社区老年女性压力性尿失禁与性激素水平关系的调查报告

Relationship between stress urinary incontinence and sex hormone levels in elderly women

摘要

目的 探讨社区老年女性血清性激素水平与压力性尿失禁（SUI）患病及病情分级的关联，以期为SUI分层管理提供依据。方法 选取2026年4-5月上海市浦东新区金桥社区≥60岁常住女性3624例作为研究对象，根据是否患有SUI分为SUI组（643例）和非SUI组（2981例）。采集受试者的空腹静脉血检测卵泡刺激素（FSH）、黄体生成素（LH）、催乳素（PRL）、孕酮、睾酮、雌二醇（E₂）。依据指南将SUI组分为轻度组（579例）、中度组（39例）、重度组（25例）。多因素log-binomial回归分析性激素水平与SUI患病及病情分级关联。结果 SUI组的FSH、LH、孕酮、睾酮、E₂均低于非SUI组（P＜0.05）。校正混杂因素后，FSH、LH、孕酮、睾酮、E₂水平与SUI患病呈负相关（PR＜1，P＜0.05），E₂保护效应最强。轻度、中度、重度SUI亚组比较，孕酮、睾酮、E₂水平随病情加重逐步下降（P＜0.01）;轻度组与中度组间E₂差异极显著（P＜0.001），中度组与重度组间睾酮差异最突出（P＜0.001）;FSH、LH、PRL的亚组间差异无统计学意义（P＞0.05）。结论 该调查结果发现，性激素水平降低与社区老年女性SUI患病相关，E₂可区分轻中度SUI，睾酮在中重度SUI中差异更明显。

Abstract

Objective To explore the relationship between serum sex hormone levels and the prevalence and grading of stress urinary incontinence (SUI) in elderly women in a community, so as to provide reference for the hierarchical management of SUI. Methods A total of 3624 permanent female residents aged ≥60 years in a community in Shanghai, Jinqiao Community, Pudong New Area, were selected during Apr. and May 2026 as the research objects. They were divided into the SUI group (n=643) and non-SUI group (n=2981) according to whether they had SUI or not. Fasting venous blood was collected to detect follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), progesterone, testosterone and estradiol (E₂). According to the guidelines, the SUI group was subdivided into the mild group (n=579), moderate group (n=39) and severe group (n=25). Multivariate log binomial regression analysis was used to analyze the correlation between sex hormone levels and the prevalence and severity of SUI. Results The levels of FSH, LH, progesterone, testosterone and E₂ in the SUI group were lower than those in the non-SUI group (P＜0.05). After the confounding factors were adjusted, FSH, LH, progesterone, testosterone and E ₂ were negatively correlated with SUI (PR＜1, P＜0.05), and E₂ had the strongest protective effect. In the subgroups, progesterone, testosterone and E₂ decreased with the aggravation of the disease (P＜0.01). The difference in E₂ between the mild group and moderate group was extremely significant (P＜0.001), and the difference in testosterone between the moderate group and severe group was the most significant (P＜0.001). There was no significant difference in FSH, LH and PRL between the subgroups (P＞0.05). Conclusion The decrease of sex hormone levels is related to the prevalence of SUI in elderly women. E₂ can differentiate mild and moderate SUI, whereas testosterone can distinguish moderate to severe SUI.

关键词

老年女性 / 压力性尿失禁 / 性激素 / 雌二醇 / 睾酮

Key words

elderly women / stress urinary incontinence / sex hormones / estradiol / testosterone

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基金资助

上海市浦东新区卫生健康委员会研究项目(2025-PWDL-10)

国家临床重点专科建设项目(10000015Z155080000004)

上海市卫生健康系统重点学科项目(2024ZDXK0043)