Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/96971
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Type: Journal article
Title: Lower urinary tract symptoms, depression, anxiety and systemic inflammatory factors in men: a population-based cohort study
Author: Martin, S.
Vincent, A.
Taylor, A.W.
Atlantis, E.
Jenkins, A.
Januszewski, A.
O'Loughlin, P.
Wittert, G.
Citation: PLoS One, 2015; 10(10):e0137903-1-e0137903-18
Publisher: Public Library of Science
Issue Date: 2015
ISSN: 1932-6203
1932-6203
Statement of
Responsibility: 
Sean Martin, Andrew Vincent, Anne W. Taylor, Evan Atlantis, Alicia Jenkins, Andrzej Januszewski, Peter O, Loughlin, Gary Wittert
Abstract: The relationship between lower urinary tract symptoms (LUTS) and common mental health disorders such as depression and anxiety in men remains unclear. Inflammation has recently been identified as an independent risk factor for LUTS and depression. This study aimed to assess the association between depression, anxiety and LUTS, and the moderating influence of systemic inflammation, in the presence of other biopsychosocial confounders.Participants were randomly-selected from urban, community-dwelling males aged 35-80 years at recruitment (n = 1195; sample response rate:67.8%). Of these, 730 men who attended baseline (2002-5) and follow-up clinic visits (2007-10), with complete outcome measures, and without prostate or bladder cancer and/or surgery, neurodegenerative conditions, or antipsychotic medications use, were selected for the present study. Unadjusted and multi-adjusted regression models of incident storage and voiding LUTS and incident depression and anxiety were combined with serum inflammatory markers (high-sensitive C-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), myeloperoxidase (MPO), soluble e-selectin (e-Sel)) and socio-demographic, lifestyle, and health-related factors. Hierarchical multiple regression was used to assessed the moderating effect of inflammatory markers.The incidence of storage, voiding LUTS, depression and anxiety was 16.3% (n = 108), 12.1% (n = 88), 14.5% (n = 108), and 12.2% (n = 107). Regression models demonstrated that men with depression and anxiety at baseline were more likely to have incident storage, but not voiding LUTS (OR: 1.26, 99%CI: 1.01-4.02; and OR:1.74; 99%CI:1.05-2.21, respectively). Men with anxiety and storage LUTS at baseline were more likely to have incident depression (OR: 2.77, 99%CI: 1.65-7.89; and OR:1.45; 99%CI:1.05-2.36, respectively), while men with depression and voiding LUTS were more likely to have anxiety at follow-up (OR: 5.06, 99%CI: 2.81-9.11; and OR:2.40; 99%CI:1.16-4.98, respectively). CRP, TNF-α, and e-Sel were found to have significant moderating effects on the development of storage LUTS (1.06, 0.91-1.96, R2 change: 12.7%), depression (1.17, 1.01-1.54, R2 change: 9.8%), and anxiety (1.35, 1.03-1.76, R2 change: 10.6%), respectively.There is a bidirectional relationship between storage, but not voiding, LUTS and both depression and anxiety. We observed variable moderation effects for selected inflammatory markers on the development of depression, anxiety and storage LUTS.
Keywords: Humans; Inflammation; Peroxidase; Tumor Necrosis Factor-alpha; C-Reactive Protein; E-Selectin; Interleukin-6; Depression; Anxiety; Life Style; Anxiety Disorders; Depressive Disorder; Adult; Aged; Aged, 80 and over; Middle Aged; Male; Lower Urinary Tract Symptoms; Surveys and Questionnaires
Rights: © 2015 Martin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
RMID: 0030037186
DOI: 10.1371/journal.pone.0137903
Appears in Collections:Medicine publications

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