哮喘与女性夜尿症的相关性：2005-2018年NHANES数据分析

Correlation between asthma and nocturia in women: an analysis based on NHANES database from 2005 to 2018

摘要

目的 基于2005-2018年美国国家健康与营养检查调查（NHANES）数据库分析哮喘与女性夜尿症的关系，为女性夜尿症的防治提供参考。方法 筛选2005-2018年NHANES数据库中年龄≥20岁且患有夜尿症或哮喘的女性受访者，排除同时患有糖尿病、脑卒中及阻塞性睡眠呼吸及暂停综合征的受访者。采用复杂抽样设计进行加权分析，通过单因素分析、倾向性评分匹配（PSM）及多因素逻辑回归模型评估哮喘与女性夜尿症的相关性。结果 本研究共筛选了14 718例受访者，其中1426例（9.7%）被诊断为哮喘，4664例（31.7%）被诊断为夜尿症。单因素分析显示，哮喘与夜尿症间存在相关性（χ²=39.846，P＜0.01），年龄、身体质量指数（BMI）、吸烟及种族与夜尿症间也存在相关性（P＜0.01）。多因素逻辑回归分析显示，PSM匹配前年龄、BMI、吸烟、种族及哮喘与夜尿症的发生风险有相关性（P＜0.05）。为消除混杂偏倚，通过PSM匹配后广义线性混合模型分析显示，哮喘患者发生夜尿症的风险依然较高（OR=1.540，95%CI：1.320～1.800，P＜0.01）。结论 哮喘与女性夜尿症具有相关性，可能是女性夜尿症的重要风险因素。

Abstract

Objective To analyze the relationship between asthma and nocturia in women based on the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2018, so as to provide reference for the prevention and treatment of female nocturia. Methods Female respondents aged ≥20 years with nocturia or asthma were selected from the 2005-2018 NHANES database. Those with both diabetes stroke and obstructive sleep apnea syndrome were excluded. A weighted analysis was conducted using a complex sampling design. The association between asthma and nocturia in women was evaluated with univariate analysis, propensity score matching (PSM), and multivariate logistic regression models. Results A total of 14 718 respondents were selected, of whom 1 426 (9.7%) were diagnosed with asthma, and 4 664 (31.7%) with nocturia. There is a significant correlation between asthma and nocturia (χ²=39.846, P<0.01). Age, body mass index (BMI), smoking and race were also associated with nocturia (P<0.01). Multivariate logistic regression analysis showed that, the age, BMI, smoking, race and asthma were correlated with the risk of nocturia, before PSM matching (P<0.05). To eliminate confounding bias, PSM was applied, and generalized linear mixed model analysis after matching showed that the risk of nocturia remained high in asthma patients (OR=1.540, 95%CI: 1.320-1.800, P<0.01). Conclusion Asthma is associated with nocturia in women, indicating that it may be an important risk factor for female nocturia.

关键词

哮喘 / 女性 / 夜尿症 / 美国国家健康与营养检查调查 / 逻辑回归 / 复杂抽样设计

Key words

asthma / women / nocturia / NHANES / logistic regression / complex sampling design

参考文献

[1] 文建国， 薛瑞， 尚小平， 等. 中国大陆中老年女性夜尿增多流行病学调查及相关因素分析[C]// 中华医学会全国妇产科学术会议， 2012.

[2] 许克新. 夜尿症的诊治[J]. 现代泌尿外科杂志， 2014， 19（1）： 6-9.

[3] 符芸升， 李天禹. 夜尿症的临床研究进展[J]. 海南医学， 2018， 29（24）： 3537-3540.

[4] CHAPPLE CR, ROSENBERG MT, MUELLER ER, et al. The patient burden of nocturnal polyuria in the United States: results from the epidemiology of nocturnal polyuria (EpiNP) study[J]. Neurourol Urodyn, 2023, 42(3): 573-585.

[5] 郭晓娟， 田国祥， 潘振宇， 等. NHANES项目介绍及数据提取流程[J]. 中国循证心血管医学杂志， 2019， 1（6）： 654-657.

[6] ALKHALIL M, SCHULMAN E, GETSY J. Obstructive sleep apnea syndrome and asthma: what are the links?[J]. J Clin Sleep Med, 2009, 5(1): 71-78.

[7] HASHIM H, BLANKER MH, DRAKE MJ, et al. International Continence Society (ICS) report on the terminology for nocturia and nocturnal lower urinary tract function[J]. Neurourol Urodyn, 2019, 38(2): 499-508.

[8] DEGER M, SURMELIOGLU O, KULECI S, et al. Risk factors associated with nocturia in patients with obstructive sleep apnea syndrome[J]. Int J Clin Pract, 2021, 75(3): e13724.

[9] CAI S, LI S, ZHOU Y, et al. The association between sedentary behavior and obstructive sleep apnea: a cross-sectional study from the NHANES (2007-2008 to 2015-2020)[J]. BMC Oral Health, 2024, 24(1): 224.

[10] MOU Y, CAO W, WANG R, et al. The causality between C-reactive protein and asthma: a two-sample Mendelian randomization analysis[J]. Postgrad Med J, 2024, 100(1186): 555-561.

[11] KUPELIAN V, ROSEN RC, ROEHRBORN CG, et al. Association of overactive bladder and C-reactive protein levels. Results from the Boston Area Community Health (BACH) survey[J]. BJU Int, 2012, 110(3): 401-407.

[12] 程浩然， 曲辅政. 哮喘与心血管疾病的研究进展[J]. 中国当代医药， 2023， 30（ 33）： 33-37.

[13] 李瀚雄， 程冯丽， 祁雪萍， 等. 生物钟紊乱对2型炎症变应性疾病的影响研究[J]. 中国耳鼻咽喉颅底外科杂志， 2024， 30（3）： 116-120.

[14] SCHEER FAJL, HILTON MF, EVONIUK HL, et al. The endogenous circadian system worsens asthma at night independent of sleep and other daily behavioral or environmental cycles[J]. Proc Natl Acad Sci USA, 2021, 118(37): e2018486118.

[15] BOSCH J, CHAPPLE CR, MUELLER ER, et al. Differences in the prevalence of nocturnal polyuria in the U.S. by definition: results from the epidemiology of nocturnal polyuria study[J]. J Urol, 2022, 208(1): 144-154.

[16] IIDA N, ITO M, NAKANISHI Y, et al. Association between male nocturia and smoking exposure: does smoking cessation improve nocturia?[J]. Eur Urol Open Sci, 2020, 19(Suppl 2): e1474.

[17] MASUDA H, HAYASHI Y, CHANCELLOR MB, et al. Roles of peripheral and central nicotinic receptors in the micturition reflex in rats[J]. J Urol, 2006, 176(1): 374-379.

基金资助

国家自然科学基金重点项目(2022YFC3602900)