Obesity and unhealthy lifestyles associated with more complex urinary issues

Now the obese will have to be more aware about themselves as a recent study shows that obese people who lead an unhealthy lifestyle are likely to suffer from various urinary problems. The study published in the May issue of the UK-based urology journal BJU International consists of data gathered from more than 5,000 men.

The health problems which raise the chances of multiple lower urinary tract symptoms are diabetes, high blood pressure and heart disease according to Boston Area Community Health Survey (BACH). There is a greater risk seen in women who have undergone hysterectomies and other gynecological surgeries and with men who have gone through prostate or bladder surgery.

The study was funded by the National Institute of Diabetes, Digestive and Kidney Diseases — part of the USA’s National Institutes of Health and the researchers have surveyed 5,506 residents’ urological symptoms in Boston, Massachusetts. These people were between the age group of 30-70 years from which 42 % were men. And amongst them 34 percent of the people were whites, 32 percent were blacks and 34 percent were Hispanic.

In the personal interview the participants were assessed on traits like weight and waist circumference, education, income and behavioral and psychosocial factors. The researchers revealed the results through statistical analysis wherein the participants with urological symptoms were grouped into different patterns, 4 were found in women and 5 in men. This methodology helped the researchers to trace the relationship between complex urological problems and other health or lifestyle factors.

Dr Raymond C Rosen, Senior Scientist at the New England Research Institutes in Massachusetts said, “The cluster analysis method is highly objective and make no assumptions about which men or women are more likely to suffer from these common conditions.”

“These results will hopefully aid our understanding of why urological problems occur and how we can manage these conditions more effectively”.

The study noted that almost three-fourth of the women who participated in the survey were found to have at least one of the 14 urological symptoms.

Key findings for women included

Four female clusters were identified.

The majority of the women who reported symptoms (54 per cent) fell into Cluster One which was characterised by storage problems, such as needing to go to the toilet frequently and getting up to go during the night. They had fewer overall symptoms than the women in the other clusters.

Symptoms increased in number and severity until they reached Cluster Four, where women had the highest number of urological symptoms. Eight per cent of women fell into this cluster.

The women who experienced symptoms had a higher Body Mass Index than the women who didn’t and this peaked in Cluster Four, where the average BMI was 34.5 and just under 65 per cent were obese.

Women in Cluster Four were four times more likely to suffer from diabetes than women who reported no urological symptoms.

On average, symptomatic women were older than women who didn’t report any symptoms and average ages in the more symptomatic clusters were higher.

A woman’s social economic status was much more likely to predict her level of urology symptoms then her race. For example, women in Cluster Four were more likely have a low social economic status.

Just over two-thirds of the men who took part in the study (69 per cent) reported urological symptoms.

Key findings for men included

Five male clusters were identified.

Half of the men were assigned to Cluster One, which covered storage problems and included the male participants with the fewest number of symptoms. The number of symptoms increased in Clusters Two, Three and Four.

Eight per cent of the symptomatic men fell into the highest category, Cluster Five, with an average of 10 symptoms per person.

There was a significant increase in age across the groups — the average age of the men with no symptoms was 44, compared with 59 in Cluster Five.

The researchers also noticed significant racial differences. Cluster Four had the lowest percentage of black and Hispanic men and Hispanic men were also under-represented in Cluster Five.

40 per cent of the men in Cluster Five came from the lowest social economic status group.

Men were much more likely to find themselves in Cluster Five if they had a sedentary lifestyle, with 54 per cent recording the lowest levels of physical activity, compared with 20 per cent for men with no symptoms.

Men in Clusters Three to Five reported significantly higher levels of diabetes, blood pressure and heart problems. For example, 40 per cent of men in Cluster Five reported problems with cardiovascular disease, compared with less then 20 per cent in Cluster One.

43 per cent of the men in Cluster Five were medically obese.

There were no significant differences in smoking or alcohol consumption across the clusters, apart from the fact that Cluster Five contained a higher percentage of men who didn’t drink (41 per cent). 26 per cent of men with no symptoms abstained, as did 25 to 30 per cent of the men in the other clusters.

Dr Rosen said, “The findings of the BACH survey are very useful for clinicians and health promotion experts as they provide evidence of a wide range of factors that influence lower urinary tract symptoms, such as age, other illnesses, lifestyle, economic status and race.”

“They underline the importance of clinicians carrying out a thorough urological assessment of patients who fall into these high risk groups.”

“And they also provide a useful basis for future research into this highly complex area.”

The BACH survey was conducted by the researchers from the New England Research Institutes and was led by Dr John B McKinlay. In BJU International, the findings have been summarized in two papers i.e. on the male and female studies. It has been written in along with urology experts from Cornell University in New York and the University of Texas and medical researchers from Pfizer Inc.