, 33(8), 1633–1641. https://doi.org/10.1097/hjh.0000000000000607CrossRef

15.

Onuma, O. K., Pencina, K., Qazi, S., et al. (2017). Relation of risk factors and abdominal aortic calcium to progression of coronary artery calcium (from the Framingham Heart Study). American Journal of Cardiology, 119(10), 1584–1589. https://doi.org/10.1016/j.amjcard.2017.02.021CrossRef

16.

Rodondi, N., Taylor, B. C., Bauer, D. C., et al. (2007). Association between aortic calcification and total and cardiovascular mortality in older women. Journal of Internal Medicine, 261(3), 238–244. https://doi.org/10.1111/j.1365-2796.2007.01769.xCrossRef

17.

Centers for Disease Control and Prevention (CDC). (2020). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, https://doi.org/https://wwwn.cdc.gov/nchs/nhanes/search/datapage.aspx?Component=Questionnaire Accessed 5 July 2020.

18.

Schousboe, J. T., Wilson, K. E., & Kiel, D. P. (2006). Detection of abdominal aortic calcification with lateral spine imaging using DXA. Journal of Clinical Densitometry, 9(3), 302–308. https://doi.org/10.1016/j.jocd.2006.05.007CrossRefPubMedCentral

19.

Centers for Disease Control and Prevention (CDC). (2020). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://doi.org/https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/DXXAAC_H.htm Accessed 5 July 2020.

20.

Centers for Disease Control and Prevention (CDC). (2020). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://doi.org/https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/KIQ_U_H.htm#KIQ480 Accessed 5 July 2020.

21.

Kauppila, L. I., Polak, J. F., Cupples, L. A., Hannan, M. T., Kiel, D. P., & Wilson, P. W. (1997). New indices to classify location, severity and progression of calcific lesions in the abdominal aorta: a 25-year follow-up study. Atherosclerosis, 132(2), 245–250. https://doi.org/10.1016/s0021-9150(97)00106-8.CrossRef

22.

Tikkinen, K. A., Johnson, T. M., Tammela, T. L., et al. (2010). Nocturia frequency, bother, and quality of life: how often is too often? A population-based study in Finland. European Urology, 57(3), 488–496. https://doi.org/10.1016/j.eururo.2009.03.080CrossRef

23.

Centers for Disease Control and Prevention (CDC). (2020). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://doi.org/https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/BPQ_H.htm Accessed 5 July 2020.

24.

Centers for Disease Control and Prevention (CDC). (2020). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://doi.org/https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/DIQ_H.htm Accessed 5 July 2020.

25.

Centers for Disease Control and Prevention (CDC). (2020). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://doi.org/https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/SMQ_H.htm Accessed 5 July 2020.

26.

Criqui, M. H., Denenberg, J. O., McClelland, R. L., et al. (2014). Abdominal aortic calcium, coronary artery calcium, and cardiovascular morbidity and mortality in the Multi-Ethnic Study of Atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology , 34(7), 1574–1579. https://doi.org/10.1161/ATVBAHA.114.303268CrossRefPubMedCentral

27.

Shirwany, N. A., & Zou, M. (2010). Arterial stiffness: A brief review. Acta Pharmacologica Sinica, 31(10), 1267–1276. https://doi.org/10.1038/aps.2010.123CrossRefPubMedCentral

28.

Vanhoutte, P. M., Shimokawa, H., Tang, E. H., & Feletou, M. (2009). Endothelial dysfunction and vascular disease. Acta Physiology (Oxford), 196(2), 193–222. https://doi.org/10.1111/j.1748-1716.2009.01964.xCrossRef

29.

Demer, L. L., & Tintut, Y. (2008). Vascular calcification: Pathobiology of a multifaceted disease. Circulation, 117(22), 2938–2948. https://doi.org/10.1161/circulationaha.107.743161CrossRefPubMedCentral

30.

31.

Torimoto, K., Hirayama, A., Samma, S., Yoshida, K., Fujimoto, K., & Hirao, Y. (2009). The relationship between nocturnal polyuria and the distribution of body fluid: Assessment by bioelectric impedance analysis. Journal of Urology, 181(1), 219–224. https://doi.org/10.1016/j.juro.2008.09.031 (discussion 224).CrossRef

32.

Tikkinen, K. A., Auvinen, A., Johnson, T. M., et al. (2009). A systematic evaluation of factors associated with nocturia—the population-based FINNO study. American Journal of Epidemiology, 170(3), 361–368. https://doi.org/10.1093/aje/kwp133CrossRefPubMedCentral

33.

Asplund, R., & Aberg, H. E. (2005). Development of nocturia in relation to health, age and the menopause. Maturitas, 51(4), 358–362. https://doi.org/10.1016/j.maturitas.2004.09.001.CrossRef

34.

Muka, T., Oliver-Williams, C., Kunutsor, S., et al. (2016). Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes, intermediate vascular traits, and all-cause mortality: A systematic review and meta-analysis. JAMA Cardiology, 1(7), 767–776.CrossRef

35.

Weiss, J. P., Blaivas, J. G., Blanker, M. H., et al. (2013). The New England Research Institutes, Inc, (NERI) Nocturia Advisory Conference 2012: focus on outcomes of therapy. BJU International, 111(5), 700–716. https://doi.org/10.1111/j.1464-410X.2012.11749.xCrossRef

Title: Nocturia is an Independent Predictor of Abdominal Aortic Calcification in Women: Results from the National Health and Nutrition Examination Survey
Authors: Saad Ahmed Khan
Ebad U. Rahman
Muchi Ditah Chobufo
Aneeq Yasin
Thomas F. Monaghan
Jeffrey P. Weiss
Jason M. Lazar
Publication date: 01-12-2020
Publisher: Springer US
Keywords: Nutrition
Arterial Occlusive Disease
Diabetes
Published in: Journal of Community Health / Issue 6/2020
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI: https://doi.org/10.1007/s10900-020-00893-x

At a glance: The STEP trials

Springer Medicine

Nocturia is an Independent Predictor of Abdominal Aortic Calcification in Women: Results from the National Health and Nutrition Examination Survey

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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